CENTRO ESCOLAR UNIVERSITY
School of Medicine
Department of Pathology
Lung Case Study
M. A. is a 68 year old man who four days prior to consultation develops a harsh, productive cough,
described as thick and yellow with streaks of fresh blood. These are accompanied by fever, shaking,
chills and malaise. One day prior to consultation, he develops pain in his right chest that intensifies with
inspiration. The patient has lost 15 lbs. over the past few months but claims no loss of appetite.
Past history reveals that he has been a chronic smoker's cough for the past "10 or 15 years" which he
describes as being mild, non-productive and occurring most often in the early morning. He has smoked 2
packs of cigarettes per day for the past 50 years. The patient is a retired military officer who has been
treated for mild hypertension and chronic bronchitis.
Physical examination reveals the following:
1. Elderly man who appears underweight and coughing continuously
2. Vital signs are as follows: blood pressure 152/90, cardiac rate 112/minute and regular, respiratory rate
24/minute and somewhat labored, temperature 39.2 C
3. Examination of the neck reveals an enlarged, non-tender hard lymph node in the right supraclavicular
fossa.
4. Both lungs are resonant by percussion with one exception: the right mid-anterior and right mid-lateral
lung fields are dull. Auscultation reveals bilateral diminished vesicular breath sounds and crackles in
the area of the right mid-anterior and right mid-lateral lung fields. The remainder of the lung fields is
clear.
5. Percussion and auscultation of the heart reveals no significant abnormality.
6. Examination of the fingers shows clubbing.
Initial laboratory: WBC 17,000/mm3; neutrophils 70%, bands 15%, lymphocytes 15%.
Virtual slides
1. b122 – right mid-lung
2. 33 – representative sections of the lower lobes
3. 4149 – representative sections of the lower lobes
4. au105 – left upper lobe
5. aacr_mets_ca – supraclavicular lymph node
CENTRO ESCOLAR UNIVERSITY
School of Medicine
Department of Pathology
Virtual Session Case Study
Report Form – Part 1 (Hypothesis Making)
Group members
1.
2.
3.
1. The heart of the matter
Observational
(clinical) data
Organ/tissue
involved
Predicted Lesion/s
Pathophysiology
2. Hypothesis on the etiopathogenesis of the predicted pathologic lesions:
3. Problem statement:
4. Hypothesis of the problem statement:
CENTRO ESCOLAR UNIVERSITY
School of Medicine
Department of Pathology
Lung Case Study – Part 2 (Pathologic Correlation)
Group members
1.
2.
3.
1. Pathologic findings (descriptions)
a. b122 – right mid-lung:
b. 33 – representative sections of the lower lobes
c. 4149 – representative sections of the lower lobes
d. au105 – left upper lobe
e. aacr_mets_ca – supraclavicular lymph node
Slide no.
b122
33
4149
au105
aacr_mets_ca
Pathologic descriptions
2. Clinico-pathologic correlation:
a. Which of the observational data is not explained by the pathologic findings?
b. Probable explanation