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Oxford Pathology FRCPATH 2021

Autopsy Pathology
Prof Ian Roberts
Autopsy Case 1
CLINICAL SUMMARY
43 year-old woman admitted with pneumonia
PMH: myasthenia gravis 15 years previously treated with steroids, thymoma, erythema multiforme, developed pneumocystis pneumonia that responded to treatment, developed right sided weakness, CT scan low attenuation internal capsule and occipital cortex
CT thorax large left sided tumour and basal consolidation on left
Progressive respiratory failure and died

MAIN PM FINDINGS
Large mass left side of chest
Right lung - multiple nodules of consolidation with cavitation
No macroscopic brain abnormality
pm01a
pm01b
pm01c
pm_01d
pm01e
pm01sv40
Diagnosis & discussion [0]
Autopsy Case 2
CLINICAL SUMMARY
82 year-old man admitted with general deterioration, hyponatraemia and anaemia.
PMH:  cutaneous SCC, duodenal ulcer, hypertension, CCF
Drugs: digoxin, aspirin, omeprazole, frusemide
Examination: anaemia, slow AF, ankle oedema, pleural effusions
Investigations failed to reach a diagnosis (including pleural cytology, CT, bone marrow biopsy)
Died one month following admission
 
MAIN PM FINDINGS
Mass obliterating the pericardial cavity
Apical scarring in both lungs and two peripheral right lung nodules
pm02a
pm02b
pm02c
pm02d
pm02e
pm02f
Diagnosis & discussion [0]
Autopsy Case 3
CLINICAL SUMMARY
28 year-old man admitted with septicaemic shock
PMH: known iv drug abuser, hepatitis C virus positive, presented to A&E with back pain 2 days prior to admission, given pain killers and discharged.
Staph aureus grown from blood cultures
CT scan: multiple abscesses in lungs + ?IVC thrombosis
Severe metabolic acidosis and suffered cardiac arrest the day following admission

MAIN PM FINDINGS
Lungs: Consolidation and haemorrhage
Organising thrombus in IVC just distal to the ostium of the renal veins
Liver: Enlarged and congested
Kidneys: Pale and mottled
Haemorrhage into psoas muscles on both sides
pm_03a
pm03b
pm03c
pm03d
pm03e
pm03f
pm03amyoglob
Diagnosis & discussion [0]
Autopsy Case 4
CLINICAL SUMMARY
58 year-old man
On holiday in Tenerife, complained of shortness of breath. Given oxygen and ventolin by doctor 4 days after arrival
PMH: asthma
Died the following day, cause of death “respiratory insufficiency”
Body embalmed and brought back to UK

MAIN PM FINDINGS
PM limited by embalming 
Left ventricular hypertrophy but minimal coronary disease
Fatty liver
pm04a
pm04b
pm04c
pm04d
pm04e
pm04f
Diagnosis & discussion [0]
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