{"id":1750,"date":"2026-06-10T07:00:14","date_gmt":"2026-06-10T07:00:14","guid":{"rendered":"https:\/\/hcsp-iap.pk\/cases\/?post_type=portfolio&#038;p=1750"},"modified":"2026-06-10T09:36:20","modified_gmt":"2026-06-10T09:36:20","slug":"case-01-4","status":"publish","type":"portfolio","link":"https:\/\/hcsp-iap.pk\/cases\/monthly_cases\/case-01-4\/","title":{"rendered":"Case 01"},"content":{"rendered":"\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-gzehw6-07240162df63d1325acd86fad61de5b3\">\n.avia-section.av-gzehw6-07240162df63d1325acd86fad61de5b3 .av-parallax .av-parallax-inner{\nbackground-repeat:no-repeat;\nbackground-image:url(https:\/\/hcsp-iap.pk\/cases\/wp-content\/uploads\/2014\/09\/slider.png);\nbackground-position:50% 50%;\nbackground-attachment:scroll;\n}\n.avia-section.av-gzehw6-07240162df63d1325acd86fad61de5b3 .av-section-color-overlay{\nopacity:0.7;\nbackground-color:#0f0f0f;\n}\n<\/style>\n<div id='av_section_1'  class='avia-section 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av_three_fourth  avia-builder-el-1  el_before_av_one_fourth  avia-builder-el-first  first flex_column_div  '     ><style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-mq7n9r29-6dc52997b9bdc5178d89d264747816f1\">\n#top .av-special-heading.av-mq7n9r29-6dc52997b9bdc5178d89d264747816f1{\npadding-bottom:40px;\ncolor:#ffffff;\nfont-size:72px;\n}\nbody .av-special-heading.av-mq7n9r29-6dc52997b9bdc5178d89d264747816f1 .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n#top #wrap_all .av-special-heading.av-mq7n9r29-6dc52997b9bdc5178d89d264747816f1 .av-special-heading-tag{\nfont-size:72px;\n}\n.av-special-heading.av-mq7n9r29-6dc52997b9bdc5178d89d264747816f1 .special-heading-inner-border{\nborder-color:#ffffff;\n}\n.av-special-heading.av-mq7n9r29-6dc52997b9bdc5178d89d264747816f1 .av-subheading{\nfont-size:20px;\n}\n\n@media only screen and (min-width: 480px) and (max-width: 767px){ \n#top #wrap_all .av-special-heading.av-mq7n9r29-6dc52997b9bdc5178d89d264747816f1 .av-special-heading-tag{\nfont-size:0.8em;\n}\n}\n\n@media only screen and (max-width: 479px){ \n#top #wrap_all .av-special-heading.av-mq7n9r29-6dc52997b9bdc5178d89d264747816f1 .av-special-heading-tag{\nfont-size:0.8em;\n}\n}\n<\/style>\n<div  class='av-special-heading av-mq7n9r29-6dc52997b9bdc5178d89d264747816f1 av-special-heading-h2 custom-color-heading blockquote modern-quote  avia-builder-el-2  avia-builder-el-no-sibling  av-inherit-size'><h2 class='av-special-heading-tag'  itemprop=\"headline\"  >Case 01<\/h2><div class='av_custom_color av-subheading av-subheading_below'><p>Case contributed by: Noreen Akhtar<br \/>\nConsultant Cellular Pathologist<br \/>\nManchester University NHS Foundation Trust<\/p>\n<\/div><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div><\/div><div  class='flex_column av-e7mgme-63522630d7a2e7802ee5974b74470c23 av_one_fourth  avia-builder-el-3 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title='PHOTO-2026-06-03-12-41-38'  height=\"300\" width=\"225\"  itemprop=\"thumbnailUrl\" srcset=\"https:\/\/hcsp-iap.pk\/cases\/wp-content\/uploads\/2026\/06\/PHOTO-2026-06-03-12-41-38-225x300.jpg 225w, https:\/\/hcsp-iap.pk\/cases\/wp-content\/uploads\/2026\/06\/PHOTO-2026-06-03-12-41-38-773x1030.jpg 773w, https:\/\/hcsp-iap.pk\/cases\/wp-content\/uploads\/2026\/06\/PHOTO-2026-06-03-12-41-38-768x1024.jpg 768w, https:\/\/hcsp-iap.pk\/cases\/wp-content\/uploads\/2026\/06\/PHOTO-2026-06-03-12-41-38-529x705.jpg 529w, https:\/\/hcsp-iap.pk\/cases\/wp-content\/uploads\/2026\/06\/PHOTO-2026-06-03-12-41-38.jpg 1086w\" sizes=\"(max-width: 225px) 100vw, 225px\" \/><\/div><\/div><\/div><\/div>\n\n<\/div><\/div><\/main><!-- close content main element --><\/div><\/div><\/div><div id='av_section_2'  class='avia-section av-d339ra-027d439db3933bfc65ac9b7468eb5c8f main_color avia-section-default avia-no-border-styling  avia-builder-el-5  el_after_av_section  el_before_av_layout_row  avia-bg-style-scroll container_wrap sidebar_right'  ><div class='container av-section-cont-open' ><div class='template-page content  av-content-small alpha units'><div class='post-entry post-entry-type-page post-entry-1750'><div class='entry-content-wrapper clearfix'>\n<div  class='flex_column av-bgov12-828d00f6952ef38ea82df3dfd4bdacb2 av_one_full  avia-builder-el-6  avia-builder-el-no-sibling  first flex_column_div  '     ><p>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-9juxs6-2e67cf6dbbf90ba39be1105da4afa729\">\n#top .av-special-heading.av-9juxs6-2e67cf6dbbf90ba39be1105da4afa729{\npadding-bottom:10px;\n}\nbody .av-special-heading.av-9juxs6-2e67cf6dbbf90ba39be1105da4afa729 .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-9juxs6-2e67cf6dbbf90ba39be1105da4afa729 .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-9juxs6-2e67cf6dbbf90ba39be1105da4afa729 av-special-heading-h2 blockquote modern-quote  avia-builder-el-7  el_before_av_textblock  avia-builder-el-first '><h2 class='av-special-heading-tag'  itemprop=\"headline\"  >Case Description<\/h2><div class='av-subheading av-subheading_below'><p>A few details<\/p>\n<\/div><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-mq7nbk66-c6ea499e2c5952566833d16b9a4a4280\">\n#top .av_textblock_section.av-mq7nbk66-c6ea499e2c5952566833d16b9a4a4280 .avia_textblock{\nfont-size:16px;\n}\n<\/style>\n<section  class='av_textblock_section av-mq7nbk66-c6ea499e2c5952566833d16b9a4a4280 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><p><strong>Case History:<\/strong><\/p>\n<p>A 48-year-old renal transplant recipient with asymptomatic non-scrapable corrugated white plaques on the lateral borders of the tongue<\/p>\n<\/div><\/section><\/p><\/div>\n\n<\/div><\/div><\/div><!-- close content main div --><\/div><\/div><div id='av-layout-grid-1'  class='av-layout-grid-container av-7omvva-8b02c1b0dfa4f2de1303a8e49bb7ab98 entry-content-wrapper main_color av-flex-cells  avia-builder-el-9  el_after_av_section  el_before_av_contact  grid-row-not-first  container_wrap sidebar_right'  >\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-kz4zq-fcf591c26370ee2a6410331b61461c92\">\n.flex_cell.av-kz4zq-fcf591c26370ee2a6410331b61461c92{\nvertical-align:middle;\nbackground-color:#584632;\n}\n.responsive #top #wrap_all .flex_cell.av-kz4zq-fcf591c26370ee2a6410331b61461c92{\npadding:0px 0px 0px 0px !important;\n}\n<\/style>\n<div class='flex_cell av-kz4zq-fcf591c26370ee2a6410331b61461c92 av-gridrow-cell av_one_full no_margin  avia-builder-el-10  avia-builder-el-no-sibling  av-zero-padding'  ><div class='flex_cell_inner'><div id='av-masonry-1' class='av-masonry 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class='av-inner-masonry-sizer'><\/div><figure class='av-inner-masonry main_color'><div class=\"av-masonry-outerimage-container\"><div class='av-masonry-image-container' style=\"background-image: url(https:\/\/hcsp-iap.pk\/cases\/wp-content\/uploads\/2026\/06\/Picture1.jpg);\"  title=\"Fig1\"   alt=\"Fig1\" ><\/div><\/div><figcaption class='av-inner-masonry-content site-background'><div class='av-inner-masonry-content-pos'><div class='av-inner-masonry-content-pos-content'><div class='avia-arrow'><\/div><h3 class='av-masonry-entry-title entry-title '  itemprop=\"headline\" >Fig1<\/h3><\/div><\/div><\/figcaption><\/figure><\/a><!--end av-masonry entry--><a href=\"https:\/\/hcsp-iap.pk\/cases\/wp-content\/uploads\/2026\/06\/Picture2.jpg\" data-srcset=\"https:\/\/hcsp-iap.pk\/cases\/wp-content\/uploads\/2026\/06\/Picture2.jpg 602w, https:\/\/hcsp-iap.pk\/cases\/wp-content\/uploads\/2026\/06\/Picture2-300x173.jpg 300w\" data-sizes=\"(max-width: 602px) 100vw, 602px\"  aria-label=\"image Fig2\"  id='av-masonry-1-item-1753' data-av-masonry-item='1753' class='av-masonry-entry isotope-item post-1753 attachment type-attachment status-inherit hentry  av-masonry-item-with-image' title=\"Fig2\" alt=\"Fig2\"    itemprop=\"thumbnailUrl\" ><div class='av-inner-masonry-sizer'><\/div><figure class='av-inner-masonry main_color'><div class=\"av-masonry-outerimage-container\"><div class='av-masonry-image-container' style=\"background-image: url(https:\/\/hcsp-iap.pk\/cases\/wp-content\/uploads\/2026\/06\/Picture2.jpg);\"  title=\"Fig2\"   alt=\"Fig2\" ><\/div><\/div><figcaption class='av-inner-masonry-content site-background'><div class='av-inner-masonry-content-pos'><div class='av-inner-masonry-content-pos-content'><div class='avia-arrow'><\/div><h3 class='av-masonry-entry-title entry-title '  itemprop=\"headline\" >Fig2<\/h3><\/div><\/div><\/figcaption><\/figure><\/a><!--end av-masonry entry--><a href=\"https:\/\/hcsp-iap.pk\/cases\/wp-content\/uploads\/2026\/06\/Picture3.jpg\" data-srcset=\"https:\/\/hcsp-iap.pk\/cases\/wp-content\/uploads\/2026\/06\/Picture3.jpg 602w, https:\/\/hcsp-iap.pk\/cases\/wp-content\/uploads\/2026\/06\/Picture3-300x178.jpg 300w\" data-sizes=\"(max-width: 602px) 100vw, 602px\"  aria-label=\"image Fig3\"  id='av-masonry-1-item-1754' data-av-masonry-item='1754' class='av-masonry-entry isotope-item post-1754 attachment type-attachment status-inherit hentry  av-masonry-item-with-image' title=\"Fig3\" alt=\"Fig3\"    itemprop=\"thumbnailUrl\" ><div class='av-inner-masonry-sizer'><\/div><figure class='av-inner-masonry main_color'><div class=\"av-masonry-outerimage-container\"><div class='av-masonry-image-container' style=\"background-image: url(https:\/\/hcsp-iap.pk\/cases\/wp-content\/uploads\/2026\/06\/Picture3.jpg);\"  title=\"Fig3\"   alt=\"Fig3\" ><\/div><\/div><figcaption class='av-inner-masonry-content site-background'><div class='av-inner-masonry-content-pos'><div class='av-inner-masonry-content-pos-content'><div class='avia-arrow'><\/div><h3 class='av-masonry-entry-title entry-title '  itemprop=\"headline\" >Fig3<\/h3><\/div><\/div><\/figcaption><\/figure><\/a><!--end av-masonry entry--><a href=\"https:\/\/hcsp-iap.pk\/cases\/wp-content\/uploads\/2026\/06\/Picture4.jpg\" data-srcset=\"https:\/\/hcsp-iap.pk\/cases\/wp-content\/uploads\/2026\/06\/Picture4.jpg 602w, https:\/\/hcsp-iap.pk\/cases\/wp-content\/uploads\/2026\/06\/Picture4-300x178.jpg 300w\" data-sizes=\"(max-width: 602px) 100vw, 602px\"  aria-label=\"image Fig4\"  id='av-masonry-1-item-1755' data-av-masonry-item='1755' class='av-masonry-entry isotope-item post-1755 attachment type-attachment status-inherit hentry  av-masonry-item-with-image' title=\"Fig4\" alt=\"Fig4\"    itemprop=\"thumbnailUrl\" ><div class='av-inner-masonry-sizer'><\/div><figure class='av-inner-masonry main_color'><div class=\"av-masonry-outerimage-container\"><div class='av-masonry-image-container' style=\"background-image: url(https:\/\/hcsp-iap.pk\/cases\/wp-content\/uploads\/2026\/06\/Picture4.jpg);\"  title=\"Fig4\"   alt=\"Fig4\" ><\/div><\/div><figcaption class='av-inner-masonry-content site-background'><div class='av-inner-masonry-content-pos'><div class='av-inner-masonry-content-pos-content'><div class='avia-arrow'><\/div><h3 class='av-masonry-entry-title entry-title '  itemprop=\"headline\" >Fig4<\/h3><\/div><\/div><\/figcaption><\/figure><\/a><!--end av-masonry entry--><\/div><\/div>\n<\/div><\/div>\n<\/div><div id='after_grid_row_1'  class='main_color av_default_container_wrap container_wrap sidebar_right'  ><div class='container av-section-cont-open' ><div class='template-page content  av-content-small alpha units'><div class='post-entry post-entry-type-page post-entry-1750'><div class='entry-content-wrapper clearfix'>\n<form action=\"https:\/\/hcsp-iap.pk\/cases\/monthly_cases\/case-01-4\/\" method=\"post\" data-fields-with-error=\"Found errors in the following field(s):\" class=\"avia_ajax_form av-form-labels-visible   avia-builder-el-12  el_after_av_layout_row  el_before_av_button  avia-builder-el-first   \" data-avia-form-id=\"1\" data-avia-redirect='' ><h3 class=''>Which of the following ancillary tests would most strongly support the diagnosis?<\/h3><fieldset><p class='  first_form  form_element form_element_half' id='element_avia_1_1'><label for=\"avia_1_1\">Choose correct option: <abbr class=\"required\" title=\"required\">*<\/abbr><\/label><select  name=\"avia_1_1\" class=\"select is_empty\" id=\"avia_1_1\"><option  selected=\"selected\" value=''><\/option><option   value='A. PAS stain demonstrating fungal hyphae'>A. PAS stain demonstrating fungal hyphae<\/option><option   value='B. Immunohistochemistry for p16'>B. Immunohistochemistry for p16<\/option><option   value='C. In situ hybridisation for Epstein\u2013Barr virus (EBV)'>C. In situ hybridisation for Epstein\u2013Barr virus (EBV)<\/option><option   value='D. Direct immunofluorescence for IgG deposition'>D. Direct immunofluorescence for IgG deposition<\/option><option   value='E. PCR for human papillomavirus (HPV)'>E. PCR for human papillomavirus (HPV)<\/option><\/select><\/p><p id='element_avia_2_1' class=' first_form  form_element form_fullwidth av-last-visible-form-element av-form-empty-line '> <\/p><p class=\"hidden\"><input type=\"text\" name=\"avia_3_1\" class=\"hidden \" id=\"avia_3_1\" value=\"\" \/><\/p><p class=\"form_element \"><input type=\"hidden\" value=\"1\" name=\"avia_generated_form1\" \/><input type=\"submit\" value=\"Submit\" class=\"button\"  data-sending-label=\"Sending\"\/><\/p><\/fieldset><\/form><div id=\"ajaxresponse_1\" class=\"ajaxresponse ajaxresponse_1 hidden\"><\/div>\n<div  class='avia-button-wrap av-a3rhi-a4cc6f1e35dadce6bb11121718215f9d-wrap avia-button-center  avia-builder-el-13  el_after_av_contact  avia-builder-el-last '><a href='https:\/\/hcsp-iap.pk\/cases\/'  class='avia-button av-a3rhi-a4cc6f1e35dadce6bb11121718215f9d avia-icon_select-yes-left-icon avia-size-x-large avia-position-center avia-color-theme-color'  ><span class='avia_button_icon avia_button_icon_left' aria-hidden='true' data-av_icon='\ue851' data-av_iconfont='entypo-fontello'><\/span><span class='avia_iconbox_title' >Back to Monthly Cases Homepage<\/span><\/a><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"featured_media":1821,"comment_status":"open","ping_status":"closed","template":"","tags":[],"portfolio_entries":[19],"class_list":["post-1750","portfolio","type-portfolio","status-publish","has-post-thumbnail","hentry","portfolio_entries-histopathology"],"_links":{"self":[{"href":"https:\/\/hcsp-iap.pk\/cases\/wp-json\/wp\/v2\/portfolio\/1750","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/hcsp-iap.pk\/cases\/wp-json\/wp\/v2\/portfolio"}],"about":[{"href":"https:\/\/hcsp-iap.pk\/cases\/wp-json\/wp\/v2\/types\/portfolio"}],"replies":[{"embeddable":true,"href":"https:\/\/hcsp-iap.pk\/cases\/wp-json\/wp\/v2\/comments?post=1750"}],"version-history":[{"count":13,"href":"https:\/\/hcsp-iap.pk\/cases\/wp-json\/wp\/v2\/portfolio\/1750\/revisions"}],"predecessor-version":[{"id":1862,"href":"https:\/\/hcsp-iap.pk\/cases\/wp-json\/wp\/v2\/portfolio\/1750\/revisions\/1862"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/hcsp-iap.pk\/cases\/wp-json\/wp\/v2\/media\/1821"}],"wp:attachment":[{"href":"https:\/\/hcsp-iap.pk\/cases\/wp-json\/wp\/v2\/media?parent=1750"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/hcsp-iap.pk\/cases\/wp-json\/wp\/v2\/tags?post=1750"},{"taxonomy":"portfolio_entries","embeddable":true,"href":"https:\/\/hcsp-iap.pk\/cases\/wp-json\/wp\/v2\/portfolio_entries?post=1750"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}