1️⃣ Case Study: Breast Cancer Diagnosis (Biopsy & IHC)
Clinical Scenario:
A 45-year-old female presents with a painless lump in the left breast for 3 months. Family history reveals breast cancer in her mother. Mammography shows a spiculated mass in the upper outer quadrant.
Pathology Workup:
- FNAC: Atypical ductal cells with high nuclear-cytoplasmic ratio.
- Core Needle Biopsy:
- Histopathology: Infiltrating ductal carcinoma (IDC).
- IHC Panel:MarkerResultClinical SignificanceER (Estrogen Receptor)PositiveHormone therapy (Tamoxifen) indicatedPR (Progesterone Receptor)PositiveBetter prognosisHER2/neuNegativeNo Trastuzumab neededKi-6730%High proliferation rate
Diagnosis: Infiltrating ductal carcinoma, ER/PR positive, HER2-negative.
Clinical Decision: Initiate hormonal therapy (Tamoxifen) + Lumpectomy with sentinel lymph node biopsy.
2️⃣ Case Study: Cervical Cancer Screening (Pap Smear & Colposcopy Biopsy)
Clinical Scenario:
A 30-year-old woman with post-coital bleeding undergoes a routine Pap smear.
Pathology Workup:
- Pap Smear Result: High-Grade Squamous Intraepithelial Lesion (HSIL).
- Colposcopy Biopsy:
- Histopathology: CIN III (Cervical Intraepithelial Neoplasia Grade III).
- HPV Testing: Positive for HPV-16.
Diagnosis: Cervical precancerous lesion (CIN III).
Clinical Decision: LEEP (Loop Electrosurgical Excision Procedure) performed to remove dysplastic tissue.
3️⃣ Case Study: Thyroid Nodule Evaluation (FNAC & Frozen Section)
Clinical Scenario:
A 55-year-old male presents with a slow-growing thyroid nodule.
Pathology Workup:
- FNAC Result: Suspicious for follicular neoplasm.
- Intraoperative Frozen Section: Cannot differentiate benign from malignant follicular lesions.
- Final Histopathology (Post-Thyroidectomy): Papillary Thyroid Carcinoma.
Diagnosis: Papillary Thyroid Carcinoma.
Clinical Decision: Total thyroidectomy + Lymph node dissection.
4️⃣ Case Study: Lymphoma Diagnosis (Biopsy & Flow Cytometry)
Clinical Scenario:
A 60-year-old male presents with painless neck swelling and night sweats.
Pathology Workup:
- Excisional Lymph Node Biopsy:
- Reed-Sternberg cells observed.
- Immunohistochemistry: CD15+, CD30+.
- Flow Cytometry: Confirms Hodgkin Lymphoma.
Diagnosis: Hodgkin Lymphoma.
Clinical Decision: Initiate ABVD chemotherapy.
5️⃣ Case Study: Liver Biopsy in Cirrhosis (Histopathology & Special Staining)
Clinical Scenario:
A 50-year-old male with chronic alcoholism presents with jaundice and ascites.
Pathology Workup:
- Liver Biopsy:
- Histology: Bridging fibrosis and regenerative nodules.
- Special Stain (Masson’s Trichrome): Confirms cirrhosis.
Diagnosis: Alcoholic Liver Cirrhosis.
Clinical Decision: Lifestyle modification + Liver transplantation evaluation.
🔎 points
✅ Biopsy remains the gold standard for solid tumor diagnosis.
✅ Pap smear + HPV testing aids early cervical cancer detection.
✅ FNAC is first-line for thyroid, breast, and lymph node evaluations.
✅ Frozen section is useful in intraoperative decision-making.
✅ IHC and Flow Cytometry refine lymphoma and cancer subtyping.