Case 239

Surgical Pathology Case

 

CLINICAL INFORMATION

 

A 40 year-old male, history of hypertension, obesity (>170kg) and lumbar disc disease with leg and back pain for 7 - 10 years. Recently, he had

worsening back pain with radiating to the leg, and MRI scan revealed paracentral disk protrusion with L5 nerve root displacement and moderate nerve root deformity. He had no bowel or bladder dysfunction. He then underwent left L4-5 microlumbar diskectomy and microdissection.

Five days post surgery during a hospital visit, he suddenly collapsed in the hospital with acute onset of shortness of breath. He died within 30 minutes in spite of extensive management.

     

GROSS DESCRIPTION

 

 

Pulmonary arteries

Pulmonary arteries

 

 

Cross section of the lung

Cross section of the lung

 

     
 

Cross section of the right lung

Thromboemboli from the pulmonary artery

 

 

Thromboemboli from the pulmonary artery. HE, 2

Thromboemboli from the pulmonary artery. HE, 10

 

 

HE, 4

HE, 10

     
 

Click here for diagnosis and case discussion.

 

Source: Department of Pathology, Creighton University Medical Center, Omaha, NE

Photo: Zenggang Pan

Discussion: Zenggang Pan