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Case 1

 Gender and age: 25 女性


 Occupation: 學生
 Past history: Pityriasis rosea
 Personal history: Smoking (-)
 Chief complaint: progressive dyspnea for two
months
2009/9/12 CT scan

1. a large tumor in the superior mediastinum,
about 12*6cm. There is no calcification or cystic
content. DDx: germ cell tumor, thymoma,
thyroid tumor, teratoma, or lymphoma.

2. high density pericardial effusion, r/o tumor
involvement.

3. enlarged lymph nodes in the left scalene and
supraclavicular regions.
9/14 chest echo-guided Tru-cut
biopsy


MEDIASTINUM, ANTERIOR, CORE NEEDLE
BIOPSY

----PRIMARY MEDIASTINAL LARGE B-
CELL LYMPHOMA
Final diagnosis

1. NHL(primary mediastinal B-cell lymphoma)
stageIIAX, 12*6cm, with left neck LAP.
pericardial invasion was also found.
Case 2

 Gender and age: 76 女性


 Occupation: 無
 Past history: .ESRD regular H/D, Hypertnesion
 Personal history: Smoking (-)
 Chief complaint: hemoptysis 6 days ago.
Final diagnosis

Aortic arch aneurysm
Case 3

 Gender and age: 19 女性


 Occupation: 學生
 Past history: p-ANCA vasculitis, End stage
renal disease, due to focal segmental
glomerulosclerosis
 Personal history: Smoking (-)
 Chief complaint: Dyspnea for 2 days.
2009/08/21 CT scan

Diffuse patchy consolidation/ground-glass
attenuation and pulmonary nodules of
varying sizes (5 mm to 10 cm) in
nonsegmental distribution without zonal
predominance, favor intraalveolar pulmonary
hemorrhage.
After pulse therapy

2009/08/26 CXR
2009/08/27 bronchoscopy


Broncheoalveolar lavage IRON STAIN(+).
Final diagnosis

Pulmonary hemorrhage, due to 2

P-ANCA vasculitis, suspected microscopic
polyangitis
Case 4

 Gender and age: 59 女性


 Occupation: 自由業
 Past history: hypertension
 Personal history: Smoking (-)
 Chief complaint: progressive dyspnea and
bilateral limbs edema for 3 weeks

After pigtail drainage
2009/9/8 CT scan

Huge left breast cancer with chest wall
invasion, T4cN3M1.

Mild pericardial effusion.

Pleura: Right pleural effusion. Left
hydropneumothorax with pleuritis and a
drain tube insertion.

Pleural effusion cytology


RESULT:

SUGGESTIVE OF MALIGNANCY

採檢品質 : ADEQUATE SPECIMEN


COMMENT:

ADENOCARCINOMA IS FAVORED.
Pathology

BREAST, LEFT, CORE NEEDLE BIOPSY

----MIXED MUCINOUS CARCINOMA AND
INVASIVE DUCTAL CARCINOMA
Final diagnosis

Huge left breast cancer with chest wall
invasion and malignant pleural effusion,
Case 5
 Gender and age: 21 男性
 Occupation: 自由業
 種族 : Korean
 婚姻 : single
 旅遊史 :In Thailand 2 days ago
 Past history: unknown
 Personal history: smoking -
 Chief complaint: Vomiting, conscious change
for one day
2009/08/26


CXR and CT scan 3 days later
2009/08/26 CT scan

Bilateral lower lobe consolidation with bilateral
pleural effusion.

After extubation
Final diagnosis

RLL consolidation with pleural effusion, suspect
aspiration pneumonia

Heroin body packing caused opioid intoxication
complicated with consciousness change,
respiratory failure, and shock status, status post
endotracheal tube insertion and mechanical
ventilation

Thanks for your
attention.

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