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Week 19 Pathology & Microbiology Cases . Case No. 223
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Case No. 223 • Clinical History: A 13 year old male had an enlarging mass in the left thigh for 1 1/2 months. It was not associated with pain or tenderness. The X-ray revealed a large tumor extending around the entire shaft and lower 1/3 or the left femur. Amputation was performed after biopsy. Limb salvage surgery is commonly performed today. [Case 223 ImageScope][Case 223 WebScope]
[Case 223 ImageScope] [Case 223 WebScope]
[Case 223 ImageScope] [Case 223 WebScope]
Case No. 200 • Clinical History: A 30 year old white female noted intermittent pain and swelling of her knee for 1 1/2 years. She slipped on the stairs and suffered immediate severe pain in the knee. X-ray revealed a tumor which was a large area of decalcification with expansion of tibia, but with thinning of the cortex. The tumor was removed by curetting. [Case 200 ImageScope][Case 200 WebScope]
[Case 200 ImageScope] [Case 200 WebScope]
Case No. 161 • Clinical History: This was a sixteen year old white male who complained a pain and swelling in his hip. He gave a history of having been struck by a baseball four months previously. [Case 161 ImageScope][Case 161 WebScope]
[Case 161 ImageScope] [Case 161 WebScope]
[Case 161 ImageScope] [Case 161 WebScope]
Case No. 221 • Clinical History: A 62 year old white male had surgery for renal cell carcinoma. This was followed by chemotherapy. He developed leukopenia, thrombocytopenia and a painful, linear, vesicular rash on his shoulder. (NOTE: no virtual slide for this case)
Case No. 227 • Clinical History: A 62 year old white farmer entered with a complaint of a lesion on the right cheek. It had been growing slowly for several years. [Case 227 ImageScope][Case 227 WebScope]
[Case 227 ImageScope] [Case 227 WebScope]
[Case 227 ImageScope] [Case 227 WebScope]
[Case 227 ImageScope] [Case 227 WebScope]
Case No. 203 • Clinical History: 49 year old man with lesions on his hands [Case 203 ImageScope][Case 203 WebScope]
[Case 203 ImageScope] [Case 203 WebScope]
Micro case 10 • A 66 year old man incurs extensive thermal burns to his skin and undergoes skin grafting procedures in the surgical intensive care unit. Two weeks later, he has increasing respiratory distress. Laboratory studies show hemoglobin of 13.1 g/dL, hematocrit 39.2%, platelet count 222,200/mm3, and WBC count 4520/mm3 with 15% monocytes. A chest radiograph shows extensive bilateral infiltrates with patchy areas of consolidation.
Micro case 11 • A suscipious envelope arrived for sorting at rural post office. The envelope was opened and found to contain white powder. Approximately two days later, the postal worker who handled the letter developed cutaneous boils, which were and 1 to 5 cm in diameter with central necrosis and eschars. He and his wife also developed a mild nonproductive cough with fatigue, myalgia for 72 hours, followed by severe dyspnea, diaphoresis and cyanosis. Temperature of 39.5°C, pulse 105/min, respiration 25/min, and blood pressure 85/45mm Hg. Crackles were heard at the lung bases. A chest xray shows a widened mediastinum and small pleural effusions. WBC count of 13,130/mm3, hemoglobin 13.7g/dL, hematocrit 41.2%, MCV 91 um3, and platelet count 244,000/mm3. Both died despite antibiotic therapy. Several cattle, horses, and sheep on the postal worker's farm also died.
Micro case 13 • A 25 year old man is involved in an accident in which he is ejected from the vehicle. He sustains a compound fracture of the left humerus and undergoes open reduction with internal fixation of the humeral fracture. Several days later, he has marked swelling of the left arm and crepitus.
