Pathology Cases

Week 6

Circulatory part 1
• A 60 year old woman underwent total
hip replacement surgery. Two days later
she suffered from tender calf muscles
then she suddenly experienced acute
chest pain and shortness of breath and
died. During the autopsy a red mass is
found within a branch of the left main
pulmonary artery with gelatinous, with
smooth surface.
Discussion ……….
• A 60 year old woman underwent total
hip replacement surgery. Two days later
she suffered from tender calf muscles
then she suddenly experienced acute
chest pain and shortness of breath, with
haemoptysis and died. During the
autopsy a red mass is found occluding
the left main pulmonary artery with
gelatinous, with smooth surface.
Find your clues !!

➢60 year old woman

➢Total hip replacement surgery.
➢Tender calf muscles
➢Suddenly experienced acute chest pain
and shortness of breath
➢Red mass is found occluding the left
main pulmonary artery
 Questions
1. What is your most likely diagnosis? And why?
2. What is the most likely predisposing factors
for this condition in light of the patient’s
history?
3. Explain the patient’s main case of death in
light of your diagnosis?
4. Suggest the medical advice/ treatment plan
that you would give to such similar cases to
avoid this scenario
An 86 -year-old diabetic woman with known history
of DVT of her right leg suffers from left sided
heart failure and progressive breathing problems.
She suddenly experienced chest pain and
shortness of breath, with haemoptysis. After her
death, autopsy reveals enlarged, heavy, firm
lungs, with deep red discolouration. Numerous
hemosiderin-laden cells are seen within the
alveoli in sections prepared from the lung. A
wedge shaped triangular area is detected with
dark red color with the base of triangle directed
outward.
Discussion ……….
A 68 -year-old diabetic woman with known history
of DVT of her right leg suffers from left sided
heart failure and progressive breathing problems.
She suddenly experienced chest pain and
shortness of breath, with haemoptysis. After her
death, autopsy reveals enlarged, heavy, firm
lungs, with deep red discolouration. Numerous
hemosiderin-laden cells are seen within the
alveoli in sections prepared from the lung. A
wedge shaped triangular area is detected with
dark red color with the base of triangle directed
outward.
Find your clues !!
➢ A 68 -year-old diabetic
➢ Left sided heart failure
➢ Progressive breathing problems.
➢ Suddenly experienced chest pain and shortness
of breath, with haemoptysis.
➢ Enlarged, heavy, firm lungs, with deep red
discolouration.
➢ A wedge shaped triangular area is detected with
dark red color with the base of triangle directed
outward.
 Questions
1. What is your most likely diagnosis? And why?
2. What is the most likely predisposing factors
for this condition in light of the patient’s
history?
3. Explain the patient’s main complaint in light
of your diagnosis?
4. Describe the expected microscopic picture of
the biopsy send to the pathology lab.
5. Suggest the medical advice/ treatment plan
that you would give to such similar cases to
avoid this scenario
After travelling by air from Egypt to New York, a
55-year-old woman with known history of DVT
develops a sudden onset of chest pain and
shortness of breath, with haemoptysis. She
had history of similar attack after cesarean
delivery of her last child 15 years ago. On
examination, the patient appears anxious and
tachypneic (rapid, short breath).
Discussion ……….

After travelling by air from Egypt to New York, a

55-year-old male develops a sudden onset of
chest pain and shortness of breath, with
haemoptysis. She had history of similar attack
after cesarean delivery of her last child 15
years ago. . On examination, the patient
appears anxious and tachypneic (rapid, short
breath).
To avoid DVT
Find your clues !!

Travelling by air from Egypt to New York,

a 55-year-old male
Sudden onset of chest pain and shortness of
breath, with haemoptysis.
Tachypneic (rapid, short breath).
 Questions
1. What is your most likely diagnosis? And why?
2. What is the most likely predisposing factors
for this condition in light of the patient’s
history?
3. Explain the patient’s main complaint in light
of your diagnosis?
4. Suggest the medical advice/ treatment plan
that you would give to such similar cases to
avoid this scenario.
• A 50 -year-old male suffers from congestive
heart failure. He noticed difficulty on wearing
his shoes after long standing or sitting mostly
due to lower limb edema and increasing lower
limb edema and progressive increase in
abdominal girth. He sought medical advice on
examination his physician detected bilateral
lower limb below knee pitting edema, bilateral
dilated congested neck veins and enlarged
tinder liver. On abdominal ultrasound
moderate amount of ascites was found.
Discussion ……….
• A 50 -year-old male suffers from congestive heart
failure. He noticed difficulty on wearing his shoes
after long standing or sitting mostly due to lower
limb edema and increasing lower limb edema and
progressive increase in abdominal girth. He
sought medical advice on examination his
physician detected bilateral lower limb below
knee pitting edema , bilateral dilated congested
neck veins and enlarged tinder liver. On
abdominal ultrasound moderate amount of
ascites was found.
Find your clues !!

➢Congestive heart failure

➢Difficulty on wearing his shoes mostly due to
lower limb edema
➢Increasing lower limb edema
➢Bilateral lower limb below knee pitting edema
➢Bilateral dilated congested neck veins
➢Enlarged tinder liver
➢Ascites
 Questions
1. What is your most likely diagnosis? And why?
2. What is the most likely predisposing factors
for this condition in light of the patient’s
history?
3. Explain the patient’s main complaint in light
of your diagnosis?
4. Describe the expected gross picture of LIVER.
5. Describe the expected microscopic picture of
LIVER biopsy send to the pathology lab.
6. Suggest the medical advice/ treatment plan
that you would give to such patient