Ahmad Alkhasawneh Login to follow
Cerebral vein thrombosis in a young female patient
A female patient in her fourth decade presented with several months right sided headache associated with nausea. CT head showed extensive cerebral venous thrombosis. Patient was taking OCP at the time which was thought to be the provoking event. OCPs discontinued, patient was placed on anticoagulation.
Abnormal lab test
A 21-year-old female with no previous medical history was admitted with acute abdomen. Coagulation screening tests were ordered for impending urgent surgery for acute appendicitis.
Frequent bruising and hematoma
A 5 year-old girl (adopted) brought by her mother with frequent bruising and severe periorbital hematoma after laceration of left eyebrow. Mother tells the clinician that her daughter cut her left eyebrow with scissors 2 weeks ago. For 2-4 days, it looked as it was healing well and then it looked like fresh bleeding at the injury site. This cycle of healing and worsening repeated but the wound still does not seem healing.
Bruising after playing soccer
7-year-old boy with complains of multiple bruises on his legs and arms. Recently he started to play football with his friends and his mother noticed the bruises. After questioning mother, she remembers his son had nosebleeds a few times in the past, mainly at wintertime. It usually stopped after a short time and thought it was due to the dry air in the house. No medical care was needed. Boy is healthy, rarely has cold symptoms, and not on any medication.
Severe menorrhagia
A 14-year-old girl came to the pediatrician with complains menstrual period lasting for 6-7 days. She needs to get up 1-2 times during the night to change her pads. She stopped her basketball practice when she has her period because she soaks through her pads during practice. She is not receiving any medication.
Left arm deep vein thrombosis
A 27-year-old man presented with swelling in the left arm. Doppler ultrasound showed deep vein thrombosis. He has no history of recent travel, immobility, excessive bleeding or medication. Initial laboratory findings are shown.
Severe bleeding after delivery
30-year-old woman with recent delivery of her second baby 4 months ago, presents with large hematoma on her thigh. She does not recall any injury to the site. No significant history of bleeding or medication. Blood was drawn from left forearm.
Uncontrolled bleeding in a newborn
2 weeks old male neonate presented with uncontrolled bleeding at circumcision site. Initial work up studies are shown.
Recurrent thromboembolism in young female
A 39-year-old woman with past medical history of autoimmune disorder presenting to ED with acute onset shortness of breath. She was hypoxemic upon arrival, and CT scan showed pulmonary emboli. She was not on anticoagulant therapy on presentation. (Note: confirmatory tests can be obtained).
Aggressive tumor
74-year-old man with abdominal pain, inguinal lymphadenopathy and mesenteric mass. Inguinal lymph node biopsy was performed. ##Note: Subclassification is required. Work up (including immunohistochemistry on tissue, flow cytometry, karyotype, FISH, and molecular), and flow cytometry guide are available under "specials to order".
Neck lymphadenopathy in a young patient
30-year-old man presented with cervical lymphadenopathy. Excisional lymph node biopsy was performed, and representative section is provided. Work up (including immunohistochemistry on tissue, flow cytometry, karyotype, FISH, and molecular), and flow cytometry guide are available under "specials to order".
Mesenteric mass
79-year-old man presenting with abdominal pain and found to have left mesenteric mass. Needle core biopsy was obtained. Work up (including immunohistochemistry on tissue, flow cytometry, karyotype, FISH, and molecular), and flow cytometry guide are available under "specials to order".
Inguinal lymphadenopathy
69-year-old man with enlarged lymph nodes in neck and inguinal lymph nodes. He underwent inguinal lymph node biopsy. Work up (including immunohistochemistry on tissue, flow cytometry, karyotype, FISH, and molecular), and flow cytometry guide are available under "specials to order".
Back pain from a compression fracture
58-year-old man with acute on chronic back pain and found to have compression fracture L2. Lab findings are shown, and bone marrow biopsy was performed. Representative cells from marrow aspirate smears and representative bone marrow are provided. Work up (including immunohistochemistry on tissue, flow cytometry, SPEP, free light chains, karyotype, FISH, and molecular), morphology guide for blood smear and flow cytometry guide are available under "specials to order".
Duodenal mass
31-year-old woman with large mass involving the stomach and duodenum. Endoscopic biopsies of duodenum are shown. Work up (including immunohistochemistry on tissue, flow cytometry, karyotype, FISH, and molecular), and flow cytometry guide are available under "specials to order".
Neutrophilia with left shift.
51-year-old women admitted with worsening lower back pain and found to have severe leukocytosis. Work up (including immunohistochemistry on tissue, flow cytometry, karyotype, FISH, and molecular), morphology guide for blood smear and flow cytometry guide are available under "specials to order".