Luqman Dad, MD

A 50-year-old black man initially presented to his ear, nose and throat specialist with a 2-month history of sinusitis that was not relieved by antibiotic therapy. His symptoms at the time included nasal swelling and congestion; he reported no fevers, night sweats or chills.

A 46-year-old perimenopausal black woman presented complaining of a sudden change in the appearance of her left breast. She recalled that the size of her left breast almost doubled during four weeks time. Her past medical history was otherwise noncontributory. She denied any associated constitutional symptoms, fevers or weight loss. She has no family history of breast cancer and no history of benign breast biopsies. Her last screening mammogram was six months prior and it did not reveal any significant abnormalities. She had an excellent performance status, and otherwise negative review of systems.

A 83 year-old woman initially presented with a 50 pack-year smoking history and early-stage squamous cell carcinoma of the left lower lobe, status post-left lower lobectomy (pT2N0Mx) with negative margins seven years prior, followed by no adjuvant treatment. She had been followed by routine surveillance and was in her usual state of health until she presented to her local emergency department complaining of shortness of breath and difficulty breathing two months prior. Her medical comorbidities included asthma, chronic obstructive pulmonary disease, chronic heart failure, and cardiac dysrhythmia requiring a pacemaker. She had an excellent performance status, and otherwise negative review of systems.

A 17-year-old woman with no significant past medical history presented to her primary care physician after having headaches for two weeks. She mentioned a fall during a basketball game, a closed-head, sports-related injury that had been dismissed as a mild concussion. She had begun to notice new-onset, left-sided facial numbness for one week with no associated seizure-like activity or constitutional symptoms. She otherwise had no known genetic abnormalities, nor any history of exposure to any environmental toxins or ionizing radiation.

A 48-year-old man with HIV diagnosed more than 20 years prior who has been treated with protease inhibitor-based highly active antiretroviral therapy regimen presented to our clinic with rectal bleeding and anal mass since three months. His CD4+ T-lymphocyte count was 620 cells/mcL and he had an undetectable HIV-1 viral load.