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30 f c/of pain and swelling in elbow since 3 months. swelling rapidly increased in size.severe tenderness..globular swelling, no line of demarcation .no trauma. no familial history. diagnosis?



Accepted Answer 

gct …fibrous cortical defect

60 year old female obese hypertensive on telmisartan 40 controlled since 7 years, Diabetetic since 3 years on metformin 500 mg of..latest FBS 128 mg/ DL..latest HbA1c 7.10.. kindly suggest further management..


Accepted Answer

your patient is already in hyperglycemia. Adding Glmp 1 mg will not cause hypoglycaemic. First you have to achieve euglycemic goals. FBS 128 is not acceptable. This much of persistent hyperglycemia will lead to complications in a patient which already has comorbid conditions. And, don’t forget about the increased CAD risk. Latest guideline say that in presence of these two comorbid conditions, DM & HTN, aspirin or clopidogrel with a statin in low dose should be started to reduce the risk of CAD. For cardiac remodelling an ACE inhibitor is also mandatory. the patient is also obese. So, he is most likely going to develop target organ damage within 5 years.


A 53 year old male patient presents with sudden onset of abdominal pain. MRI revealed a ruptured space occupying lesion in the liver. The histological images are shown. what is the diagnosis? 


Accepted Answer

Good evening, my revered medical fraternity. We are grateful to kind Dr.Jain madam for posting, interesting slides. Salient histopathological features appreciated : Microtrabecular architectural pattern. Presence of more than 2 to 3 cell thick hepatocellular cords or plates separated by sinusoids. Polygonal tumor cells with distinct cell membrane, abundant granular eosinophilic cytoplasm, enlarged round nuclei with coarse chromatin and thickened nuclear membrane, showing prominent nucleoli. Presence of dilated bile canaliculus surrounded by hepatocytes (tumor cells). Bile pigment is also seen. Based on age, site (liver), lesion ( can present as solitary mass), Histopathology (Typical) a diagnosis of WELL DIFFERENTIATED, HEPATOCELLULAR CARCINOMA WITH MICROTRABECULAR PATTERN to be considered


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