~ .....

- DATE OF AC>MN
- .... ,fHHCi~
INST ITUT E OF 01
·····- - ··-····
l"'II AI
COL OGY
8.
WARD
ROOM/BEDNO IPN O
\ LJHID
H 0000067089
13-Nov-2:3 03:53:14 PM Male General ward 5 MBH IP57 033
KAMB ·
1■111■ 111■ 101
OF THE A TTENDINtG DOCTOR
NAM E OF THE ADM ITTI NG
N~~E K G-400008 (Medical Onc DOC TOR
or.snnrvas ology) Dr.Srinivas K G (Medical Onc
ology)
: Mr. CHANDJ!\N KUMAR M N Ref erre d By
Patient Name : SELF
: 31 Yrs Gen der : Male Con tact No
Age : 91-9 886 959 960

(Permanent) : #26 53,2 ND

Ema il ID
,.
Address CROSS ,GHANDHINAGRA,MAND : ,
YA TOWN,MANDYA, Bloo d Group :
' Mandya, Mandya ,
r..arnaraKa,1n~1a1.
:
l
t..-ocal Ad<freSS

Local contact No : 91-9535810850

-
-~ame of next of Kin
~W ard ~
: CHETHAN KU~ AR

c- _ -/
Rel atio nsh ip : Bro tl}er

-
htormed HK :
MLC

Mod e of pa¥meF1t
~

- L-~ : Cas h

/ ----- ,

tfJ We have been explained abo ut the

pmp ose d rare . _
-
~ I We hav e been exp lain ed abo ut the
exp ecte d resu lts.
~

'
~h av e been explau,edabout
the pos sible
co p cations.
~ e bee n exp lain
ed abo ut the exp ecte d cos ts.
y I declare that above information
prov ided by me is true to the
ood the hospitars rules and regulatio bes t of my kno wled ge and also
ns. I hav e fully read and

Spouse,Parent or Guardian
Nam e :
(Only in case of minor or unable
to take inde pen den t decision
)

Sign atur e:

Bharath Hospital And Institu

te of On co log y
led By(Date Time):Anupama B H(1
3-Nov-23 3:53 :20P M)

Page 1 of 1
 1

HISTORY & PHYSICAL :\fr. C~ff.000006 7089

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Name and Signature Date& Tlme:

 ---u..., nno~»FS~ NOTES
Mr. c~BH.0000061089 in-patient units)
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Re D · rs/Male
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*KA Ph No.:91-9886959960
me:....................... MBH.0000067089* ·········································
Age ........................yrs ,. .......................................
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NOTES & TREATMENT

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 DATE& TIME
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NOTES & TREATMENT
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NOTES & TREATMENT

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Nam• and Signature of consultant
 \

C,
medall
DIAGNOSTICS
experls who care

Mr. CHANDAN KUMAR Customer ID MEDl 11955650

Name
31Y/M Visit Date Nov 13 2023 12:27PM
Age&Gender
Ref Doctor DR. SRINIVAS K.G.

CECT SCAN OF ABDOMEN AND PELVIS

Following oraltheand
starting from rectalofcootraSt
domes diaphragm down to thealevel
administration,. 17:~ .s to
of pubicAP
preliminary ~
of the bdomen and pelvt_s
0 625
.
. was obtamed. Volume scans were performed
conuast enhancement. Multiplanar reconstructions were also perf=ed'.sis, employmg - mm sections. 80 ml of Ornnipaque 350 mg was used for

OBSERVATIONS:.

LIVER:
Larg~ lobulated !lwracic mas~ is noted with extensio~ into the right dome of diaphragm,
subd1aphragmat1c space and infiltration of segment VIII of liver. ·
The porta hepatis and portal vein are normal.
The intrahepatic portal venous radicals are normal.
No evidence of intrahepatic biliary radicular dilatation.
The hepatic veins and intrahepatic portion of inferior venacava are normal.

GALL BLADDER:
Normal in size, shape and outlines. Pericholecystic area is normal. The common bile duct is not dilated.

SPLEEN:
Spleen is normal in size, shape and attenuation values. The splenic bilum and splenic vein are normal.

PANCREAS:
Pancreas is nonnal in size, contour and attenuations values. · No evidence of focal mass
lesion/pancreatic duct dilatation.

KIDNEYS:
shape.
. Kidneys are normal in size andand
The renal outlines are normal both kidneys are showing good concentration and prompt excretion
of contrast. ·
No evidence of focal mass lesion/hydronephrosis/calculi.
Left adrenal gland is normal in size and attenuation values.
Right adrenal gland is compressed by the mass with suspicious infiltration.

STOMACH & INTESTINES:

Stomach is well distended. No evidence of wall thickening or intraluminal mass lesion.·

Duodenum, Jejunum and !leal bowel loops are well distended. No evidence of wall thickening or
evidence of intestinal obstruction.
Caecum, Asc.,,;ding colon, transverse colon, Descending aiid Sigmoid colon are nonnal. No wall

Pagel ot l.
 I
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Name
----~-:-:-------- -========~~~~~~--M
.C·. . . .1.0:._: 3~0-~
Mr. CHANDAN KUMAR Customer ID MED!1)9 Mr
• l Catcgory: GENE RAL
Age &Gender 31 y /M Visit Date Nov 13 20 I>at,cn
Req est I.umber: 3240177
RefDoctor DR. SRINIVAS K.G. M/\LI RE SP IH/\TORY MEDICI NE W/\RD / RESMED-M-01 Req~esteu o~ :0&-11-2023 / 11 35

Consulti ng Doctor Dr JAYARAJ B 5 1111,11 111111111U/1 11:11Ilil,1111111 II

thickening or mass lesion. Reque sted by: Dr JAYAR AJ B s
No evidence of free fluid seen in the abdomen. TEST NAME. (SPECIMEN) Results Reference Range
Few subcentimeter sized preaortic and paraaortic lymphnodes are noted measuring Upto 71111 HISTOPATHOLOGY • Collected on 06-11-2023 / 11:3S • Dept Received on 06-11-2023 / 13:07, Approved on 11-11-2023 / 12:39
short axis. SM ALL SIZE. BIOPSY . /LUNGS)

Urinary bladder is distended, shows normal wall thickness. No evic'.lence of mass lesion or cal
within. Peri Vesical fat planes are normal. C\ Site of Biopsy
Right Hemithoracic mass.

Pro~tate is no~al in s~e, shape ~d attenuation values. No evidence of any mass lesion seen.S Clinical Diagnosis
vesicle and seminal vesicle angle 1s normal. Right sided moderate pleural effusion .

Para spinal soft tissues are normal. MACRO Specimen consists of a single grey white tissue co re
Aorta, Celiac trunk, SMA, IMA and Iliac vessels are normal. measuring 1. x 0.2cm. (All embedded }

MICRO Sections show spindle cells arranged in in terlacing fascicles .

Impression: KIC/0 Mediastinal Sarcoma With Right Hemithorax Extension. CT Abdominal Areas of necrosis noted .
Morphology Suggests
Features are suggestive of Spindle cell tum our.
• Large Lobulated Thoracic Mass With Extension Into Right Dome Of n·
Subdiaphragniatic Space And Infiltration OfSegment Viii Of Liver. 14/ DI AGNOSIS Biopsy, Right Hemithoracic mass- Features are suggestive of
• Subcentimeter Sized Preaortic An4 Paraaortic Lymphnodes. Spindle cell tumour.
Compression Of R~ght Adr~nal Gland By The Mass With Susplcio11s Infiltration.
• No Other Metastatic Deposits In Abdomen And Pelvis._ RI MARKS
Recommended lmmunohistochemistry for furt her

~ categorisation .

DR.:UOBAN.B Biopsy No
~fD• D~, EDIR, FELLOW IN CAI
7698-2023

CONSUL TANT RADIOLOGIST - - - - - - -- End Of Report----- - - -

Dr SHOUREE KR Dr. SUCHITHA S

MBBS, MD, DNB MBBS, MD, DNB
SENIOR RESIDENT PROFESSOR
Pathologist(Histopathology) ' Pa tholog ist( Histopathology)

I
lfSULT ENTERED BY : 0 s0725 09-11 2023 / 15:09

JSSH/ ADM/10·11
Yo~ can also conveniently view the reports and trends M.G. Road, Mysuru -570 004, ~. 082 1-2335555
through our App. Scan QR code to download thP Ann Fax. 0821-2335556 E'llail cortact@jsshosp1tal in Website · wm..,3shosp1tal ,r
 0ISCIIAR GE SUMMA RY

DEPART I\IENT OF RESPIRA TORY MEDICIN E

_ 2651808/ 485610 NAM[

/II' NO ~------ ------- ---1..- ------- -~~=:. Mr.CHANDAN KUMAR MN
:..:....: .:..::..: .::.:...: :..:_~. :_:____ ___
- : JO Years ADMITTFD ON
- rv-1,-\L_[_ - - - - - - - - - - , - -D 02-11-2023
- I-SC-.H-A-RG_l_D_O
_N_ _ _ _
_l _l_ll___. . :20__:2,=-.3_ _ _ _ _ _ _ _ __
------------1----------------
R[SM [I) - M-Ol UNIT ll[AD Dr.JAYARAJ B S MBBS, MD,D M
----
Unit I
HOSAHALLI MANDYA TOWN

MANDYA

- AT REQUEST AND REFERRAL

HARGE

MONARY MEDICINE

Jayaraj. B. S. Dr. Mahesh. P.A. Dr. Chaya. S. K. Dr. Lokesh. K. S.

nosis:
H MEDIASTINAL MALIGNANT SPINDLE CELL TUMOUR ?SPINDLE CELL SARCOMA
(HIGH GRADE)
T SIDED MODEl~ATE PLEURAL EFFUSION-EXUDATIVE LYMPHOCYTE PREDOMIN
ANT LOW ADA TYPE
D PAH(PASP:44MMHG)
Clf'IED GRANULOMA RIGHT LOBE OF LIVER

senting complaints :
RIGHT SIDED CHEST fJAIN FOR 1 WEEK
COUGH WITH EXPECTORATION FOR 1 WEEK

ory:
VLAR OLD MALE WITH NO KNOWN COMORBIDITIES CAME WITH C/0 COUGH
WITH MILD EXPECRTORATION OF WHITISH MUCOID
JTUM, NON FOUL SMELLING, NOT BLOOD STAINED NOT ASASOCIATED WITH
ANY DIURNAL OR POSTURAL VARIATION SINCE 1 WEEK.
RIGHT SIDED CHEST PAIN SINCE 7 DAYS, PRICKING TYPE OF PAIN, NON RADIATING
, MORE ON LYING DOWN ON RIGHT SIDE AND
GRAVATlcS ON COUGHING AND TAKING DEEP BREATH.
C/0 urrn SYMPTOMS
C/0 ITVER WITH CHILLS,LOSS OF WEIGHT,LOSS OF APETTITE
C/0 SHORTNESS OF BREATH,ORTHOPNEA,PND,PEDAL EDEMA
C/0 CHEST PAIN ,PALPITATION, HEMOPTYSIS
C/0 i-1\CIAI. PUFFINESS ,DECREASED URINE OUTPUT,ABDOMINAL DISTENSIO
N
C/0 GI/URINARY DISTURBANCES
/0 PTB, COVID, ASTHMA, ALLERGY.
0 DM,HYPERlTNSION,CAD,CVA,CKD,SEIZURE DISESE,THYROID DISEASE
0 ANY CHRONIC RE:SPIRATORY COMPLAINTS IN THE PAST

Biomass Smoke Exposure: NON SMOKER

. n· PRINTING PRESS WORK

ICIIFindings:
II NT IS CONSCIOUS AND ORIENTED
104 lli>M
: 120/80 MMHG
02: 96% ATROOM AIR
. 20 CPM
: B/L AIR ENTIW PRESENT ,RIGHT SIDED DLCR[/\SED BREATH SOUNDS
S: 51 ,52 HEARD WITH NO MURMURS
A. SOI l, NON ff:NDI R Willi NO ORGANOMEGALY

M.G. Road , Mysuru - 570 004, ~ : 0821-2335555 JSSH/ ADM/O l

Fax: 0821-2335556 Email : conta ct@jsshospital.in Website : www.jss
hospital.in
 REG/IP NO : 265180 8 / 485610
M ON
'N.,..S AD:\1 TTED .TO MA L E p~L
CNS: NO ABNOR MALITI ES DETECTED LA -
oNED coMP • ' ._
ABOVE MENTI 1 NTIBIO.,..' C5 \JEBUL l::>fD f l'\10 1\i
~►
Course in Hospit al :PATIE NT CAME WITH 02-11- 23) :RJGH r GROSS 1-' lE.dR,' \ l
NS WERE SENT STARTED ON :/~ RAY(
EVALU ATED ,RELEV ANT INVESTIGATIO HETER OECHO GENIC IT Y W llH N.0 [/O IN
RTIVE MEDICA TIONS. CHE ' UNG -
BRONC HODILA TORS ' MUCOL YTICS ' SUPPO ERLYJNGL · ON ,' /1 l
OLIDAT JON OF UND EURAL FLUID \SP."R,\TJO N \V,-\S l)0Nl
(1/11/2 3) MODER ATE RIGHT PE -750 cc,coNS p~ANT LOW ADA TYPE, NO \,, ')ENCF or 1\1'\ ~IG '\JI\N
ORAX.USG GUIDED THERA PEUTIC
VASCULARITY NOTED IN RIGHT HEMITH E:E' N NG U<;
L EFFUS ION WITH J\,,J,\SS LESION .SCH
EXUDATIVE LYMPHOCYTE PREDOM~URA
SAMPL E SENT FOR ANALYSIS SHOWE D ,\L C,\VJ IY \'
3 SHOWE D ?RIGHT GROSS p~C PLEUR AL FLUID JN R'GHT SIDED PL.EUR
2/11/2 J t iO ,1\CJC Cv
CELLS.REPEAT CHEST XRAY DONE ON TEROE CHOGE NIC LESION IN RIGI-! 1
OF PLEURAL FLUID SHOWE D lOO l\v
DONE FOR FURTHER QUANT IFICAT ION HE VI AND VI RIGHT LOBE Of- l I\. rn ) NLOPl \$
EN AND PELVIS (3-11-2 3): ILL DEFINE D
INTERN AL SEPTAT IONS.U SG ABDOM ' pE: .R IC,\RD l r\L l H USION Cl~ I IC
N ENTING SEGME NT. OF CE
AND I D 4 Cl II IQ
INFILTR ATING T HE RIGHT DOME OF DIAPHR AGM ), TRA . .
L LVEF'65% MILD PAH(PASP .4 MMHG LESION LXTcN DI N(, IO IN\ Ol VI RIG II I
CTIOLOGY.2DECHO (S/11/2 3)·MIL D TR NORMA
l y ENHANCING AN~ERIOR AND MEDIA STINAL
(4/11/2 3),ILL DEFINED HETER~G ENOU~ O.rA) Sue,
NEOPLASTIC AEl rot OGY ;?Gt l<MIN
I ONS AND EXTENSIONS AS DESCRIBED.
HEMOTHORAX WITH MASS EFFECT ,RELAT SG GUIDE D T I IOPSY Of RIGf-1 I
mu-cu
DESCR IBED.U
TO GROSS PLEURAL EFFUSION AS : 1.\TUR l SO
HPE CORRE LATION ,RIGHT MODER ATE UTSIDE ) SHOW ED HISTO LOGIC \ l H
RMED ON /ll/ 23 AND SENT FOR HPE(O I Ol oc.1c:i '
HEMIT HORAX MASS LESION WAS PERFO 6 MA, PRllVIA RY / SECON DAl<Y. , I 115
PHOLOGY FAVORING SPINDLE CELL SARCO
MALIG NANT SPINDLE CELL TUMOUR,MOR R/0 SPIND LE CELL SARCO MA AND I DR,'
FOR CONFI RMATI ON, TO
., SUGGEST, IHC STUDY 1\I Tf ND[ HS U
(FNCLCC) '2+3+2 •7/8, G3, HIGH GRADE AOVlSE FOLLO WED.P A Tl EN r·s
WAS TAKEN IN VIEW OF THE REPORTS AND
TYPI NG.MEDICAL ONCOLOGY OPINION ER MANA GEME NT UNDER ONCO I OGIS I1 f;,I\S
FURTH 11
TION OF THE PATIENT AND NEED FOR MAN( LML ¾
COUNSELLED REAGRDING THE CONDI
TO TAKE PATIEN TTO KIDWA I CANCER CENTRE BANGL ORE FOR FUR IHFR
EXPLAINEO,PATIENT'S ATTENDERS WANTS Nr
ADVICE .
CALLY STABLE SATE WITH FOLLO WING
HUNG DISCHARGED IN A HEMOD YNAMI

Investi gation Summa ry:

PLEURAL EFFUSION
CHEST X RAY( 02-11- 23): RIGHT GROSS
ERLYIN G LUNG ' HETER OE.Cf fOG[N ICI
l"Y WI 11 f No1 1
PE -750 CC,CONSOLIDATION OF UNO
USG THORA X (1/11/2 3 ) MODER ATE RIGHT
HEMITH ORAX
INTERN AL VASCULARITY NOTED IN RIGHT
PERIC AIWIAL [ffUSI ON
A~,M ILD PAH(PA SP:44M MHG),T RACE
2DECH O (5/11/2 3 ):MILD TR,N ORM

PLEURAL EFFUSION wm-1 MASS L[SION .

CHEST XRAY (2/11/2 3) : 'RIGHT GROSS
ING 111[ RI(
IN RIGHT THORA CIC CAVIT Y INFIL l'RA'I
: ILL DEFINED HETEROECHOGENIC LESION
USG ABDOM EN AND PELVIS (3-11-2 3) OF LIVER? NEOPL ASTIC ETIOL OGY
SEGME NT OF VI AND VII RIGHT LOBE
DOME OF DIAPHR AGM AND INDENT ING
IO INVOIVI
MEDIA STINA L LESION EXTEN DING
OGENOUSLY ENHAN CING ANTER IOR AND HMll'I OMJ\)
CECTT HORAX (4/11/2 3 ):ILL DEFINED HETER DESCR IBED - NEOPL ASTIC AETIO LOGY (?Gl
,RELAT IONS AND EXTENS IONS AS
KIGHT HEMOT HORAX WITH MASS EFFECT ON AS DESCR IBED.
MODER ATE TO GROSS PLEURAL EFFUSI
SUGGESTED HPE CORRE LATION ,RIGHT
Ur.ID[· r
WITH INTER NAL SEPTA TIONS WITH .HI YIII,
MILD PLEURAL EFFUSION OF 350-40 0CC
SCREENING USG THORA X(9/11 /23 ):RIGHT
COLLAPSE AND CONS O LIDATI ON

DIAGNOSTICS) (9/11/ 23) :

HISTOPATH OLOGY REPORT(VENUGOPAL
CORE NEEDLE BIOPSY , RIGHT HEMITH ORAX MASS LESION
er GUIDED
NA NT SPINDLE CELL TUMOU H
··HISTOLOGICA L FEATURES OF A MALIG
SPINDL E CELL SA RCOMA , PRIMA RY/ SECONDARY.
.. MORPH OLOGY FAVOR ING
7/8, G3, HIGH GRADE.
- HISTOLOGICAL GRADE (FNCLC C): 2+3+2=
AND
ST: IHC STUDY FOR CONFI RMATI O N, TO R/O SPINDLE CELL SARCO MA
- SUGGE FOR TUMO UR TYPIN G

PLEURAL FLUID CULTU RE:NEGATIVE

PLEURAL FLUID CBNAAT :NEGA TIVE
CE OF MALIG NANT/A TYPICA L CELLS
PLEURAL FLUID CELL BLOCl<:NO EVIDEN
SPUTU M CBNAt..T:NEGATIVE
SPUTU M C/S:NO GROW TH

ljeatm ent:
Medica tions:
F/B
INJ CEFGLOBE 5 1.5 GM IV 1-0-1 X 6 DAYS
 'A
"/I NO
•~:~c ➔'
t'f 1V J.-0-0
-;,26~5-;-;18;;;0;8//~48~Si66;10J______C ~ : - - - - - - - - - - - - - - - - - - -- ~
/O l-0-1 X 3 DAYS

~r-/RdlVIG~G p/0 1-0-1

NAME : Mr.CHANDAN KUMAR MN
~
~j,
DOI O 5SO Iii X
UN 1-l-l
DUO . _
11
INH/\LEX l·
Pl\ TCH roR L;MI 1-0-1 X 3 DAYS
ULTRACET S AMP JV STAT
TRAMADOL 1
apeutics: NIL
piratory rher
sive care : NIL
piratory lnten
nsfusion (if any): NIL
d Product Tra
.. f atient at time of discharge:
d1t1on o p , . zzCPM BP:130/80 MMHG MMHG SP02: 98%AT ROOM AIR RS:BILATERAL AE+,RIGHT DECREASED
122 llPM hR -
TH souN DS+
upport requirement: NONE
en & others
e (at advice/ against advice): AT REQUEST
of Discharg

·a1 Instructions :
RRED TO KIDWAI CANCER CENTRE BANGLORE AT REQUEST FOR FURTHER MANAGEMENT-FOLLOW UP WITH ONCOLOGIST IN

Al BANGLORE

~.. . . . . . .
se seek doctor's opinion or emergency medical services In case of warning signs like new onset or worsening of symptoms
ough, wheezing, breathlessness, chest pain or increase in sputum/phlegm, coughing blood in sputum.

Resident: Dr. SHAM NAZ, DR MOHIT

eon discharge has been explained to patient and relative {NAME: CH ETHAN KUMAR MN , RELATIONSHIP: BROTHER).

VOi.VJ Verified By: DR. SHAMNAZ

MA)
E OF EMERGENCY/URGENCY PLEASE CALL 0821-2335000 OR VISIT EMERGENCY SERVICES AT GROUND FLOOR OF HOSPITAL
IS OPEN 24x7x365
I YING OUR EMERGENCY AMBULANCE HELPLINE NUMBER TO SEEK MEDICAL HELP: 14455 {24/7).

147mg/dl [ 70-140mg/dl]

21mg/dl [ 12.6-42.6mg/dl]

0.85mg/dl [ 0.7-1.3mg/dl]

4.4mg/dl [ 34-7mg/dl]

138mEq/L [ 136-145mEq/L]

44mEq/L [ 3.5-5.lmEq/L]

M.G Road, Mysuru -570 004, ~: 0821-23355-55 JSSH/ADM/Ol

Fax 0821-2335556 Email: contact@jsshospital ,n Website· ½'WW.jsshospital.in
 ~~ -- "'"°'I"'"° NAME Mr.CHANDAN KUMAR MN
Chloride

--
NAME
101mEq/L ( 98-107mEq/L]
3.7g/dl i 3,S-S.2g/dl]

Mr.CHANDAN KUMAR MN )Sf'!TJ

:E TO LIFE
- --
sag BY Clia ( Chemiluminescence
croparticle 1mmuno Assay)
/ E5TIGATION DONE:

testing sequence
CMIA FOR HBsAG
Albumin 64gm/dl i 6-8.3gm/dl I NON REACTIVE
PORT: HBsAG
Total Proteins 1.4NONE [ 1.2-1.SNONE] 0.21
:o (samp le RLU/ Cuttoff RLU)
A/G Ratio 19U/L [ -40U/L I S/CO <1.00 (NON REACTIVE) 5/CO >=l.00 (REACTIVE)
rERPRETATION
Ast(Sr,ot) 0.70mg/dl [ -0.2mg/dl] ARCHITECT -ABBOTT - (2nd Generation kit)
. N/\ME :
Bilirubin Direct CLIA is a screening assay. Reactive samples may be confirmed by
llU/L [ -41U/L]
Alt(Sgpt) OT NOTE confirmatory tests.
117U/L [ 40-129U/L]
Alkaline Phosphatase 1. For diagnostic purposes, results should be used in con1unctio0 with
l.34mg/dl [ -1.2mg/dl] clinical history and other hepatitis markers. 2. This test shall not be used as a
Bilirubin Total
sole criterion for diagnosis of HBV infection. Reactive sample should be
Anti Hcv By Clia ( Chemiluminesce nce confirmed with PCR for HBV DNA . 3. Persistence of HBs Ag for more than sox
Micro particle lmmuno Assay ) >TE:-
months indicates development of carrier state or chronic liver disease. 4 For
CM IA FOR ANTI HCV
INVESTIGATION DONE diagnostic purposes, results of HBs Ag test should be used in conjunction with
NONREACTIVE clinical history and sample should be tested for other hepatitis markers
REPORT: ANTI HCV
0.08 Jcalcitonin By Elfa (Microbiology)
S/CO (Sample RLU/Cuttoff RLU)
S/CO <1.00 (NON REACTIVE) 5/CO >=1.00 (REACTIVE) 0.41 ng/ml
INTERPRETATION ,served Value
CLIA is a screening assay. Reactive samples may be confirmed by VIOAS BRAHMS PCT(BIOMERIEUX)
" NAME:·
FOOT NOTE confirmatory tests.
• Bacterial infection - absent • Initiation of antibiotics - strongly
ARCHITECT - ABBOTT - [3rd Generation kit) T value·· O.lngm/ml:- discouraged
KIT NAME:
: , These antibody titre are high during the acute phase, decrease along t~T value- 0 1_0 _2Sngm/ml • Bacterial infection - unlikely • Initiation of antibiotics - discouraged
illness as lgG antibodies appear. In chronic hepatitis, however lhe spikes of ·
• Bacterial infection - possible • Initiation of antibiotics- recommended
anti Hbc lgM synthesis are present, confirming the reactivation of HOV in ·1 value- 0.26-0.Sngm/ml
hepatocytes with perma nent lgM low titres. • Indicator of pa st or present • Bacterial infection - suggestive • Initiation of antibiotics- strongly
infection, but does not differentiate between Acute/ Chronic/ Hcsolved T value- >0.5ngm/ml recommended
infection. Routine screening of low and high prevalence populations includi~ • If PCT =0.25ngm/ml - discontinue antibiotic • For cases of sepsis 1n ICU 11
NOTES:- blood donors is recommended. • HCV RNA PCR is recommend ed in all re,c1t1hen to stop antibiotic?: PCT <0.5ngm or PCT drops >=80% - discontinue antibiotics
results to differentiate between past and present infection. • False positive
results are seen in autoimmune diseases, Rheumatoid factor, ed iclion of antibiotic response in • If PCT values decrease by 10% everyday- good response to antib1ot1c
Hypergammaglobulinemia, Paraproteinemia, passive antibody transfer, in thi tie nts started • If PCT values remains same or increases - antibiotic treatment failure
presence of Anti- idiotypes & Anti superoxide dismutase enzyme. • f'alsc p (B io) 221.78mg/l [ -5mg/l]
negative results are seen during early phase of infection, lmmunosuppressioe .
& lmmuno-incompetence > (H aemoglobin) 14.0g/dl [ 13-16.5g/dl]
Anti Hiv By Clia I Chemiluminescence : (Total Leucocyte Count) 13720Cells/cumm [ 4000-llOOOCells/cumm]
Microparticle lmmuno Assay) : (Die) - Differential Count
INV[ STIGATION DONE: CMIA FOR ANTI HIV iutrophils 85.5
REPORT: ANTI HIV NONREACTIVE mphocytes 7.8
S/CO (sample RLU /Cutoff RLU) 0.15 » inophils 1.6
INTERPRETATION onocytes
S/CO < 1.00 - NON REACTIVE S/CO >= 1.00 - REACTIVE 4.9
coot Note: CUA is a screening assay .Reactive samples may be confirmed by iso ph ils 0.2
confirmatory tests
:v/Hct (Packed Cell Volume/
KIT NAME 42.8% ( 40A8% ]
ARCHITECT - /\BBOTT. - (4th Generation kit) aem atocrit)
oc Count 4 74million/cumm [ 45-5.Smillion/cumm]
1. A Non Reactive result does not exclude the possibility of exposure or atelet Count
2.35Lakh/cumm [ l.5-4.5Lakh/cumm]
NOTES: infection with HIV 1 and/or HIV 2. 2. Samples that are repeatedly reactive ~y lcv (Mean Corpuscular Volume)
ELISA and negative with rapid card tests repeat sample should be tested a ICI 90.4fl [ 83-lOlfl I
false A molecular
months. or
3 to 6negative false positive or a we~tern
testissues blot test will
3. Confidentiality, appropriate
th
help to resolve e -------------------------------:-------:JS Slil/lilli/01
counselling and Medical evaluation to be considered an essential aspect ol l11
JSSH/ ADM/01
M.G. Road, Mysuru - 570 004, ~: 0821-2335555
Fax: 0821-2335556 Email: contact@jsshospital.in Website· www.jsshospital.in
 ?
~~ --- 2651808 / 485610 }1AMt Mr.CHANOAN KUMAR MN
; / 1 ~-
,rrAL
["'0,"' m,,., I""'" :::-:::J""' ~ •'·'"'"" ""•'" •, ~~ tafn
........;·.:
!stiP,ation oonc
Gram Stain
Moderate n number
M ch (Mean Corpuscular Haemoglobin) 29.Spg I 27-32pg I Jrnrnatorv cells
Plenty in number
345
M chc (Mean Corpuscular Haemoglobin 32 _7 /di I 315 _ / di I hclial Cells
Gram Positive Cocci ~ Chains
Concentration) g g ;rnisms
13.7% I 11.6-14% I Gram Positive Bae1
Rd w Cv (Red Cell Distribution Width)
11730/µL [ 2000-7000/µL j Bartlett Score - 0
Neutrophilstt (Anc)
1070/µL [ 1000-3000/µL j
/Zn Stai n
l yrnphocytesll (Ale) Acid fast Staining for Mycobacter,a
220/µL I 20-500/µL j istiP,ation oonc
Eosmophilstt (Aec) AFB NOT SEEN
670/µL [ 200-1000/µL j a rt
Monocytes# (Arne) AFB/ZN STAIN (Gabbets Method:
30/µL [ 20-100/µL j thod
8a5ophil,U (Abe)
Prothrombi n Tim e
Urine Specific Gravity 14.1
1.018
URI NE SPECI FIC GRAVITY 13.5
trol
Urine Sugar (Glucose) 1.05
: Negative
1.1
io
Urine - Albumin ( Protein )
l+ e :-
11-2023
Urine - Ketone Bodies
Negative Thorax
Urine Urobilinogen
Negati ve
Urine - Microscopy
!DINGS AND IMPRESION
0-1
RB CS
3-4
Pus Cells
Epithelial Ce lls
0-1 ht moderate pleural effusion of volume ~
750 cc with internal septae noted in right pleural cavity with
Nil lapse/ consolidation of underlying lung noted. Heteroechogenicity w i th no e / o internal vasculanty
Casts :ed in right hemithorax. * Suggested CECT thorax for further evaluation.
Nil
Crystal s
Nil
Oth ers
Urine Nitrite
Negative 1
pleural cavi ty appea rs clear.
Urine Leucocytes
Negative
Urine Ph Kavya BT
1sultant Radiologist
Urine Colour
Amber
jlucose 88.00rng/dl [ 50-70mg/dl)
Urine Bilirubin •rotein
Negative
URiNE BILIRUBIN ;erved Value: 4.90
Urine Clarity :hloride 103 60mmol/L [ 116-122mrnol/L)
Clear
URINE CLARITY
1/Zn Stain
Koh Preparation KOH Prepration est iP,at,on Done Acid fast Staining for l\lycobacteria
Investigation Done
Fungal Elements, NOT SEEN
Report
JSSH/ADM/01
M.G. Road, Mysuru - 570 004 ii : 0821-2335555
Fax· 0821-2335556 Ema1. contact@Jsshosp1tal in Website www.jsshospital.in
RlG/IP NO
2651808 / 485610
NAME
AFB NOT SEEN

Mr.CHANDAN KUMAR MN ;~
)SPtfAt
:t .

7651808 / 485610 NAME

No calculi / hydronephros1s or focal lesions seen
Mr CHANOAN KUMAR MN
Report NARY BLADDER: Partially distended. No e/o calculi
AFB/ZN STAIN (Gabbets Method)
Method
,sTATE: Volume J2 cc, rt ,s normal ,n Sile and echote,ture
Gram Stain
Gram Stain
Investigation Done ER FINDI NGS: No asc,tes noted Visualised bowel loops appear norf'lal
Few in number
Inflammatory cells
Not Seen
Organisms
RESSION :
Plenty of RBCs seen
, Ill defi ned heteroechoic. lesion in the_ right thoracic ~avity infiltrating the right dome of diaphragm and indenting
Koh Preparation segment VI and VU of ri ght lobe of liver-? Neoplastic etiology. • Suggested CECT thorax for further evaluation.
KOH Prepration
Investigation Done
Fungal Elements: NOT SEEN
Report
Cell Block
CB 508/23 BF 1978/23 Pleural Fluid Dr. Kavya BT, MD, DNB.
MACRO -farisha Consultant Radiologist
Sections show sheets of lymphocytes admixed with few neutrophils and or Resident
occasional mesothelial cells in the background of acellular eosinophilic
M ICRO
material. No atypical cells/ malignant cells in the section studied.
Csf Pleura l Ascitic & Oth ers - Cell Count
.1-2023
& Cell Typ e
expert - Ceph ei d M tb/Rif Ultra
BF - 1978/2023 Pleural fluid - 10ml of hemorrhagic aspirate.
SpccimPn Cartridge Based Nucleic Acid amplification test
stigation Done
Cell Count 240
MTB - NOT DETECTED
Smear shows predominantly lymphocytes(95%) and neutrophils (5%) w. ort MTll:
GeneXpert - Cepheid MTB/RIF Ultra detects the ampli: ,ed DNA of MTB
Cell lype mesothelial cells in singles in a background of RllCs.
complex and Rifampicin resistance gene in respiratory and e,tra pulmoeary
Malignant/Atypical Cells : No atypical cells seen in the smears studied specimens. RIF Resistance Detected: Results that are positive for MTBC and •or
RIF resistance mean that the bacteria have a high probability of resistance to
Ad a (Seru m/At/ Pf)
RIF. This should be confirmed by additional rapid testing. • RJF resistance 1s
Ob,crved Value 27.8 confirmed, rapid molecular testing for drug resistance to bott> f,m ine and
second line drugs should be performed so that an effective treatment regimen
Ldh ( Af/ Pf)
can be selected. RIF Resistance Not Detected : Results that are pos1t1ve for
LOH ( AF/PF ) 1632.00 rpr ctation
MTBC, but negative for RIF resistance mean that the bacteria are probably
Usg Abdomen & Pelvis susceptible to RIF. However, all tests that are positive for MTBC should have
growth-based susceptibility testing for first-line TB drugs. RIF Resistance
FI NDING~
Indeterminate: Results that are positive for MTBC and •ndettrrr,inate for RIF
LIVER: Si,e: Measures 14.0 cm. resistance that the test could not accurately determined .f the bacter a arc
Echotexture: Normal resistant to RIF. Growth- based susceptibility testing to first li~e TB drugs
Portal vein: Normal
CBD: Normal should be performed
Intrahepatic biliary radicals are not dilated.
~
An ill defin ed heteroechoic lesion measruing 15 x 8 cm noted in the right th . ~
XPERT ULTRA MTB - RIF ASSAY
dome of diaphragm and indenting segement VI and VII of ri ght lobe of liver. No signi~::~c cavity infiltrating the rig" ame
col our Doppler. t vasculanty noted on • Bacterial load below the Limit of Detection (LOD-llCFU/ ml) may result ·n
false negative result • Patients on an anti-TB regimen can still have positive
GALL BLADDER : Partially distended. No e/o calculi to the extent seen. results due to killed bacilli ,n the specimen and hence cannot be used hr
follow -up. • A positive test result does not necessarily indicate the presence of
PANCR EAS: Head and body appear normal. Tail 1s obscured by bowel gas shadows.
viable organisms. It is, however, presumptive for the presence for the
sPLEtN : Measures 9.3 cm, Normal in size and echotexture. es presence of MycobJcterium tuberculosis (MTB) and Rifampicin (Rif)
resistance. • MTB detection is dependent on the number of organisms present
Ki l>N E'l'S_; in the sample Quality specimen collection and timely processing ot the sample
RIGHT KI DN EY : Length 9.0cm Parenchyma 1.2 cm will min1m1ze the errors.• Test results might be affected by anti-TB
Kidney ,s normal ,n size, shape and pos1t1on. Cort,comedullary differentiation is mPdication. fherefore, therapeutic success or failure cannot be assessed using
No calculi / hydronephros1s or focal lesions seen. rnainta1nect.
this test. because DNA might persist following antimicrobial therapy •
LEFT KIDNEY: Length 9. !cm Parenchyma 1.2 cm
Kidney ,s normal ,n size, shape and pos1t1on.
JSSH/ADM/01
MG. Road, Mysuru - 570 004 V 0821-2335555
Fax 0821-2335556 Email contact@Jsshosp1tal.in Website. www.Jsshospital
 --~-~==~
LREG~P NO . 1 morphisms
NAME
~~==~26~5~18~08~/G4~8~56~10~--:-;--.::=::~~~;;;:;:;~;~~;;~;~-
in primer or probe binding regions may aff
Mutations or po y k
th detection of new or un nown
e .
false-negative resu • . . .
OSPJTAt
Mr.CHANDAN KUMAR MN -
Ille, 1 'ant
MDR or Rif resistant strains
. .
~~
. eq on rrcp,n
. ' resulting i
It • Results should be interpreted in conJunction w·tL 1 ·
1"
1651808

females
I 4BS610

< 5.0

< 5.0
11AM

Pregnancy (Weeks of G•;tation)

M, CHAN DAN 'UMIIP MN

Weeks 5 TO 100
clinical data available to the clinicians.
Weeks 200 TO 3000
06-11-2023 10000 TO 80000
Weeks
small Size· Biopsy (< 2cm)
Right Hemithoracic mass.
ro 14 Weeks 90000 TO 500000
Site of Biopsy 5000 TO 80000
TO 26 Weeks
R' ht sided moderate pleural effusion.
Clinical Diagnosis ig . . . TO 40 Weeks 3000 TO 15000
. • ts of a single grey white tissue core measunnr, 2.3 x O
Specimen cons1s ·2\phoblastic Disease > 100000
MACRO (All embedded )
. Sections show spindle cells arranged in interlacing fascicles. Areas of , (Scrum) 500U/L [ 135-225U/L)
MICRO ~ecrosis are also noted. Features are suggestive of Spindle cell tumour. l ( Alpha Feta Protein)

Biopsy, Right Hemithoracic mass- Features are suggestive of Spindle cell 4.2
DIAGNOSIS tumour.
y Warn ing Si&!'.i'
Recommended lmmunohistochemistry for definitive diagnosis. e
REMARKS ise ,erk doctor's opinion or emergency medical services In case of warning signs like new onset or worsM rg of, "'lptor,is
7698-2023 ,e,ing, breathlessness, chest pain or increase in sputum/phlegm, coughing blood In soutum.
Biopsy No
08-11-2023 harge and Advice by: Dr.MAHESH PA

Hb (Haemoglobin) 12.2g/dl [ 13-16.Sg/dl ]

d Resident· Dr. SHAMNAZ, DR MOHIT
Tic (Total Leucocyte Count) 10680Cells/cumm [ 4000-llOOOCells/cumm I ce on discharge has been explained to patient and relative (NAME: CHETHAN KUMAR 'AN RELATIONSH? 8RO'l-lER

De (Die) - Differential Count ,ared By: DR. MOIIIT Verified By: DR. SHAMNAZ
Neutrophils 71.0
13.7 1\5£ OF EMERGENCY/URGENCY PLEASE CALL 0821-2335000 OR VISIT EMERGENCY SERVICES AT GROUND FLOOR OF HOSPITAL
Lymphocytes CH 15 OPEN 24x7x365
Eosinophils 8.3 OUR EMERGENCY AMBULANCE HE LPLI NE NUMBER TO SEEK MEDICAL HELP: 14455 (24/7).

Monocytes 6.4

Basophils 0.6

Pcv/Hct (Packed Cell Volume/ I

36.6% I 40-48%
Haematocrit)
Rbc Count 4.14million/cumm I 4.5-5.Smillion/cumm)

Platelet Count 3.4Lakh/cumm I 1.5-4.5Lakh/cumm )

Mcv (Mean Corpuscular Volume) 88.4fl I 83-lOlfl I

Mch (Mean corpuscular Haemoglobin) 29.4pg I 27-32pg I

Mchc (Mean Corpuscular Haemoglobin

33.3g/dl I 31 .5-34.Sg/dl I
Concentration)
Rdw Cv (Red Cell Distribution Width) 14.0% I 11.6-14% I

Neutrophilstt (Anc) 7590/µL [ 2000-7000/µL j

Lymphocytes/I (Ale) 1460/µL [ 1000-3000/µL j

Eosinophilstt (Aec) 890/µL [ 20-500/µL)

MonocytesU (Ame) 680/µL I 200-1000/µL I

Basophils/1 (Abe) 60/µL I 20-100/µL I

10-11-2023
Beta Hcg
<0.100
B HCG.
REFERENCE RANGE (mlU/ml)
JSSH/ ADM/01
M.G. Road, l'vlysJru- 570 004, fl: 0821-2335555
Fax· 0821-2335556 Email. c,ontacl@Jsshospitc11 n Website www.Jsshospital 1n
 FORM/OOC/04

- .- _ ,...._,_"""1(.-r.u,.,T,!7' nno~Dli'"-~ "NOTES

~BH.0000067089* 7 y doctor)
----------,
KA.'1BH ·000006 7089
1tlenf• Narne: .. ... Mr. CIIA.'iOAN KUMAR MN
Age/Gender:JI Yrs/\1afe .
Block/V Reg. Date: 13 11,ov 2023 HID No. :................................. .
ender: MfF/O Ph No.: 91-9886959960

------------ NOTES & TREATMENT

1\.t ~GU .J\eW '

- 1rr3 fvu_~c,_~ ~ q; ~~

P+ u aQ.M:teM
~~01 ~ lg,o

s4rr ', 31° 0

u:~-®
A,~r: /lo, 0 JP<DJ - f oo-j- ~ 8~ti
AL~~n: 31I . ~JR . T c.v-kt,__g

t39, 0
'\OkJ r~J~~ ~ ~ o er [1 -+k.L,~ ~ 'l-S" '-'\ t V
~(l~
1 ,1;·,o,~
~~)
k,f•1,Q
' I ' b· i : O· 3
cJJ . /()~10 ~ u
I ~ ~•~010,

C'ft.o.J-', \, o
09~r ~~
\.lC) r·· c:1 90 1
{WF~
me and Signature of consu/ta
reassessment's :
~s· ,,
Date and Time : =~~d Signature of consultant supervis ng the above Date and Time :
---.n,ent'a:

L
 Reg Duhi: U Nov, lUl-'

}MBi'i'.00000°61os9*
KA '\ilBI 1.0000067089 N
ANKUl\lARM .
l\lr. CHAND •3 1 Vrs/Mnle

J
~ge/Gen~e~~'"'" """or.
16-Nov-23 03: 12

PATI ENT IN FORMAl ION

Patient ID

Accession Number
DOB:
Sex: Unknown
Temperature: 37.0 C

Sample No.: 660

ACID/BASE
pH 7.480
PC02 ! 26.6 mmHg
P02 102.5 mmHg
BE ! -3 .2 mmol/L
tC02 ! 20.2 mmoljL
HC03 19.4 mmoljL
stHC03 t 21.7 mmol/L
ELECTROLYTES
Na+ 135. 7 mmoljL
K+ ! 3.30 mmol/L
Ca++ 1.19 mmol/L

HEMOGLOBIN/OXYGEN STATUS
tHb 9.2 g/dl
so2 ss.2 %
Hct(c) ! 27. 7 %
ENTERED PARAMETERS

Barometer: 694.6 mm Hg
User ID:
ADMIN
Lot: 335415
S/N:5263
Version: 2.00.0009

REFERENCE RANGES
pH 7.200 • 7.600
PC02 30.0 · 50.0 mmHg
P02 70.0 · 700.0 mmHg
Na+ 135.0 · 145.0 mmol/L
K+ 3.50 · 5.10 mmoljl
Ca++ 1.13 · 1.32 mmoljl
tHb 12.0 · 17.0 g/dl
S02 90.0 • 100,0 %
MESSAGES
PC02 under 30.0 (Ref.Lim).
K+ under 3.50 (Ref.Lim).
tHb under 12.0 (Ref.Lim).

Reminder: HbCal due.

DATE& TIME T
OF VISIT NOTES &TREATMEN

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