biopsy

A 3-year-old child is brought to the paediatric clinic by their parents due to a 2-month history of increasing abdominal distension, poor appetite, and occasional constipation. On physical examination, a firm, irregular mass is palpable in the upper abdomen, crossing the midline. Vital signs are stable. Initial blood tests, including full blood count and liver function tests, are within normal limits. An abdominal CT scan is performed (image provided). Considering the findings demonstrated in the image, which of the following investigations represents the most appropriate next step in establishing a definitive diagnosis and guiding further management?

A 72-year-old woman, status post mastectomy, presents with a lesion. What is the MOST appropriate initial diagnostic test?

A 45-year-old male presents with a 3-month history of cough and unintentional weight loss. He is a former smoker. Physical examination is unremarkable. A chest X-ray showed a nodule, and a PET-CT was performed for further characterisation, an axial view is shown. Considering the imaging findings and clinical presentation, what is the MOST appropriate next diagnostic step?

A 35-year-old male presents to his general practitioner complaining of a persistent, asymptomatic lesion on his nose that has been present for approximately 6 months. He denies any trauma to the area. He reports no other skin issues or systemic symptoms. Physical examination reveals the lesion shown. The patient is concerned about cosmetic appearance and potential for malignancy. What is the MOST appropriate initial management step?

A 35-year-old male presents with a painless lesion on his nose that has been present for several months. He denies any trauma or recent illness. Examination reveals the image shown. What is the most appropriate initial management?

A 45-year-old woman with a suspicious breast mass on mammography undergoes a biopsy, which confirms invasive ductal carcinoma. She is referred to an oncologist for further management. What is the next step in her management?

A 72-year-old woman presents with a 6-month history of a non-healing rash on her chest wall at the site of a previous mastectomy performed 10 years prior for invasive ductal carcinoma. She completed adjuvant chemotherapy and radiation. Examination reveals the findings shown. What is the MOST appropriate next step in management?

A 65-year-old patient with a history of smoking presents with a chronic cough and mild weight loss over three months. Physical examination is unremarkable, and vital signs are stable. Routine blood tests, including full blood count and inflammatory markers, are within normal limits. A chest X-ray revealed a solitary pulmonary nodule in the right upper lobe. Subsequent PET-CT imaging was performed as part of the diagnostic workup. Considering the findings demonstrated in the image provided, which of the following is the most appropriate next step in the management of this patient?

A 68-year-old male with known Hepatitis B related cirrhosis and a history of alcohol excess presents for routine surveillance. His alpha-fetoprotein (AFP) level, which has been stable at 15 ng/mL for the past two years, is now noted to be 185 ng/mL. A screening ultrasound performed three months prior was reported as showing diffuse parenchymal changes consistent with cirrhosis but no focal lesions. Due to the elevated AFP, a repeat ultrasound was performed, which identified a 2.5 cm nodule in segment VIII. To further characterise this lesion, a contrast-enhanced ultrasound (CEUS) was performed, and the images provided are representative findings from this study. The patient has well-compensated cirrhosis (Child-Pugh A) and no significant comorbidities. His liver function tests are within normal limits except for a slightly elevated GGT. Given the clinical context and the findings demonstrated in the provided images, what is the most appropriate next step in the management of this patient?

A 68-year-old former smoker with a 30 pack-year history presents to their GP with a 2-month history of persistent cough and increasing fatigue, noting a 3kg unintentional weight loss. Physical examination is unremarkable, and vital signs are stable. Routine blood tests, including full blood count and inflammatory markers, are within normal limits. A chest X-ray reveals a solitary pulmonary nodule in the right upper lobe. Subsequent PET-CT imaging is performed as part of the diagnostic workup. Considering the findings demonstrated in the image provided in the context of this patient's presentation, which of the following is the most appropriate next step in the management of this patient?

A 65-year-old woman presents with a chronic, non-healing lesion at the site of her mastectomy scar, performed 7 years ago. She denies pain but reports occasional itching. What is the MOST appropriate next investigation?

A 68-year-old male presents with fatigue, weight loss, and vague abdominal discomfort. His past medical history includes a recent diagnosis of gastric mixed adenoneuroendocrine carcinoma (MANEC). The provided image was obtained as part of his staging workup. Which of the following is the MOST appropriate next step in management?

A 55-year-old man with a history of renal transplant on immunosuppression presents with a 2-week history of low-grade fever, malaise, and dull right upper quadrant discomfort. Physical examination is unremarkable except for mild tenderness on deep palpation of the right upper quadrant. Blood tests show a mild leucocytosis and elevated CRP. Imaging is performed. Based on the clinical presentation and imaging findings, what is the most appropriate next diagnostic step?

A 42-year-old woman, nulliparous, presents to her general practitioner with a palpable lump in her left breast, noticed two weeks ago. She reports some mild, intermittent tenderness associated with the lump, which she initially attributed to her menstrual cycle, but it has persisted. She has no significant family history of breast cancer. On examination, there is a 1.5 cm, firm, mobile lump in the upper outer quadrant. No skin changes or nipple discharge are noted. Axillary nodes are not palpable. She is otherwise well. Which of the following represents the most appropriate initial management step?

A 70-year-old woman presents with a lesion on her chest wall at the site of a mastectomy performed 10 years prior. She reports it started as a small area of redness and has slowly enlarged. What is the MOST likely diagnosis?

A 40-year-old man presents with a solitary, asymptomatic nodule on his nose. Biopsy reveals perivascular eosinophilic infiltrate. What is the MOST likely diagnosis?

A 35-year-old man presents with a painless lesion on his nose, present for 6 months. Examination reveals the image shown. What is the MOST likely diagnosis?

A 68-year-old male presents with dysphagia and weight loss. Gastroscopy and biopsy confirm gastric adenocarcinoma. Staging CT imaging is shown. His ECOG performance status is 1. Considering the clinical presentation and the findings demonstrated in the provided images, what is the most appropriate initial management strategy for this patient?

A 58-year-old male presents with iron deficiency anemia and a change in bowel habits. A colonoscopy was performed, and the image is shown. Biopsies were taken. Assuming the biopsies confirm malignancy, what is the next step?

A 58-year-old male with cirrhosis presents for routine surveillance. His AFP is elevated. A CT scan with contrast is performed (image attached). What is the MOST appropriate next step to determine definitive management?

A 4-year-old presents with abdominal distension, pain, and weight loss over several weeks. On examination, a firm, irregular abdominal mass is palpable. Blood tests show mild anaemia. The provided image is an axial CT slice of the abdomen. Considering the clinical presentation and the findings demonstrated in the image, which of the following investigations is the MOST appropriate initial step to establish a definitive diagnosis?

A 65-year-old patient with a history of smoking presents with a chronic cough and mild weight loss over three months. Physical examination is unremarkable, and vital signs are stable. Routine blood tests, including full blood count and inflammatory markers, are within normal limits. A chest X-ray revealed a solitary pulmonary nodule in the right upper lobe. Subsequent PET-CT imaging was performed as part of the diagnostic workup. Considering the findings demonstrated in the image provided in the context of this patient's presentation, which of the following is the most appropriate next step in the management of this patient?

A 72-year-old patient presents with a 4-month history of tenesmus and occasional bright red rectal bleeding. Colonoscopy was performed, and a representative image is shown. Biopsies confirm adenocarcinoma. Considering the likely stage suggested by the endoscopic appearance, which investigation is MOST crucial for pre-operative staging?

A 55-year-old woman undergoes routine screening mammography. She is asymptomatic with no personal or family history of breast cancer. Physical examination is unremarkable. The provided image is a magnified view from the craniocaudal projection of the right breast. Based on the findings demonstrated, what is the most appropriate immediate next step in the management of this patient?

A 70-year-old male with known cirrhosis secondary to non-alcoholic fatty liver disease presents for routine surveillance. He has Child-Pugh class A cirrhosis and ECOG performance status 0. His recent surveillance ultrasound showed a new 3 cm lesion in segment VIII. Serum alpha-fetoprotein is elevated at 450 ng/mL. A contrast-enhanced ultrasound was performed, and representative images are shown. Considering the patient's history, clinical status, laboratory results, and the findings demonstrated in the contrast-enhanced ultrasound images, what is the MOST appropriate immediate next step in the management of this patient?

Mr. Arthur Jenkins, a 72-year-old retired accountant, presents to his GP complaining of a change in bowel habit over the past 4 months, now experiencing increased frequency and occasional loose stools mixed with some mucus. He also reports intermittent small amounts of bright red blood on the toilet paper, which he initially attributed to haemorrhoids. He denies significant weight loss or abdominal pain. His past medical history includes hypertension well-controlled on medication and osteoarthritis. On examination, his abdomen is soft and non-tender, and digital rectal examination is unremarkable. Routine blood tests, including FBE and LFTs, are within normal limits. A faecal occult blood test is positive. Given these findings, a colonoscopy is arranged. The image provided was captured during the procedure. Considering the patient's presentation and the findings observed during the colonoscopy as depicted in the image, what is the most appropriate immediate next step in the management plan?

A 65-year-old male presents with fatigue and occult blood in stool. Colonoscopy reveals the lesion shown. Biopsy confirms adenocarcinoma. What is the MOST appropriate next investigation to determine disease stage?

A 62-year-old man presents with a painless lesion on his nose, present for 8 months. He denies trauma or fever. Examination reveals the image shown. Histopathology is MOST likely to show which of the following?

A 35-year-old man presents with a painless lesion on his nose that has been present for several months. He denies any trauma or recent illness. Examination reveals the image shown. What is the most appropriate initial management?

A 45-year-old man presents with the finding shown. He denies pain but is concerned about its appearance. What is the MOST appropriate initial step?

A 50-year-old woman with a breast lump undergoes a mammogram, which shows microcalcifications. A core biopsy confirms ductal carcinoma in situ (DCIS). What is the most appropriate next step?

A 35-year-old woman presents with a 2cm, firm, mobile lump in her left breast, noticed two weeks ago. She is otherwise well. What is the most appropriate initial investigation?

A 55-year-old man presents to his GP with a lesion on his nose that has been slowly enlarging over the past 4 months. He reports no associated pain, itching, or bleeding. He is otherwise well, with no significant past medical history. On examination, vital signs are within normal limits. The lesion is as shown in the image. Considering the clinical presentation and the appearance of the lesion, what is the most appropriate initial step in the management of this patient?

A 50-year-old man presents with a slowly growing nasal lesion. Examination reveals the image shown. What is the MOST appropriate initial management?

A 35-year-old man presents to the clinic with a 3-month history of fatigue, weight loss, and night sweats. He has no significant past medical history and does not take any medications. On examination, he has palpable cervical and axillary lymphadenopathy. A lymph node biopsy reveals Reed-Sternberg cells. What is the most likely diagnosis?

A 68-year-old woman presents to her general practitioner with a persistent, pruritic rash on her chest wall. She reports a history of left mastectomy for invasive ductal carcinoma 8 years ago, followed by adjuvant chemotherapy and radiation therapy. She denies any recent trauma or changes in soaps or detergents. Physical examination reveals the findings shown. A punch biopsy is performed. Which of the following immunohistochemical stains would most likely be positive in this patient's biopsy sample, supporting the suspected diagnosis?

A 55-year-old man presents to the clinic with a 3-month history of fatigue, weight loss, and night sweats. He has no significant past medical history. On examination, he has palpable lymphadenopathy in the cervical and axillary regions. Blood tests reveal a hemoglobin level of 10 g/dL, white blood cell count of 15,000/mm³ with a predominance of lymphocytes, and a platelet count of 150,000/mm³. A lymph node biopsy is performed, showing small lymphocytic lymphoma. What is the most appropriate initial management for this patient?

A 35-year-old male presents with hemoptysis and weight loss. PET-CT is shown. Bronchoscopy with biopsy is MOST likely to reveal which of the following?

A 45-year-old male presents with a painless lesion on his nose that has been present for 6 months. He denies any trauma or previous skin conditions. Examination reveals the lesion seen in the image. What is the MOST appropriate next step in management?

A 72-year-old woman presents with a persistent, slowly expanding skin lesion on her right chest wall, present for several months. She underwent a right mastectomy for invasive ductal carcinoma 12 years ago. She denies pain, discharge, or systemic symptoms. Physical examination reveals the appearance shown. Considering the patient's history and the clinical finding, which of the following investigations is most appropriate to assess for potential underlying malignancy or systemic involvement?

Mrs. Eleanor Vance, a 62-year-old retired teacher, presents for her routine biennial screening mammogram through the BreastScreen Australia program. She has no personal history of breast disease, and her family history is negative for breast or ovarian cancer in first-degree relatives. She is otherwise healthy, with a history of diet-controlled type 2 diabetes and osteoarthritis managed with paracetamol. She denies any breast pain, lumps, nipple discharge, or skin changes. Her last mammogram two years ago was reported as normal (BIRADS 1). Physical examination of both breasts and axillae is unremarkable. The current screening mammogram is performed. The image provided is a magnified view from the craniocaudal projection of the left breast, specifically highlighting an area that has been flagged for further assessment by the reporting radiologist due to a change from the previous study. Based on the appearance of the abnormality demonstrated in the provided image, which is the most appropriate method for obtaining a tissue diagnosis?

A 58-year-old male presents with fatigue and iron deficiency anemia. Colonoscopy reveals the image shown. Biopsies are taken. Assuming pathology confirms malignancy, what is the MOST appropriate next investigation to determine disease stage?

A 45-year-old male presents with a painless lesion on his nose that has been present for several months. He denies any trauma or recent illness. Examination reveals the image shown. What is the MOST appropriate initial management?

A 68-year-old woman presents with a persistent, pruritic rash on her chest wall at the site of a previous mastectomy performed 8 years ago for invasive ductal carcinoma. She completed adjuvant chemotherapy and radiation at that time. Examination reveals the area shown. What is the MOST appropriate next step in management?

A 55-year-old man presents to the clinic with a 3-month history of fatigue, weight loss, and abdominal discomfort. He has a history of chronic hepatitis B infection. On examination, he has mild hepatomegaly and jaundice. Blood tests reveal elevated liver enzymes and alpha-fetoprotein levels. An ultrasound of the abdomen shows a 3 cm lesion in the right lobe of the liver. What is the most likely diagnosis?

A 55-year-old man presents to the clinic with a 3-month history of worsening cough, weight loss, and night sweats. He has a 30-pack-year smoking history and worked in construction for 20 years. On examination, he has clubbing of the fingers and decreased breath sounds in the right lower lung field. A chest X-ray shows a right lower lobe mass. What is the most appropriate next step in the management of this patient?

A 35-year-old male presents with a two-month history of fatigue, unintentional weight loss, and a persistent dry cough. He denies fever or night sweats. A PET-CT scan of the chest was performed (image shown). What is the MOST appropriate next step in management?

A 72-year-old woman presents with a 6-month history of a non-healing rash on her chest wall at the site of a previous mastectomy performed 10 years prior for invasive ductal carcinoma. She has completed adjuvant chemotherapy and radiation. Examination reveals the findings shown. What is the MOST appropriate next step in management?

A 3-month-old baby presents with abdominal swelling and constipation. A rectal biopsy shows the absence of ganglion cells. What is the most likely diagnosis?

A 70-year-old male with cirrhosis secondary to NAFLD presents for routine surveillance. A new 3 cm lesion was found in segment VIII on ultrasound, with AFP 45. Contrast-enhanced ultrasound was performed, with representative images shown. Considering the clinical context and the findings demonstrated, what is the most appropriate immediate next step in this patient's management?