EARNEST FERNANDES SLIDE SEMINAR CYTOCON 2012 BHUVANSESHWAR 02 Nov2012

Transcription

1 EARNEST FERNANDES SLIDE SEMINAR CYTOCON 2012 BHUVANSESHWAR 02 Nov2012 Dr Col U S Dinesh Professor SDM College of Medical Sciences & Hospital Dharwad(Karnataka)

2 Case 1 62 year-old female presented with gradually increasing painless swelling right cheek Right submandibular cervical lymph node palpable 3x2 cm in size. FNAC smears from the swelling.

3

4

5

6

7 Case 2 60 years Female. ISOL in Right cerebellar hemisphere. CT: well defined thick irregular ring enhancing hypodense cystic lesion in right cerebellar hemisphere with mild perilesional white matter edema. Obstructive hydrocephalus. Bits received for Frozen Section. Squash preparation

8 Squash prep of brain tumor

9

10

11

12 Case 3 23 year old male H/o headache and vomiting- 1 year On & off (projectile) Weakness- right upper and lower limbs 10 days duration gradually increasing CNS Examination Pupils B/L equal and reactive Right sided hemiparesis CT brain suggestive of parasaggital abscess (? Pyogenic/tubercular) Left fronto-parietal parasaggital craniotomy with near total excision of lesion Tissue for histopathological & microbiological examination Squash smears.

13 SQUASH SMEARS

14

15

16

17

18 CASE 4 6 yr female child- Large swelling over the right side of the neck of 3 mths duration

19

20

21

22 CASE 5 57 year Female Pain abdomen since 2 days Fever since 1 day Loose stools 3 episodes K/C/O DM, hypertension and hypothyroidism P/A Examination: Tenderness in the left hypochondrium Sr amylase: 35 U/L (Normal: <85 U/L) CA 19-9: >12000 U/L (Normal: <37 U/L) Sr lipase: 25 U/L (Normal: <37 U/L) Fluid amylase: 418 U/L(Normal: <35 U/L) USG: Evidence of large cystic mass measuring 11.7x11x12 cm in the lesser sac -? Pancreatic pseudo cyst

23

24

25 USG GUIDED FNAC

26

27 Case 6 57 yr Female Pain and tenderness over epigastrium-1 month USG:Part of head and body of pancreas appears echogenic with maintained outline. Large cystic 12 x 11 x 12.5 cms in lesser sac, pancreto-leino-renal area with thick septa and internal echoes. Possibility of pancreatic pseudocyst.

28 USG:Part of head and body appears echogenic with maintained outline. Large cystic 12 x 11 x 12.5 cms in lesser sac, pancreto-leino-renal area with thick septa and itnernal echos. Possibility of pancreatic pseudocyst. CT; Body & tail show parenchymal atrophic changes. Head and uncinate process normal. Large well defined muliloculated irregular walled hypodense cystic lesion seen abutting tail and expanding into lesser sac with ant-med displacement of stomach. Minimal enhancing intra-cystic solid components with septal calcifications with tiny wall calcifications see. Celiac vessels stretched around lesion which measures 13x12 x 12 cm. Loss of fat planes seen between mass and posterior part of stomach.

29

30

31

32

33 Case 7 6years female child Swelling in the Right Gluteal region- 4 months FNAC

34

35

36

37

38 CASE 8 65 yr post menopausal 10 yrs H/O Lump in both the breasts 5 months FNAC Left breast lump

39 HR USG Breast

40

41

42

43

44

45 CASE 9 11 yrs old girl reported with swelling over the right side forehead & right orbit 4 months Gradual onset and progressive increase in size No pain No visual disturbances FNAC from the swelling CT SCAN

46 FNAC

47 FNAC

48 FNAC

49 FNAC PAP 40 x

50 CASE 10 Soft firm swelling over the Left arm. 3 months in duration. FNAC slides

51

52

53 CASE yr old Male. Bleeding from nose 2 episodes since 1 month. O/E fleshy polyp seen filling left nasal cavity with mucopurulent discharge. CT scan: Vascular mass in left maxillary sinus extending into left orbit, left pterygomaxillary fissure, Left pterygopalatine fossa. FNAC from the swelling.

54

55

56 CASE yr Female Swelling thyroid front of neckmore than 40 yrs Presented with signs of dyspnoea and stridor.

57 CT NECK

58

59

60

61

62 CASE yr Female. O/E : Swelling present left mandible extending to left submandibular area, hard and tender since 2months No pain or trauma. FNAC: : Blood mixed aspirate. FNAC Smears

63

64

65

66 CASE 14 One year old child H/o progressive abdominal distension- 6 months. irritability. Local examination: Well circumscribed 11.5x6.5cms lobulated firm soft tissue mass in the abdomen. USG: Solid exophytic soft tissue mass along left posterior wall of urinary bladder with intact bladder mucosa. Well defined,predominantly exophytic with splaying of muscles. The mucosa is intact. Pressure effect over the rectum. USG Guided FNAC

67

68

69

70

71 CASE year old Female Presented to the Gynecology OPD with complaints of a swelling over the left perineal region Examination revealed a soft to firm mass vague over the left perinal nodule. FNAC from the nodule

72

73

74

75

76

77 Case years Female Left breast lump 6 months, 5x6 cm, mobile, smooth surface. Inner upper quad. HRUSG: Suggestive of Abscess Blood mixed material aspirated FNAC smears

78

79

80

81