Cytology rounds 9 April carcinoma gall bladder.pptx

All about cytology. Patient presented with jaundice and was found to have carcinoma gall bladder

1. Cytology Rounds GE 2 09-04-2024

2. Personal details Mrs KD 39yr/F R/o Bihar Informant – Self

3. Chief complaints Pain abdomen x 04 months Jaundice x 04 months

4. Pain abdomen Insidious onset Progressive Right upper quadrant Dull aching Mild to moderate in intensity No radiation No aggravating or relieving factors

5. Jaundice Yellowing discoloration of urine and eyes Insidious onset Progressive

6. H/o pruritus+ H/o clay colored stools+ H/o wt loss + (unquantified) H/o loss of appetite +

7. Negative history No h/o CAM intake No h/o abdominal lump No h/o hematemesis/melena No history of HPB surgery.

8. Past history Personal history No h/o major illness in the past. No h/o diabetes mellitus No h/o hypertension No h/o major surgery in the past. Non alcoholic, non smoker Mixed diet No h/o tobacco or drug abuse

9. Examination Average built and nourishment Conscious, oriented Icterus + No pallor, cyanosis, clubbing, Lymphadenopathy or Edema Vitals PR 88/min BP 110/70 mmHg SpO2 99% on Room air

10. Systemic examination GIT PA soft Mild tenderness Rt hypochondrium Liver palpable 3 cm below RCM Gall bladder palpable No evidence of free fluid in abdomen Bowel sounds + spleen was not palpable. CNS Conscious, alert, oriented to time, place and person No focal deficit RS Normal vesicular breath sounds bilateral lung fields. CVS S1, S2 normal No S3/S4/murmur

11. Investigations Investigations Reports Hb (g/dl) 8.5 TLC (/mm 3 ) 5410 DLC (N/L) 43/41 Plt (/mm 3 ) 3.04L Urea/Creatinine (mg/dl) 12/0.62 Na/K ( meq /L) 136/4.7 T.Bil /Dir (mg/dl) 11.71/8.7 AST/ALT (IU/L) 57/88 ALP (IU/L) 972U/L T.P/Alb (mg/dl) 6.5/3.3

12. USG Abdomen Liver 18cm GB partially distended, asymmetric wall thickening in fundus and body with echogenic contents within ? sludge

13. CECT Abdomen GB – Diffuse asymmetric circumferential wall thickening. There is indistinct interface between GB and contiguous liver segments 5 and 4a. Thickening involves CHD and primary confluence with resultant bilobar IHBRD.

14. EUS EUS FNB taken from the lesion

15. Unit Diagnosis Carcinoma Gall Bladder Lab ID - 2931