Nerve-conduction studies performed in the right arm and in both legs revealed that the sural responses were absent, that the ulnar sensory response was normal, and that the amplitude of the median ...sensory response was low, with preserved conduction velocity. The patient was discharged and thereafter underwent daily physical and occupational therapy and weekly clinical examinations.
Case 28-2003 Ryan, Paula D; Haber, Daniel A; Shannon, Kristen M ...
The New England journal of medicine,
09/2003, Letnik:
349, Številka:
11
Journal Article
Recenzirano
Presentation of Case
A 51-year-old, premenopausal woman came to this hospital with a newly diagnosed breast carcinoma and a strong family history of breast cancer.
Three months earlier, on physical ...examination at another institution, a mass in the upper outer quadrant of the right breast had been found. Examination of a fine-needle aspirate showed atypical ductal cells. An excisional biopsy, also performed elsewhere, revealed a 0.2-cm invasive lobular carcinoma (stage T1a), with ductal carcinoma in situ and lobular carcinoma in situ (Figure 1).
The patient came to this hospital for further treatment of her breast carcinoma. The results of routine . . .
The diagnostic procedure during the current admission was a wedge biopsy of the lung. Examination of each of two small specimens revealed a firm, tan nodule, 0.6 to 1.3 cm in diameter. Each nodule ...was sharply demarcated from the adjacent lung parenchyma with internal fibrous bands. The cells formed compact nests, cords, and acini; had cytoplasm that ranged from clear to slightly granular and eosinophilic; and had a low mitotic rate (Fig. 6). The tumor cells palisaded around thin-walled blood vessels.
A 15-year-old boy with impaired vision and pain in his right eye was found to have a mass in his eye-socket. A biopsy showed that it was Langerhans'-cell histiocytosis, which belongs to a class of ...diseases called granulomatous diseases.
There was no history of fever, chills, rash, vomiting, diarrhea, chest pain, dyspnea, peripheral edema, cough, abdominal pain, gastrointestinal bleeding, hemoptysis, slurred speech, changed mental ...status, unilateral weakness, or loss of consciousness. In this case, we have good information about the patient's history and the results of an incomplete physical examination, but we do not have the results of laboratory tests or imaging studies performed on admission. ...we have an opportunity to see whether the old ways still apply.
Hurwitz and Faquin discuss a 15-year-old boy who was admitted to the hospital because of a retro-orbital mass. They also discuss the treatment options of disease.
Case 9-2003 Friedmann, Alison M; Oliva, Esther; Zietman, Anthony L ...
The New England journal of medicine,
03/2003, Letnik:
348, Številka:
12
Journal Article
Recenzirano
Presentation of Case
An 18-year-old man was admitted to the hospital because of back and leg pain and a nondiagnostic biopsy specimen from a paravertebral mass.
The patient had been well until eight ...months earlier, when the back pain began. Despite the use of ibuprofen and local application of ice, the pain increased, and three months before admission, pain developed in the right lower leg. A chiropractor obtained a radiograph of the spine, which revealed a compression fracture at the L3 vertebra. About one month before admission, a computed tomographic (CT) scan of the lumbosacral spine, obtained at another facility, . . .
Examination of a frozen section provided no diagnostic information, and review of a slide at this hospital revealed only parotid parenchyma and associated lymphoid tissue, features characteristic of ...a parotid lymph node. The hematocrit was 36.9 percent; the white-cell count was 7900 per cubic millimeter, with 70 percent neutrophils, 21 percent lymphocytes, 6 percent monocytes, 2 percent eosinophils, and 1 percent basophils; the platelet count was 282,000 per cubic millimeter, and the mean corpuscular volume was 84.9 μm3 .
A 58-year-old man with a history of eosinophilic granuloma in his lungs was diagnosed with a recurrence of the disease after developing chronic shortness of breath and chest pain. He was a smoker and ...had continued to smoke after his first diagnosis of eosinophilic granuloma 25 years earlier. This probably caused the disease to progress.
There was no history of arthralgia, vision loss, rash, motor or sensory deficits, neck stiffness, nausea, vomiting, chest or abdominal pain, cough, head injury or other trauma, exposure to ...tuberculosis, or other illnesses in recent months. The hematocrit was 39.5 percent; the white-cell count was 12,000 per cubic millimeter, with 67 percent neutrophils, 25 percent lymphocytes, 5 percent monocytes, 2 percent eosinophils, and 1 percent basophils; the platelet count was 545,000 per cubic millimeter; the mean corpuscular volume was 86 μm3 ; and the erythrocyte sedimentation rate was 99 mm per hour.
