C ASE S TUDIES IN N EUROPATHOLOGY Kenneth Clark, MD Neuropathology Fellow, UPMC

C LINICAL H ISTORY 30-year-old man with no significant past medical history. No smoking, no drug abuse, no meds 2-month history of “flu-like” symptoms Awoke in the morning and returned to bed stating “I don’t feel well” A couple of hours later his wife found him unresponsive in bed  medics

Clinical Course Arrived at the emergency department, intubated and unresponsive CT scan of the head revealed the following…

Differential Diagnosis

Clinical Course Labs drawn… Physical exam: –Pupils fixed and dilated –No pain response –No spontaneous respirations

Clinical Course Lab results –WBC > 600,000 –14% blasts –6% promyelocytes –22% myelocytes –5% metamyelocytes –22% bands –22% neutrophils –5% eosinophils

Differential Diagnosis

LENTICULOSTRIATE VESSELS

Cause of Death Acute Myelogenous Leukemia

M ECHANISM OF D EATH

H ERNIATION