History: A 14-year-old Caucasian girl presenting with worsening abdominal pain was found to have marked splenomegaly and moderate pancytopenia. She was admitted with the clinical impression of acute leukemia. A bone marrow biopsy was performed. Her past medical history was remarkable only for a hip fracture after falling from the bicycle about 4 years previously (Fig. 1).“March 2008: A 14 y.o. with pancytopenia and massive splenomegaly”Continue reading
History: A 40-year-old male presented with a 10 day history of abdominal pain, distension and vomiting. The clinical diagnosis of intestinal obstruction resulted in a subsequent hemicolectomy.
The excised specimen included terminal ileum, colon, cecum and appendix. The colon and cecum were dilated and had thickened walls with spotty whitish mucosal plaques with necrosis (Fig. 1). The specimen had a bad odor even after fixation.“February 2008: A 40 year old man with colonic obstruction”Continue reading
History: A 48 y/o woman underwent a hysterectomy and right salpingo-oophorectomy ten years previously for an enlarged uterus. A large number of blood vessels were found throughout the endometrium and myometrium that were commented upon as being “unusual/uncertain”. Ten years later she presented with microscopic hematuria and severe pain radiating to her back. An IVP identified a pelvic mass which was biopsied and later excised. Following removal of the mass the CA-125, which had been elevated, returned to normal limits.“January 2008: A 48 year old woman with a pelvic mass”Continue reading
History: A three-month old male presented for evaluation of an enlarging lesion on the right arm that had been present since birth. His mother noted rapid growth over the period of one month with central crusting of the lesion and minimal bleeding. The boy had been born full-term in a normal spontaneous vaginal delivery to a gravida 1, para 1 mother. He had no other medical problems and family history was noncontributory.“December 2007: An arm nodule in a three month old boy”Continue reading
History: A 57 year old male presented with a painless 5 x 3.5 x 2.5 cm mass in the superficial tissues of the right upper back. An excisional biopsy was performed.
Grossly, the mass appeared circumscribed and had a brown-tan lobulated appearance.“November 2007: A 57 year old man with a mass in the upper back”Continue reading