Please type your query here. Since this query is directed to our panel of specialists Clinical Information : Pain & swelling and restricted movement at the left hip joint. Subtrochanteric fracture left femur 22 days old ? Pathological.

Gross Description : The specimen is recieved in formalin coded as "Bone tissue left femur". It consits of multiple tissue fragments that measures 4x3cm in agg. Some hard bony fragments are present, along with blood clots. The soft tissue fragments are entirely submitted in single cassette. where as the bone fragments will be submitted in cassette B after declacification (RS).

Microscopic Description : Section shows fragments of bone and fibrocollagenous tissue mixed with blood and fibrin. There are clusters and sheets of small sized plump to polygonal cells having scanty cytoplasm and nuclei showing hyperchromasia and mostly inconsipicious nucleoli. Immunohistochemical profile of the tumour cells is as follows:

Cytokeratin Cam 5.2 = Positive.

LCA = Negative.

CD99 = Negative.

CD56 = Positive.

Cytokeratin 7 = Positive.

Cytokeratin 20 = Negative.

TTF-1 = Positive.



Diagnosis :- Bone Tissue, Left femur, Biopsy : Metastatic carcinoma with neuroendocrine differentiation. Based on morphology and immunohistochemistry lung should be excluded as possible primary site of origin of tumour. Clinical & radiological correlation is advised.



Whole Body Bone Scan Test Result :- Scan Description:.. Whole body skeletal scintigraphy, notes non-uniform increased uptake of tracer in proximal half of left femur, the primary site of problem & surgery.

Apart from that increased uptake is noted in right 7th & 8th rib laterally, ? Traumatic , radiology is recommended.

Rest of skeleton shows bilaterally symmetrical distribution of radiopharmaceutical.

Kidneys are seen, activity seen in urinary bladder.



Sir , please help me about the problem, because the CA problem is not diagnosis completely, what should i do next, i'll be very thankful & pray to you to help n sort out the above problem. Thanks .. and super-specialists, please mention your problem in as much detail as possible. Do not forget to highlight your Age, Gender, Medical History and Treatment History of the problem you are facing.