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Week 5 Pathology and Microbiology Cases. Case No. 26
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Case No. 26 • Clinical History: This 48 year old female was admitted with a history of chills, fever, and pain in the right upper quadrant. In view of the clinical diagnosis of cholelithiasis, cholangitis and cholecystitis, the gallbladder was resected. [Case 26 ImageScope][Case 26 WebScope]
Case No. 121 • Clinical History: A 59 year old white female had rheumatoid arthritis over a number of years. Subcutaneous nodules were present over the extensor surfaces of the arms. One of these was surgically excised. [Case 121 ImageScope][Case 121WebScope]
[Case 121 ImageScope] [Case 121WebScope]
Case No. 19 • Clinical History: This 51 year old male had tuberculosis for many years. He developed some ankle edema, and was found to have an enlarged liver and 2+ proteinuria. [Case 19 ImageScope][Case 19WebScope]
19-Amyloid (Kidney & Liver) [Case 19 ImageScope][Case 19WebScope]
Case No. 264 • Clinical History: A 38 year old white female complained of a mass in the neck of several months duration. At the time of examination the thyroid was enlarged and somewhat nodular. She had no symptoms of hypothyroidism or hyperthyroidism. [Case 264ImageScope][Case 264 WebScope]
Case No. 18 • Clinical History: This 29 year old male's illness began 10 weeks prior to death, with an episode of "flu". Two weeks later his urine became "smoky". He was found to have hematuria, albuminuria and elevated BUN (180 mg/dl). He died from a pulmonary embolus. [Case 18 ImageScope][Case 18WebScope]
Case No. 17 • Clinical History: Four years before death the patient was seen in the hospital because of nausea and vomiting. He had hematuria, proteinuria, urinary casts, and a BUN of 50 mg/dl. A diagnosis of "chronic glomerulonephritis" was made. He did well for over 3 1/2 years, with elevated BUN of 50-60 mg/dl. His blood pressure was 150/90. A month before death his BUN increased and he died of renal failure. [Case 17 ImageScope][Case 17WebScope]
[Case 17 ImageScope] [Case 17WebScope]
Micro case 17 • A 50 year old resident of Phoenix, Arizona, has a cough that has persisted for 1 month. On physical examination, his temperature is 38.1C. A chest radiograph shows 3.5-cm opacity with central cavitation in the right apical region. An open lung biopsy is performed to exclude cancer.
Micro case 18 • For the past 3 weeks, a 52 year old man has had a chronic cough with a low-grade fever. On physical examination, his temperature is 37.4C. A chest radiograph shows bilateral, scattered, 0.3- to 2-cm nodules in the upper lobes and hilaradenopathy. A fine needle aspirate of one of the nodules shows inflammation with mononuclear cells and macrophages.
Micro case 19 • For the past 3 days, a 68 year old man has had a fever and a cough productive of yellow sputum. On physical examination, there is dullness to percussion at the left lung base. A chest radiograph shows areas of consolidation in the left lower lobe. Despite antibiotic therapy, the course of the disease is complicated by abscess formation, and he dies.
Micro case 20 • A 42 year old HIV positive man has had a fever and cough for the past month. On physical examination, his temperature is 37.5. On auscultation of the chest, decreased breath sounds are heard over the right posterior lung. A chest radiograph shows a large area of consolidation with a central air-fluid level involving the right middle lobe. A transbronchial biopsy specimen contains gram-positive filamentous organisms that are weakly acid fast.
