101 Medical Autopsy Cases

Introduction


Medical Autopsy: The Strongest Teaching Tool in Medicine


Section 1: Hematological Disorders—Adult Cases


Case 1: Mantle Cell Lymphoma, Presenting with Florid Cutaneous Lesions, with Common Variant Morphology in the Nodal/Extranodal Sites and Blastoid Morphology in the Peripheral Blood:PM 25983


Case 2: Primary Myelofibrosis, Cellular Phase with Formation of Sclerosing Extramedullary Hematopoietic Tumors: PM 27873


Case 3: Primary Myelofibrosis, Cellular Phase with Extensive Extramedullary Hematopoiesis and Transformation into Acute Leukemia: PM 23618


Case 4: Hepatosplenic T-cell Lymphoma: PM 23096


Case 5: Acute Promyelocytic Leukemia with Early Death due to Disseminated Intravascular Coagulation and Right Temporal Lobe Hemorrhage: PM 26880


Case 6: Acute Promyelocytic Leukemia with Differentiation Syndrome: PM 17959


Case 7: Chronic Lymphatic Leukemia, Post-Bone Marrow Transplantation with Recurrence, Massive Lymphadenopathy and Hemophagocytosis: PM 21710


Case 8: Symptomatic Plasma Cell Myeloma with Primary Systemic Amyloidosis Showing a Predominant Involvement of the Heart and Gastrointestinal Tract: PM 19667


Section 2: Malignancy—Adult Cases


Case 9: Microscopic/Occult Testicular Seminoma with Germ Cell Neoplasia in situ and Widespread Nonseminomatous Metastasis in a Young Male: PM 14170


Case 10:Malignant Teratoma, Primary Pulmonary, Containing Yolk Sac tumor, Associated with Hematologic Neoplasia: PM 13633


Case 11:Young Male with Metastasis: Do not Waste Time—Look for the Primary in the Testes: PM 19388


Case 12: Occult, Peripheral, Mucin-secreting Adenocarcinoma of Lung with Florid Meningeal Carcinomatosis along with Thrombotic Microangiopathy and Disseminated Intravascular Coagulation, Leading to Bilateral Renal Infarction: PM 26226


Case 13: Young Male with Occult, Diffuse Type, Mucin-secreting Adenocarcinoma of the Stomach with Extensive Lymphangitic Carcinomatosis, Presenting with Deep Vein Thrombosis and Pulmonary Embolism: PM 21829


Section 3: Infections—Adult Cases


Case 14: Amebic Ileocolitis, Perforation and Liver Abscess: PM 18836


Case 15: Cerebral Toxoplasmosis in a Human Immunodeficiency Virus Positive Patient: PM 19210


Case 16: Pulmonary Hyalinizing Granuloma with Recent Onset Cryptococcal Meningoencephalitis in an Immunocompetent Male: PM 21122


Case 17: Leptospirosis with Multiorgan Involvement: PM 22793


Case 18: Silicotuberculosis: PM 26075


Case 19: Rabies Meningoencephalitis, Post-Pet Dog Bite: PM 27786


Section 4: Hepatobiliary and Pancreatic Disorders—Adult Cases


Case 20: Extrahepatic Portal Venous Obstruction due to Cavernomatous Transformation of Portal Vein and Portal Cavernoma Cholangiopathy: PM 22260


Case 21: Chronic Budd-Chiari Syndrome with Mesoatrial Shunt, Venocentric Cirrhosis, Hepatocellular Carcinoma Infiltrating into the Hepatic Duct Causing Obstruction and Hemobilia: PM 27800


Case 22: Acute on Chronic Pancreatitis Leading to Portal Vein Pyemia, with Multiple Liver Abscesses and Life-threatening Sepsis Shock: PM 25975


Case 23: Lipomatous Pseudohypertrophy of the Pancreas with Polyglandular Autoimmune Syndrome Type II and Inflammatory Myopathy: PM 22590


Case 24: Young Male with Early Onset Micronodular Cirrhosis due to Synergistic Hepatotoxic Effect of Alcohol and Hepatitis C Virus Infection along with Cryoglobulinemic Vasculitis: PM 27791


Case 25: Diffuse Hepatocellular Carcinoma Arising in a Setting of Mixed Nodular Cirrhosis, Hepatitis C Virus and Alcohol Related: PM 26695


Case 26:Acute Liver Failure and Encephalopathy in a Case of Dengue Shock Syndrome: PM 25035


Case 27: Postpartum, Hyperacute, Fulminant Hepatic Failure due to Hepatitis E Virus: PM 26595


Case 28: Sporadic, Hepatitis E-related Massive Hepatic Necrosis in a Young Female: PM 26254


Case 29: A Classical Case of Wilson’s Disease with Hepatic and Neuropsychiatric Manifestations: PM 26195


Section 5: Cardiovascular System—Adult Cases


Case 30: Silent Healed Myocardial Infarction and its Complications—Infarct Expansion, Mural Thrombosis, Aneurysm Formation, Extensive Arterial Embolization, Deep Vein Thrombosis and Subsequent Fatal Venous Thromboembolism: PM 21817


Case 31: Coexistence of Acute-on-Chronic Rheumatic Heart Disease and Acute Poststreptococcal Glomerulonephritis: PM 21119


Case 32: A Classical Case of Marfan Syndrome with Aortic Root Dilatation, Aneurysm of the Ascending Aorta and Acute Aortic Dissection: PM 22554


Case 33: Adult Tetralogy of Fallot with Tricuspid Valve Infective Endocarditis and Thromboembolic Botryomycotic Cerebral Abscess: PM 26941


Case 34: Cocaine-induced Vasculopathy Leading to Cardiomyopathy, Renal Infarcts, Gangrene of Digits with Autoamputation: PM 23445


Case 35: Aftermath of Hypertension in a Middle-aged Male—Intraparenchymal Brain Hemorrhage, Pontine and Thalamic: PM 26485


Section 6: Systemic Vasculitides—Adult and Pediatric Cases


Systemic Vasculitides—Introduction


Small Vessel Vasculitides


Case 36: Renal Limited Microscopic Polyangiitis: PM 13127


Case 37: Microscopic Polyangiitis, ANCA Negative, with Florid Glomerulitis and Granulomatous Glomerulonephritis: PM 15649


Case 38: Microscopic Polyangiitis in a Child: PM 16450


Case 39: Microscopic Polyangiitis, ANCA Negative, Clinically Mimicking Granulomatosis with Polyangiitis (Wegener’s Granulomatosis) and Presenting with a Breast Mass: PM 18473


Case 40: Microscopic Polyangiitis—Chronic Phase: PM 18987


Case 41: Microscopic Polyangiitis with Acute Vasculitis of Small, Medium and Large-sized Arteries: PM 20415


Case 42: p-ANCA Positive Classic Polyarteritis Nodosa: PM 24277


Case 43: Takayasu’s Aortoarteritis, Pulmonary Hypertension, and Pulmonary Capillary Hemangiomatosis: PM 14993


Case 44: Takayasu Aortoarteritis, Presenting with Pulmonary Arterial Hypertension Secondary to Extensive Involvement of Right Pulmonary Artery: PM 25988


Case 45: Granulomatosis with Polyangiitis (Wegener’s Granulomatosis) with Left Foot Gangrene and Right Hemiplegia: PM 14106


Case 46: Granulomatosis with Polyangiitis—Wegener’s Granulomatosis, Presenting as an Anterior Mediastinal Mass: PM 18613


Case 47: Granulomatosis with Polyangiitis, i.e Wegener’s with Multiple Pulmonary Nodules and Total Splenic Necrosis: PM 21594


Case 48: c-ANCA Positive, Nonreactive, Disseminated Tuberculosis with Pulmonary and Mesenteric Vasculitis: PM 14513


Section 7: Primary Renal Mucormycosis—Adult and Pediatric Cases


Case 49: Isolated Bilateral Renal Mucormycosis with Contiguous Spread to the Adrenals, Mesentery, Pancreas and Colon in an Apparently Immunocompetent Adult: PM 27250


Case 50: Primary Bilateral Renal Mucormycosis in an Apparently Immunocompetent Child: PM 22863


Section 8: Histiocytosis—Pediatric and Adult Cases


Case 51: Primary/Familial Hemophagocytic Lymphohistiocytosis with Extensive Involvement of the Brain: PM 20788


Case 52: Langerhans Cell Histiocytosis Presenting as an Anterior Mediastinal Mass: PM 21476


Case 53: Macrophage Activation Syndrome—A Fatal Complication of Systemic Onset Juvenile Idiopathic Arthritis: PM 26202


Case 54: Epstein–Barr Virus-associated Secondary Hemophagocytic Lymphohistiocytosis—


A Rare Complication: PM 21703


Section 9: Primary Immunodeficiency—Pediatric Cases


Case 55: Disseminated Bacillus Calmette–Guérin Infection in a Case of Severe Combined


Immunodeficiency: PM 22931


Case 56: Chronic Granulomatous Disease of Childhood: PM 24170


Case 57: Disseminated Nonreactive Tuberculosis, PCR-Proven Dual Positivity for Mycobacterium Tuberculosis and Abscessus ? Mendelian Susceptibility to Mycobacterial Disease: PM 25174


Section 10: Infantile Nephrotic Syndrome


Case 58: Congenital Nephrotic Syndrome of the Finnish Type: PM 23777


Case 59: Infantile Nephrotic Syndrome—Diffuse Mesangial Sclerosis in a 10-Month-Old Male Child: PM 26462


Section 11: Infections—Pediatric Cases


Case 60: Disseminated Congenital Cytomegalovirus Infection with Islet Cell Hyperplasia as the Cause of Persistent Hypoglycemia in a Neonate: PM 23822


Case 61: Congenital Tuberculosis: An Underdiagnosed Entity: PM 24753


Case 62: Disseminated Cryptococcomas Mimicking Disseminated Malignancy, with Hepatic Dysfunction as the Initial Manifestation, in an Immunocompetent Child: PM 25744


Introduction to Tubercular Meningitis


Case 63: Catastrophic Posterior Circulation Tubercular Arteritis with Infarcts and Cortical


Venous Thrombosis—A Rare Co-existence: PM 26344


Case 64: Child with Disseminated Miliary Tuberculosis, Tubercular Meningitis with


Extensive Arteritis, Infarction and Ischemic Hepatitis: PM 25901


Case 65: Disseminated Cryptococcal Infection in an HIV-positive Child: PM 23563


Section 12: Cardiovascular System—Pediatric Case


Case 66: Transposition of Great Arteries: PM 24027


Section 13: Hematological Disorders—Pediatric Cases


Case 67: Child with Acute Lymphoblastic Leukemia on Induction Therapy with Febrile


Neutropenia and Disseminated Aspergillus Infection: PM 25927


Case 68: Myeloid Sarcoma of Lacrimal Sac as the First Manifestation of AML-M1 with Acute Diffuse Colorectal Neutropenic Colitis in a Child: PM 23395 576


Section 14: Storage Disorder


Case 69: Niemann–Pick Type B Presenting with Massive Splenohepatomegaly and Hypertensive Crisis in a 12-year-old Child: PM 27096


Section 15: Pediatric Renal Cystic Disease (Developmental/Genetic/Syndromes)


Pediatric Cystic Disease (Developmental/Genetic) of Kidney—Introduction


Section 15A: Renal Dysplasia


Case 70: Recurrent Bilateral Multicystic Dysplastic Kidneys, Consistent with Hereditary


Renal Adysplasia: PM 20505


Case 71: Symmetrically Enlarged, Solid Dysplastic Kidneys with Intrauterine Growth


Retardation: PM 24340


Case 72: Multicystic Dysplastic Kidneys with Dilated Ureters and Hypertrophied Urinary


Bladder Leading to Obstructed Labor and Uterine Rupture: PM 26207


Case 73-74: Renal Hypodysplasia: PM 19521, PM 25711 619


Nandita Bharadwaj Kakkar


Case 75: Bilateral Renal Agenesis: PM 24019


Case 76-80: Unilateral Renal Malformation: PM 22428, PM 22393, PM 26428, PM 26291, PM 26824


Case 81: Segmental Renal Dysplasia with Duplex Kidney and Ureterocele: PM 19965


Section 15B: Posterior Urethral Valve


Case 82-83: Posterior Urethral Valve Leading to Congenital Hydroureteronephrosis and


Hypertrophied Urinary Bladder: PM 18485, PM 26118


Section 15C: Renal Hypoplasia


Case 84: Neonate with Bilateral Simple Renal Hypoplasia, Lung Hypoplasia and Hydrocephalous: PM 27245


Case 85: Bilateral Simple Renal Hypoplasia, Cystic Periventricular Leukomalacia with Hydrocephalus ex vacuo in Surviving Twin, after death of Monochorionic Co-twin: PM 25677


Case 86: Segmental Hypoplasia (Ask-Upmark Kidney): S-14525/2008


Section 15D: Genetic Disorders


Case 87: A Classical Case of Autosomal Recessive Polycystic Kidney Disease: PM 22879


Case 88: Autosomal Dominant Polycystic Kidney Disease with Cyst Infection: PM 22828


Section 15E: Glomerulocystic Kidney Disease


Case 89: Co-existing Glomerulocystic Kidney Disease and Renal Tubular Dysgenesis with Late Onset Oligohydramnios and Renal Failure at D2 of Life: PM 28154


Case 90: Glomerulocystic Kidney Associated with Posterior Urethral Valve— A Rare Association: PM 28255


Section 15F: Syndromes


Case 91-92: Meckel–Gruber Syndrome: PM 20070, PM 26190


Case 93-94: Prune Belly Syndrome Leading to a Markedly Distended Urinary Bladder and


Hydroureteronephrosis: PM 23424, PM 25509


Case 95: Sirenomelia with Bilateral Renal Agenesis and Multiple Other Malformations: PM 27025


Section 16: Liver Disorders—Pediatric Cases


Case 96: Coexistence of Duarte 2 Variant of Galactosemia with Niemann–Pick Disease Type B, in an Infant: PM 23108


Case 97: A Classical Case of Galactosemia: PM 23869


Case 98: Galactosemia, Double Heterozygous for N314D and Q188R Mutations, with


Micronodular Cirrhosis and Absence of Steatosis: PM 25342


Case 99: A Case of Galactosemia, Double Heterozygous for Q188R and E308K Mutations with Early Neonatal Acute Liver Failure: PM 25552


Case 100: Neonate with Hemolytic Disease of Newborn (Due to Rh Isoimmunization—for both Rh-D Antigen and Rh-C Antigen), Conjugated Hyperbilirubinemia, and Associated Nonsyndromic Paucity of Intrahepatic Bile Ducts: PM 27937


Case 101: Indian Childhood Cirrhosis: PM 24527


Abbreviations


Index