病理学见习课课件：case 3.ppt

Case 3 Clinical Summary A 46-year-old woman with a long history of alcohol abuse fell and hurt her back while working in her garden. Magnetic resonance imaging (MRI) revealed a hip mass but no obvious injury. She was instructed to see a physician. Four weeks later her boyfriend found her unresponsive on the floor?of her house. She was unable to be resuscitated. No signs of trauma were found on her body. Investigators found several empty and partially full vodka bottles at the scene. 2013 Case 3 2013 Case 3 Autopsy Findings At autopsy, the pericardial sac contained 1050 mL of hemorrhagic fluid. The gross and histological appearance of the heart, upper lobe of the right lung, and the thoracic vertebral bodies are as follows. （Fig. A-L） The breasts, liver, pancreas, gastrointestinal tract, and reproductive organs were unremarkable. Toxicology (including ethanol screening) was negative. A) Heart B) Heart, cross section C) Right lung D) Vertebral bodies E) Right lung, low magnification (HE) F) Right lung, medium magnification (HE) G) Right lung, high magnification (HE) H) Epicardium, low magnification (HE) I) Epicardium, medium magnification (HE) J) Epicardium, high magnification (HE) K) Vertebral body, low magnification (HE) L) Vertebral body, high magnification (HE) What is the most likely diagnosis for the heart? Please describe the gross and the histological findings of the heart, the right lung, and the thoracic vertebral bodies. Where is the most likely origin of this case? How to identify the origin of the lesions? What are the mechanisms of the occurrence and development of this case? 2013 Case 3 5. Which of the following is most likely to produce a hemorrhagic pericarditis? Pneumococcal infection Sarcoidosis Systemic lupus erythematosus Tuberculosis Uremia 2013 Case 3 6. Which of the following primary tumors has the highest incidence of cardiac metastases? Hepatocellular carcinoma Melanoma Thyroid carcinoma Prostate carcinoma Rena