Amit Patel, MD

A 34-year-old female with no medical history originally presented with hoarseness and a choking sensation in November 2007.

The patient is a 65-year-old woman who presented to our institution with a biopsy-proven left breast cancer metastatic to the left axillary lymph node. Patient states that she first felt the left breast mass 5 months prior, and noted increase in its size. She denies any other palpable mass in the breast, no nipple discharge, or any other symptoms. Patient has sarcoidosis hypothyroidism, and a history of bilateral breast reductions. Her family history is pertinent for a sister who had breast cancer at the age of 49 years and a maternal aunt who also had breast cancer at the age of 42 years.

An 84-year-old woman presented to her hematologist’s office with an asymptomatic leukocytosis and associated lymphocytosis seen on routine blood work. She noted complaints of fatigue and had an unintentional weight loss of 15 lb within 1 year. At the time of initial consultation, her blood work showed a total white blood cell count of 25,000 cells/mcL with 75% lymphocytes, which fluctuated to as high as 33,000 cells/mcL with 76% lymphocytes. She also had a normocytic anemia and normal renal function, but workup revealed an elevated serum globulin level, elevated lactate dehydrogenase, and a beta-2 microglobulin of 7,303. Peripheral smear exam was consistent only with small lymphocytes

A 65-year-old woman with a past medical history significant for depression and anxiety disorder presented in 1991 with abdominal distension and increasing girth. Imaging studies revealed bilateral ovarian masses, and she underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy and debulking surgery for a stage IIb ovarian epithelial cell carcinoma.

A 57-year-old man with no stated past medical history presented to the ED with complaints of headache and blurry vision that were getting progressively more severe. These symptoms began about 6 months before presentation. He also noted worsening bloody bowel movements.

A 63-year-old woman without significant personal past medical history presented to her primary physician with a one-month complaint of palpable right breast mass. The patient was referred to a breast surgeon for evaluation and underwent imaging studies that showed a 4 cm × 3 cm mass in the right upper outer quadrant. Core biopsy of the mass was performed and pathology revealed an invasive lobular carcinoma, classical type.