Focal Monomorphic Ventricular Tachycardia As The First Manifestation Of Amyloid Cardiomyopathy

52-year-old patient presented with palpitation and well tolerated monomorphic ventricular tachycardia. He had normal echocardiogram and coronary angiogram 3 months prior to presentation. Surface EKG revealed regular wide-complex tachycardia with right bundle branch block morphology and right inferior axis. In conjunction with recent negative cardiac evaluation, this suggested idiopathic focal ventricular tachycardia from anterolateral basal left ventricle. CARTO based activation mapping confirmed the presence of VT focus in that area. Radiofrequency ablation at the site of perfect pacemap resulted in a partial suppression of the focus. Echocardiogram was subsequently performed because of progressive dyspnea. It revealed asymmetrical thickening of posterolateral left ventricle, with delayed enhancement on contrast magnetic resonance imaging. Fine needle aspiration of abdominal fat stained with Congo red confirmed the diagnosis of systemic AL amyloidosis due to IgG λ-light chain deposition. Consequently, the patient underwent placement of implantable defibrillator and hematopoetic stem cell transplantation. He remains in excellent functional status 18 months after presentation

Pathology Case Study: Abdominal Pain

This is a case study presented by the University of Pittsburgh Department of Pathology in which a 65-year-old man is complaining of abdominal pain. Visitors are given the radiology, gross and microscopic descriptions, flow cytometry, and molecular diagnostics, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in hematopathology

Pathology Case Study: Right Adrenal Mass

The University of Pittsburgh School of Medicine's Department of Pathology has compiled a series of case studies to help both students and instructors. In this particular study a 27-year-old white male has an unremarkable medical history until being recently diagnosed with hypertension. He then developed bilateral gynecomastia and began experiencing sever right flank pain while working. A sonogram and computerized tomography were performed and the images are available here along with microscopic photos and description. Clicking on the final diagnosis provides a thorough explanation of the diagnosis and treatment

Pathology Case Study: Flank Mass

This is a case study presented by the University of Pittsburgh Department of Pathology in which a man noticed a large and painful mass on his right flank. A previous mass had been removed surgically but developed a post- operation fever and related difficulties. Visitors can view both microscopic and gross descriptions, including images, and have the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to introduce or test students of clinical microbiology

Pathology Case Study: Acute Leukemia, Nodular Skin Lesions and Splenomegaly

The Department of Pathology at the University of Pittsburgh Medical Center has compiled a wide range of pathology case studies to aid students and instructors in learning. In this case, a 22-year-old patient was diagnosed with lymphoblastic leukemia after receiving treatment for a rib injury. Gross and microscopic descriptions and images are provided along with molecular and immunohistologic information to aid in understanding the final diagnosis. In addition to the official findings in the "Final Diagnosis" section, the patientâs treatment plan is also included in the section titled "Therapy." Students entering health sciences fields will find this resource very helpful, as it provides experience with patient history, lab results and diagnostics

Changes in Resident Graduate Characteristics in a Large Pathology Training Program, 1994 to 2013

The field of pathology has changed dramatically over the recent decades and has become more complex with emphasis toward subspecialization. These changes potentially influence resident training as programs and trainees search for cutting-edge skills in the evolving field. Over the last 20 years, our institution’s residency education was modified profoundly to emphasize subspecialty practice. Furthermore, efforts were made to search for and recruit candidates who desired such training. In this study, we examined a 20-year time period to determine how these changes may have influenced the characteristics of our resident graduates. For each trainee who graduated from our pathology residency program (1994-2013), the following parameters were evaluated: highest academic degree, gender, graduating medical school, type of training, number of publications during residency, enrollment in fellowships, and type of career position. The data collected were divided into 4 time periods. Fisher exact test and 2-tailed t test were used for statistical analyses comparing the first half (1994-2003) to the latter half (2004-2013) of the study. In the second half, there were more graduates who pursued single track pathology training—anatomic pathology or clinical pathology versus combined anatomic/clinical pathology training ( P = .035), more first author and total publications per graduate during residency ( P < .001), more graduates who enrolled in fellowships ( P < .001), and a greater tendency toward an academic career position than all other types combined ( P = .034). In parallel to the subspecialization trends in our department, we witnessed changes in the characteristics of our resident graduates whose interests and career choices have become more focused