PathWays Case Study: June 9

A 61-year-old man with two years of progressive dyspnea, lung infiltrates ,and elevated pulmonary arterial pressures leading to double lunch transplantation.
A 61-year-old man with two years of progressive dyspnea, lung infiltrates, and elevated pulmonary arterial pressures leading to double lung transplantation.

 

pathways060915-1Patient A is a 61-year-old gentleman with a two-year history of progressive shortness of breath. His past medical history includes type II diabetes, hypothyroidism, hyperlipidemia, and a distant history of tobacco use. His cardiopulmonary evaluation showed elevated pulmonary arterial pressures and normal left-side heart function. His chest CT scan showed mild interlobular septal thickening and centrilobular ground glass opacities. He underwent double lung transplantation. His explanted lungs were grossly unremarkable. H & E and VVG stains showed the following patchy areas throughout his explanted lungs.

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Justin Juskewitch, M.D., Ph.D.

Justin Juskewitch, M.D., Ph.D.
Resident, Division of Anatomic and Clinical Pathology
Mayo Clinic

 

 

 

Marie Christine Aubry, M.D.

Marie Christine Aubry, M.D.
Consultant, Division of Anatomic Pathology
Mayo Clinic
Professor of Laboratory Medicine and Pathology,
Mayo Clinic College of Medicine

apriljosselyn

April Josselyn

April Josselyn is a Marketing Associate at Mayo Medical Laboratories. She is the editor of Mayo Clinic PathWays and supports corporate communications strategies and internal communications. She has worked at Mayo Clinic since 2012. Outside of work, April enjoys the outdoors and being "hockey mom" for her two sports-crazed boys.

Responses

informative case and discussion. thank you

Hello Dr. Aubry,
An excellent case:-) I am sure it was a great learning opportunity for Justin as well.
Have a nice week.
Sertac

Histopathology and radical treatment leads.. for untrained eye a diagnosis of exclusion.

WISH I COULD GET MORE INFORMSTION ON THIS CASE TO BETTER UNDERSTAND PULMONARY HYPERTENSION

nice looking at pathology of explanted tissues. Thks

One acquired cause of post-capillary pulmonary hypertension could be chronic i.v. users with talc and/or other foreign deposit buildup.

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