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Tuesday slide seminar, January 25th 2011
Hannu Kalimo
Division of Pathology, HUSLAB, University Central Hospital, Helsinki, Finland

 
Slide 1  
Case 2
An 8-year-old boy, who in 2004 at the age of 1.5 years had undergone an operation for a large posterior fossa tumor. Now the tumor had recurred.

Slide: Biopsy sample from the recurred tumor.
  

 Diagnosis

 
Slide 1  
Case 3
A 21-year-old female. Flexor contracture of fingers III and IV. In V/2007 diseased parts of M. flexor digitorum superficialis excised, but the flexor-contracture recurred within some months. Tendon-elongation performed after some months, but the flexor contracture recurred again and in addition pain. A relatively extensive reoperation IX/2010 with removal of m. palmaris brevis and m. flexor digitorum superficialis II-V which had necrotic appearance.

Slide: Flexor digitorum superficialis III-V -muscle.
  

 Diagnosis

 
Slide 1  
Case 4
A 84-year old male, who has had Ménière´s disease since 1970´s. Increasing problems with balance and walking in late 2000´s. IV/2009 fell in the street and hit his head. CT revealed fracture of the medial wall of the orbita and lesser contusion hemorrhage in left frontal lobe. Hospitalized until moved to a nursing home VI/2009. He fell repeatedly and his general condition was weak. X/2009 fell from the bed and CT revealed thin subdural effusions and some cortical atrophy. Right arm became paretic and there was marked muscle weakness in all extremities, which according to the neurosurgeon was not explainable by the subdural effusions. MRI showed myelomalacia in cervical spinal cord. Bedridden since I/2010, died of pneumonia VII/2020.
During the period 2002-2009 mild chronic macrocytic anemia (repeated MCV-values over 100 (normal 82-98 fl). Folic acid in 2005-2007: within normal limits, B12 value in 2007: 149 (normal 145-635 pmol/l).

Slide: Myelin stained (luxol-fast-blue & cresyl violet) section form cervical spinal cord.
  

 Diagnosis

 
Slide 1  
Case 5
Previously healthy 34-year-old female. 30.10.2009 at night complained headache and soon thereafter at 03.40 her husband woke up when she fell on him, groaned and remained lifeless. She was resuscitated for 24 minutes until the ambulance arrived. She was taken intubated, hypotonic to Meilahti emergency room, where in TT she was found to suffer from massive subarachnoidal hemorrhage with preponderance in the region of left middle cerebral artery. Due to the poor intracranial circulation no aneurysm was detected and angiography could not be performed. No improvement, the patient was declared brain dead the same day at 19.15. In the autopsy no definite aneurysm was detected (not even in stereomicroscopic examination of the basal arteries).

Slide: Herovici-stained sample from the region of distal a. basilaris.
  

 Diagnosis

 
Slide 1  
Case 6
59-year-old female. Previously healthy. In summer 2007 began to suffer from progressive weakness and clumsiness of lower extremities. In private MRI XI/2007 alterations in left basal ganglia and in Jorvi MRI examinations XII/2007 in addition fresh infarct on the right. In MRA finding compatible with vasculitis. In CSF leukocytes elevated as well as Borrelia burgdorferi antibodies compatible with intrathecal synthesis. The vasculitis and infarction alterations progressed and patient died 6.1.2008.

Slide: Section from left frontal lobe parasagittally
  

 Diagnosis


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