neck lump

Describe the lump and give your differential diagnosis 

case study 3

Ms Lee, a 49 year old unmarried Chinese lady came to the hospital with complaint of painless lump at the left breast for 4 months prior to admission. On examination there was a single lump at the lower inner quadrant of the left breast.

what's your differential diagnosis??

what investigations you want to do for this patient and how would you manage her?

case study 2

Mrs BL, a 54 year old housewife, no known medical illness, presented to the clinic in Selayang Hospital with complaint of painless progressive enlargement of neck swelling since 5 years ago located at the center extending to the right side of the neck. It was associated with tiredness, insomnia, constipation and amenorrhea for 2 years. 

INSPECTION

The swelling moved with swallowing. The swelling is in the central part of the neck extending to the right side, ovoid in shape with the measurement of approximately 5cm in height, 10cm in length and 3cm in thickness. The skin overlying the swelling is smooth with no break and had no erythema. There are no dilated veins seen. There are no visible  pulsation seen.

PALPATION

On palpation, the swelling is well defined, smooth, soft and nontender. There was on nodule appreciated and it moves with swallowing. The isthmus and tracheal margin could not be appreciated. There were no palpable supraclavicular lymph node.

PERCUSSION

Percussion on the sternum was resonance.

AUSCULTATION

On auscultation, there was no carotid bruit heard.

what's ur differential diagnosis???

case study

Mr Mok Lang, 67 year old Chinese gentleman, a known case of hypercholesterolaemia was admitted to Selayang Hospital with the chief complaint of right upper quadrant pain 5 days prior to admission. It is associated with yellowish discoloration of skin, vomiting and fever. He is an ex-smoker and occasional drinker.

On examination, he is afebrile and other vital signs are normal. There is yellowish of sclera. There is guarding and tenderness over the right upper quadrant. There was hepatomegaly. Murphy’s sign positive.

what's ur differential diagnosis????