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Surgical Pathology

A Singapore-Malaysia Experience

IAP Slide Seminar Series

Surgical Pathology – A Singapore-Malaysia Experience is made up of 11 cases to be presented as a slide seminar at the 25th International Congress of the IAP, Brisbane, 2004.

Convenors: Khoon Leong Chuah

Co-Chairpersons: Gilbert Chang and Looi Lai Meng

Series editor: Robin A. Cooke

CASE 1: A 42-year-old Chinese male first presented with right hypochondrial pain associated with weight loss in December 2000. He was a known hepatitis B carrier. Serum alpha-fetoprotein (AFP) level was >1000 ug/L (normal range, 0-15).

CT scan of the abdomen revealed a large, 11 cm-diameter, heterogeneous and hypodense mass in the right lobe of the liver. It had breached the liver capsule with intraperitoneal bleeding. Hepatic angiogram confirmed a hypervascular mass. Selective embolisation with gelfoam was performed.
Aileen Wee

CASE 2: A 37-year-old Burmese male, presented to NUH-EMD on May, 2002 with five-day history of abdominal and bilateral testicular pain. Initially the pain had been epigastric, later suprapubic and then in the RIF. There was no nausea or vomiting. Exploratory laparotomy showed a mass involving the terminal ileum, with fixation of the mesentery to the retroperitoneum in the midline.
Angela Takano

CASE 3: A 19-year-old female presented with a two-week history of fever, cough and a central colicky non-radiating abdominal pain. There was no loss of appetite or weight and with no prior medical history of note. There was a non-tender, 8 cm irregular mass in the right upper quadrant, hepatomegaly and a palpable spleen.
Jacqueline Siok Gek Hwang

CASE 4: A 3-year-old Chinese girl presented with a large liver mass. Serum AFP was within the normal range. Clinical diagnosis: haemangioendothelioma. The excised tumour was pseudoencapsulated, 18 x 16 x 11 cm, occupying nearly the entire right lobe. It was largely necrotic and haemorrhagic.
Looi Lai Meng

CASE 5: A 67–year-old Chinese male presented with haemoptysis. A chest X-ray revealed a right upper lobe mass. CT scan disclosed a 3.3 cm mass without evidence of metastasis. Subsequently, a right upper lobectomy was performed.
Khoon Leong Chuah

CASE 6: A 30-year-old Chinese female presented with a painless swelling of the left hand present for one year. X-ray showed an erosive tumour in the left fourth metacarpus; no transgression across the joint was seen. The tumour with the metacarpus was excised.
Looi Lai Meng

CASE 7: An 18-year-old Orang Asli (aboriginal) male became comatosed after a week of fever in his jungle home. He was brought to hospital and expired after three days in the Intensive Care Unit. Autopsy revealed purulent meningitis and septicaemia. The section submitted is an incidental finding of a whitish nodule in the liver.
Looi Lai Meng

CASE 8: A 27-year-old Chinese male presented with right hypochondrial pain and an enlarged liver. Computer tomography (CT) scan showed a hepatic nodule.
Siok-Bian Ng

CASE 9: A 19-year-old Chinese male complained of cough for about a year. He was found to have a left main bronchus tumour. This was resected.
Cheah Phaik Leng

CASE 10: An 82-year-old female Chinese presented with a left breast lump.
Puay Hoon Tan

CASE 11: A 26-year-old Chinese female presented with a 2-week history of swinging fever and right cervical lymphadenopathy. The clinical diagnosis was possible Kikuchi's lymphadenitis. A 2 cm right cervical lymph node was excised.
Leonard Tan

Author: Khoon Leong Chuah

Media: Book, CD

Product code: SA25

ISBN: 1920696679