Since returning from Mt. Kenya I've been taking the opportunity to rest and recover from the journey. This is my final week in Kijabe before I head to Nairobi next week and start a one week safari/beach vacation. After such a big adventure I've dedicated myself to the simple pleasures of home: cooking, lying on the couch, reading, writing, walking around town.
During our work this week we encountered a rather unusual case. a 35 yr old female with non-tender left scapula mass measuring 14 x 8 cm for 3 yrs which is soft, mobile and not attached to underlying tissue. Ultrasound also revealed multiple solid masses at the posterior of T8 measuring 4.4 cm and 2.2 cm. Clinically, they thought this was a lipoma. Grossly, the excised left upper back mass appeared as a tan yellow encapsulated lesion with tan-yellow to tan-white fatty to myxoid/gelatinous lobular firm cut surfaces. Here are the microscopic images:
 |
| Spindled cells with cigar shaped nuclei, mild to moderate atypia |
 |
| A hypercellular lesion for what we thought was a lipoma.. |
 |
| Focal palisading, suggesting possible nerve sheath origin |
We ended up sending
this case as a consult to UW. One of the BST pathologists there agreed that this could perhaps be a nerve sheath tumor, likely a schwannoma. The atypia might be degenerative atypia (ancient changes). Aside from that case I've fallen back into the routine of previewing cases in the morning, handing them off for later review by the attending, and grossing in the afternoon. The workload has been light.
Other highlights of a peaceful week in Kijabe:
 |
| Rift Valley Sunset |
 |
| Locals will turn anything into a plant pot, including old bottles of cooking oil! |
 |
| IHC is performed in this pressure cooker; UW lab procurement staff take note: next time we need new IHC equipment a trip to Wal-Mart may suffice! |
 |
| Shipping containers as structural elements at the local university |
 |
| An abundance of delicious fresh fruit |
 |
| This fellow's bike has a leek, several actually... |
 |
| A portion of tissue that looks like Africa... |
 |
| An unusually large amount of potatoes on the patio |
 |
| Trying out the restaurant at the local gas station (recommended by Phillip): stewed chicken, ugali, and greens |
 |
| A path leading downhill opens to a view of the rift valley |
 |
| Exchanging gifts on the last day: a heartfelt goodbye to our colleagues at Kijabe hospital. Kwa heri, tutaonana tena (goodbye for now, we will meet again!) |
No comments:
Post a Comment