LABORATORY EXAM

Oct. 22, 2008 Radiographic Report The Lungs fields are clear. The Heart is not enlarged. The aorta is aortous and calcific. The Pulmonary vessels are within normal limits. The trachea is in the midline. Both hemidiaphragm are sharp and distinct. The osseous thoracic cage reveals no significant bony abnormality. Conclusion: ATHEROSCLEROTIC Oct. 22, 2008 Blood Chemistry RESULT INTERPRETATION FBS Normal Blood Urea Nitrogen Normal Creatinine Normal 1.03mg/dl 0.50 - 1.20 12.30mg/dl 8.00 - 23.00 85.74mg/dl 70 - 160 NORMAL VALUES

Hematology RESULT INTERPRETATION Clotting Time Normal Bleeding Time Normal Blood Type RH Typing B Positive 1130 mins. 130 mins. NORMAL VALUES 5 - 15 mins. 1 - 3 mins.

Complete Blood Count RESULT INTERPRETATION WBC Normal RBC Normal Hgb Normal Hematocrit Normal Platelets Count Normal 0.41 151 0.42 - 0.52 150 - 450 Not 144 140 - 175 4.82 4.60 - 6.00 6.6 4.00 - 11.30 NORMAL VALUES

Differential Count Neutrophiles Normal Lymphocytes Normal Monocytes Normal Eosinophiles Not Normal 0.06 0.09 0.54 0.31 0.50 - 0.70 0.18 - 0.42 0.02 - 0.06 0.00 - 0.06 Oct. 22, 2008 Urinalysis RESULT Color Transparency pH S. Gravity Protein 6.00 1.020 Trace Yellow Clear

Glucose Bilirubin Blood Leukocytes Ketone Ascorbic Acid RBC WBC Epithelial cell Bacteria Mucus Threads Sperm cell

Negative Negative Negative Negative Negative Negative 0-1 2-5 Rare Rare Many Few

Oct. 29, 2008 Histopathology Report Gross: The specimen consist of 2 fragment of tan tissue aggregately measuring 10mm. Microscopic: Section shows a malignant neoplasm made up of proliferating squamous cells possessed with round to ovoid pleomorphic and hyperchromatic nuclei some of which appear to be vesicular with prominent nucleoli surrounded by moderate amount of cytoplasm. They form solid nests infiltrating the supporting stroma 0-2 mitotic figures are seen per high power field. Diagnosis: INVASIVE SQUAMOUS CELL CARCINOMA, NON KERATINIZING. Nov. 11, 2008 Arterial Blood Gas Result RESULT INTERPRETATION pO2 Not Normal 192.4 NORMAL VALUES 80.00 - 100.00

pH Normal pCO2 Not Normal HCO3

7.417 49.6 29.5

7.350 - 7.450 35.00 - 45.00

Nov. 9, 2008 RESULT INTERPRETATION Sodium Normal Potassium Normal 137 mmol/L 3.1 mmol/L NORMAL VALUES 136 - 145 3.5 - 5.1 Not Nov. 10, 2008 Potassium Normal 3.8 mmol/L 1.5 mmol/L 3.5 - 5.1 2.5 - 6.4 71 - 115 Not Nov. 16, 2208 Potassium Normal 4.3 mmol/L 3.5 - 5.1

Blood Urea Nitrogen Not Normal Creatinine Normal

66 mmol/L

Nov. 11, 2008 CT Scan CT Scan of the Neck Multiple axial images of the chest were obtained with intravenous contrast There is a mildly enhancing lobulated soft tissue mass involving the right supraglottis region extending down to the glottis area measuring approximately 2.3 x 3.0 cm. The mass involves part of the hyoid bone and

right side of the thyroid cartilage. There is evidence of contralateral extension of the mass. The laryngeal ventricle is obliterated by the mass. There is a large 4.0 x 3.0 cm hypodense nodule seen at the right side of the neck at the level of the hyoid. This likely represents adenopathy. Thyroid gland appears normal and is unremarkable. Visualized nasopharynx appear normal Mucosal thickening is seen at the left maxillary sinus. Endotracheal tube is seen. The rest of the study is unremarkable. IMPRESSION: Large supraglottic mass. Consider malignancy with metastatic adenopathy at the right side of the neck, level 2. Suggest biopsy correlation. Left maxillary sinusitis. Nov. 17, 208 Hematology RESULT INTERPRETATION Hgb Normal Hematocrit Normal WBC RBC Differential Count Basophiles Eosinophiles Not Normal Neutrophiles Segmenters Normal Lymphocytes Normal Monocytes Normal Platelets Count 0.07 251 0.62 0.23 0.50 - 0.70 0.20 - 0.40 0.02 - 0.05 150 - 300 Not Normal 0.00 0.08 0.02 - 0.04 13.1 0.37 6.1 4.3 4 - 11 5.0 - 6.4 NORMAL VALUES 14 - 18 g/l 0.40 - 0.54 Not Not Normal Not Normal

Bleeding time Normal Clotting time Normal

330 mins. 500 mins.

1 - 5 mins. 1 - 5 mins. 10.4 - 14. 0 secs. Normal Nov 17, 2008

Prothrombin time 13.2 secs.

Electrocardiogram Heart Rate : 69bpm PR Int : 176ms QRS Duration : 80ms QT/QTC : 380/406ms P-R-T axes : 14, 13, 8 Nov. 18, 2008 Urinalysis RESULT Color Transparency pH Protein S. Gravity RBC WBC Epithelial Cell Amorphous Urates/Phospate Bacteria Mucus Few Few 1.005 0-1 1-3 Few Few 6.0 Negative Yellow Hazy