Unveiling Cancer

Abstract

This article narrates a multifaceted educational journey undertaken by a medical student through a weekly SCRAPS (surgery, clinical disciplines, radiology, anatomy, psychiatry and laboratory sciences) clinico-pathological meeting held in the College of Medicine & Health Sciences at Sultan Qaboos University in Muscat, Oman. Through a presentation titled 'Unveiling Cancer', the multidisciplinary and interprofessional audience witnessed a simulated interaction between a medical student, a technologist peer and tutors in medicine, pathology and radiology. The presentation was based on the complexities of presentation, diagnosis and management of a patient with anaplastic large cell lymphoma, a rare type of non-Hodgkin lymphoma, in the aftermath of a bone marrow transplantation. After describing the case, the student shared with the audience a spectrum of learning objectives, which included integration in the complex world of contemporary medicine, insight into the triumphs and travails of technology (immunohistochemistry) and peer collaboration, communication and mentorship.

Keywords: Anaplastic Large-Cell Lymphoma; Clinico-Pathological Conference; Immunohistochemistry; Medical Education; Oman.

Figure 1A & B:

Chest imaging (A) X-ray and (B) computed tomography scan showing a right lower lobe collapse and endobronchial mass.

Figure 2A & B:

A: Computed tomography scan of the abdomen, showing an irregular mass in the right adrenal gland. B: Magnetic resonance imaging of the thigh, showing a large oval solid soft tissue mass in the medial aspect of the lower thigh.

Figure 3:

Shopping cart illustrating the panel of antibodies used for immunophenotypic characterisation of the biopsies from the bronchial and thigh masses. LCA = leukocyte common antigen; MYOD1 = myoblast determination protein 1; CD = cluster of differentiation.

Figure 4A & B:

Haematoxylin and eosin stains of biopsies from the (A) bronchial mass and (B) thigh mass showing a malignant round blue cell tumour at x100 magnification. Boxes display immunohistochemistry patterns in both biopsies: CD99, CD30 positive/LCA negative. Additional markers on the thigh biopsy clinched the diagnosis of anaplastic large cell lymphoma by immunoreactivity for ALK and CD43. CD = cluster of differentiation; LCA = leukocyte common antigen; ALK = anaplastic lymphoma kinase.