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cytology rounds GE 1 14 November.A case to to be checked pptx

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Cytology Rounds GE 2 16-01-2024
Personal details • Mrs R K • 57/F • R/o HP • Informant – Patient and her daughter
Chief complaints Jaundice - 1 and half months Pruritus – 1 month Fever 1 week
Jaundice • He also complained of yellowish discoloration of eyes • Insidious in onset • First noticed by the realtives in the sclera • Gradually progressive • Progressed to torso –palms and soles • Not associated with clay colored stools • Associated with pruritus • Associated with high color urine
Pruritus • Insidious in onset • Gradually progressive • Initiated in palms and soles then progressed to the torso • Initially it was nocturnal later diurnal pruritus developed • Associated with excoriation marks in shin and abdomen. • Associated with loss of appetite and loss of weight
Fever • Insidious in onset • High grade max 103 F • Chills and rigor • Continuous in nature • Associated with jaundice • Associated with loss of appetite and loss of weight
Negative history • No h/o CAM intake • No h/o abdominal lump • No h/o hematemesis/melena • No history of HPB surgery.
Past history Personal histroy • No h/o major illness in the past. • No h/o diabetes mellitus • No h/o hypertension • No h/o major surgery in the past. • Non alcoholic, non smoker • Mixed diet • No h/o tobacco or drug abuse
GPE • Average built and nourishment • Conscious, oriented • Icterus + • No Pallor, Cyanosis, Clubbing, Lymphadenopathy or Edema • Vitals • BP 110/70 mmHg • PR 88/min • SpO2 99% on Room air
Systemic examination • GIT • PA soft • Non tender • Gall bladder not palpable • No evidence of free fluid in abdomen • Bowel sounds + • spleen was not palpable. • CNS • Conscious, alert, oriented to time, place and person • No focal deficit • RS • Normal vesicular breath sounds bilateral lung fields.
Investigations TESTS RESULTS CBC 7.7/10800/2.53 lakhs DLC N54;L28 Urea/Creatinine 25/0.87 Na/K 138/3.9 T.B/D.B 5.18/3.48 ALT/AST 20/33 ALP 774 U/L T.P/Alb 7.3/4.38 Amylase 20 PT INR 9.8/0.84 CA 19.9 and CEA 106.1 IU/ml and 1.16 ng/ml Iron profile Serum iron 24.8 / ferritin 480
USG Abdomen (03/12/2023) Bilateral IHBRD Primary confluence: growth seen MPD is not dilated. No Peripancreatic lymph nodes
MRCP 22/12/2023 • Obstruction in the biliary system at the porta hepatis • ?Inflitrative disorder • GB wall thickening • ? Malignancy Hilar cholangio ca
PTBD 21/12/2024 • Guidewire passed Into the left ductal system • 10F PTBD placed • Biliary brushing done .
• Unit Diagnosis • ? Hilar Cholangio CA • Lab ID 10900
cytology rounds GE 1 14 November.A case to to be checked pptx
cytology rounds GE 1 14 November.A case to to be checked pptx

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cytology rounds GE 1 14 November.A case to to be checked pptx

  • 1. Cytology Rounds GE 2 16-01-2024
  • 2. Personal details • Mrs R K • 57/F • R/o HP • Informant – Patient and her daughter
  • 3. Chief complaints Jaundice - 1 and half months Pruritus – 1 month Fever 1 week
  • 4. Jaundice • He also complained of yellowish discoloration of eyes • Insidious in onset • First noticed by the realtives in the sclera • Gradually progressive • Progressed to torso –palms and soles • Not associated with clay colored stools • Associated with pruritus • Associated with high color urine
  • 5. Pruritus • Insidious in onset • Gradually progressive • Initiated in palms and soles then progressed to the torso • Initially it was nocturnal later diurnal pruritus developed • Associated with excoriation marks in shin and abdomen. • Associated with loss of appetite and loss of weight
  • 6. Fever • Insidious in onset • High grade max 103 F • Chills and rigor • Continuous in nature • Associated with jaundice • Associated with loss of appetite and loss of weight
  • 7. Negative history • No h/o CAM intake • No h/o abdominal lump • No h/o hematemesis/melena • No history of HPB surgery.
  • 8. Past history Personal histroy • No h/o major illness in the past. • No h/o diabetes mellitus • No h/o hypertension • No h/o major surgery in the past. • Non alcoholic, non smoker • Mixed diet • No h/o tobacco or drug abuse
  • 9. GPE • Average built and nourishment • Conscious, oriented • Icterus + • No Pallor, Cyanosis, Clubbing, Lymphadenopathy or Edema • Vitals • BP 110/70 mmHg • PR 88/min • SpO2 99% on Room air
  • 10. Systemic examination • GIT • PA soft • Non tender • Gall bladder not palpable • No evidence of free fluid in abdomen • Bowel sounds + • spleen was not palpable. • CNS • Conscious, alert, oriented to time, place and person • No focal deficit • RS • Normal vesicular breath sounds bilateral lung fields.
  • 11. Investigations TESTS RESULTS CBC 7.7/10800/2.53 lakhs DLC N54;L28 Urea/Creatinine 25/0.87 Na/K 138/3.9 T.B/D.B 5.18/3.48 ALT/AST 20/33 ALP 774 U/L T.P/Alb 7.3/4.38 Amylase 20 PT INR 9.8/0.84 CA 19.9 and CEA 106.1 IU/ml and 1.16 ng/ml Iron profile Serum iron 24.8 / ferritin 480
  • 12. USG Abdomen (03/12/2023) Bilateral IHBRD Primary confluence: growth seen MPD is not dilated. No Peripancreatic lymph nodes
  • 13. MRCP 22/12/2023 • Obstruction in the biliary system at the porta hepatis • ?Inflitrative disorder • GB wall thickening • ? Malignancy Hilar cholangio ca
  • 14. PTBD 21/12/2024 • Guidewire passed Into the left ductal system • 10F PTBD placed • Biliary brushing done .
  • 15. • Unit Diagnosis • ? Hilar Cholangio CA • Lab ID 10900