from reportlab.lib.pagesizes import A4
from reportlab.lib import colors
from reportlab.lib.units import mm, cm
from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle
from reportlab.lib.enums import TA_LEFT, TA_CENTER, TA_JUSTIFY
from reportlab.platypus import (
    SimpleDocTemplate, Paragraph, Spacer, Table, TableStyle,
    HRFlowable, PageBreak, KeepTogether
)
from reportlab.platypus.flowables import Flowable
from reportlab.lib.colors import HexColor
import reportlab.lib.colors as rlcolors

# ── Colour palette ──────────────────────────────────────────────
C_DARK_BLUE   = HexColor("#1A3A5C")   # main headings
C_MED_BLUE    = HexColor("#2E6DA4")   # section headings
C_LIGHT_BLUE  = HexColor("#D6E8F7")   # table header bg
C_STAR_BG     = HexColor("#FFF8DC")   # star/callout box bg
C_STAR_BORDER = HexColor("#D4A017")   # star box border
C_RED_NOTE    = HexColor("#C0392B")   # important labels
C_GREY_LINE   = HexColor("#CCCCCC")   # divider
C_SUBSEC_BG   = HexColor("#EAF2FB")   # sub-section heading bg
C_WHITE       = colors.white

PAGE_W, PAGE_H = A4
MARGIN = 20 * mm

# ── Document ─────────────────────────────────────────────────────
doc = SimpleDocTemplate(
    "/tmp/workspace/swellings-exam-notes/Swellings_Exam_Notes.pdf",
    pagesize=A4,
    leftMargin=MARGIN, rightMargin=MARGIN,
    topMargin=MARGIN, bottomMargin=MARGIN,
    title="Concept of Swellings — Exam Notes",
    author="A Concise Textbook of Surgery"
)

styles = getSampleStyleSheet()

# ── Custom styles ────────────────────────────────────────────────
def S(name, **kw):
    return ParagraphStyle(name, **kw)

st_cover_title = S("CoverTitle",
    fontName="Helvetica-Bold", fontSize=26, textColor=C_DARK_BLUE,
    spaceAfter=6, leading=32, alignment=TA_CENTER)

st_cover_sub = S("CoverSub",
    fontName="Helvetica", fontSize=13, textColor=C_MED_BLUE,
    spaceAfter=4, leading=18, alignment=TA_CENTER)

st_cover_meta = S("CoverMeta",
    fontName="Helvetica-Oblique", fontSize=10, textColor=colors.grey,
    spaceAfter=4, leading=14, alignment=TA_CENTER)

st_part = S("Part",
    fontName="Helvetica-Bold", fontSize=15, textColor=C_WHITE,
    spaceBefore=14, spaceAfter=6, leading=20, alignment=TA_CENTER,
    backColor=C_DARK_BLUE, borderPadding=(5, 8, 5, 8))

st_h1 = S("H1",
    fontName="Helvetica-Bold", fontSize=13, textColor=C_DARK_BLUE,
    spaceBefore=12, spaceAfter=4, leading=17,
    borderPadding=(3, 6, 3, 6), backColor=C_SUBSEC_BG)

st_h2 = S("H2",
    fontName="Helvetica-Bold", fontSize=11, textColor=C_MED_BLUE,
    spaceBefore=10, spaceAfter=3, leading=15)

st_h3 = S("H3",
    fontName="Helvetica-BoldOblique", fontSize=10, textColor=C_DARK_BLUE,
    spaceBefore=7, spaceAfter=2, leading=14)

st_body = S("Body",
    fontName="Helvetica", fontSize=9.5, textColor=colors.black,
    spaceBefore=2, spaceAfter=2, leading=14, alignment=TA_JUSTIFY)

st_bullet = S("Bullet",
    fontName="Helvetica", fontSize=9.5, textColor=colors.black,
    spaceBefore=1, spaceAfter=1, leading=13,
    leftIndent=14, firstLineIndent=-10)

st_bullet2 = S("Bullet2",
    fontName="Helvetica", fontSize=9, textColor=HexColor("#333333"),
    spaceBefore=1, spaceAfter=1, leading=12,
    leftIndent=26, firstLineIndent=-10)

st_star = S("Star",
    fontName="Helvetica-Bold", fontSize=9.5, textColor=HexColor("#7B4400"),
    spaceBefore=2, spaceAfter=2, leading=13, leftIndent=6)

st_tbl_hdr = S("TblHdr",
    fontName="Helvetica-Bold", fontSize=9, textColor=C_WHITE,
    leading=12, alignment=TA_CENTER)

st_tbl_cell = S("TblCell",
    fontName="Helvetica", fontSize=8.8, textColor=colors.black,
    leading=12, alignment=TA_LEFT)

st_tbl_cell_c = S("TblCellC",
    fontName="Helvetica", fontSize=8.8, textColor=colors.black,
    leading=12, alignment=TA_CENTER)

st_label = S("Label",
    fontName="Helvetica-Bold", fontSize=9, textColor=C_RED_NOTE,
    spaceBefore=4, spaceAfter=0, leading=12)

st_definition = S("Def",
    fontName="Helvetica", fontSize=9.5, textColor=colors.black,
    spaceBefore=3, spaceAfter=3, leading=14,
    leftIndent=10, borderPadding=(4, 8, 4, 8),
    backColor=HexColor("#F0F8FF"))

# ── Helpers ──────────────────────────────────────────────────────
def h1(txt):  return Paragraph(txt, st_h1)
def h2(txt):  return Paragraph(txt, st_h2)
def h3(txt):  return Paragraph(txt, st_h3)
def body(txt): return Paragraph(txt, st_body)
def bullet(txt, level=1):
    marker = "•" if level == 1 else "–"
    st = st_bullet if level == 1 else st_bullet2
    return Paragraph(f"{marker}  {txt}", st)
def sp(h=4):  return Spacer(1, h * mm)
def hr():     return HRFlowable(width="100%", thickness=0.5, color=C_GREY_LINE, spaceAfter=3)

def star_box(lines):
    """Yellow callout box with star bullets."""
    items = []
    for line in lines:
        items.append(Paragraph(f"★  {line}", st_star))
    t = Table([[items]], colWidths=[PAGE_W - 2*MARGIN])
    t.setStyle(TableStyle([
        ("BOX",        (0,0), (-1,-1), 1.2, C_STAR_BORDER),
        ("BACKGROUND", (0,0), (-1,-1), C_STAR_BG),
        ("TOPPADDING",    (0,0), (-1,-1), 5),
        ("BOTTOMPADDING", (0,0), (-1,-1), 5),
        ("LEFTPADDING",   (0,0), (-1,-1), 8),
        ("RIGHTPADDING",  (0,0), (-1,-1), 8),
    ]))
    return t

def part_banner(txt):
    t = Table([[Paragraph(txt, st_part)]], colWidths=[PAGE_W - 2*MARGIN])
    t.setStyle(TableStyle([
        ("BACKGROUND", (0,0), (-1,-1), C_DARK_BLUE),
        ("TOPPADDING",    (0,0), (-1,-1), 8),
        ("BOTTOMPADDING", (0,0), (-1,-1), 8),
        ("LEFTPADDING",   (0,0), (-1,-1), 10),
    ]))
    return t

def make_table(headers, rows, col_widths=None):
    """Build a styled table. headers = list of strings, rows = list of lists."""
    usable = PAGE_W - 2*MARGIN
    if col_widths is None:
        w = usable / len(headers)
        col_widths = [w] * len(headers)
    data = [[Paragraph(h, st_tbl_hdr) for h in headers]]
    for row in rows:
        data.append([Paragraph(str(c), st_tbl_cell) for c in row])
    t = Table(data, colWidths=col_widths)
    t.setStyle(TableStyle([
        ("BACKGROUND",    (0,0), (-1,0),  C_DARK_BLUE),
        ("ROWBACKGROUNDS",(0,1), (-1,-1), [C_WHITE, C_LIGHT_BLUE]),
        ("GRID",          (0,0), (-1,-1), 0.4, C_GREY_LINE),
        ("TOPPADDING",    (0,0), (-1,-1), 4),
        ("BOTTOMPADDING", (0,0), (-1,-1), 4),
        ("LEFTPADDING",   (0,0), (-1,-1), 5),
        ("RIGHTPADDING",  (0,0), (-1,-1), 5),
        ("VALIGN",        (0,0), (-1,-1), "TOP"),
    ]))
    return t

# ════════════════════════════════════════════════════════════════
# BUILD STORY
# ════════════════════════════════════════════════════════════════
story = []

# ── COVER PAGE ──────────────────────────────────────────────────
story += [
    sp(30),
    Paragraph("CONCEPT OF SWELLINGS", st_cover_title),
    sp(3),
    Paragraph("EXAM NOTES", S("CT2", fontName="Helvetica-Bold", fontSize=18,
              textColor=C_MED_BLUE, alignment=TA_CENTER, spaceAfter=4)),
    sp(6),
    HRFlowable(width="60%", thickness=2, color=C_MED_BLUE, hAlign="CENTER"),
    sp(6),
    Paragraph("A Concise Textbook of Surgery", st_cover_sub),
    Paragraph("Chapter 9 (Cysts) & Chapter 10 (Common Tumours & Miscellaneous Lesions of the Skin)", st_cover_meta),
    Paragraph("Pages 94–155", st_cover_meta),
    sp(20),
    Paragraph("Contents: Cysts · Classification · Individual Cysts · Tumours · Carcinoma vs Sarcoma · Spread of Malignancy · Benign Tumours in Detail", st_cover_meta),
    PageBreak(),
]

# ════════════════════════════════════════════════════════════════
# PART I — CYSTS
# ════════════════════════════════════════════════════════════════
story += [
    part_banner("PART I:  CYSTS  (Chapter 9, Page 94)"),
    sp(4),
]

# DEFINITION
story += [
    h1("DEFINITION"),
    body("A <b>soft fluctuant swelling containing fluid</b> in a sac lined by <b>epithelium or endothelium</b> is called a cyst."),
    body("(Word "cyst" = Greek for "bladder")"),
    sp(3),
]

# CLASSIFICATION
story += [
    h1("CLASSIFICATION"),
    h2("Type I: True Cysts vs False Cysts (Pseudocysts)"),
    h3("1. True Cysts — lined by epithelium or endothelium (if infected → lined by granulation tissue)"),
    bullet("Fluid contents: Serous/mucoid (colourless to brown — altered blood; may contain <b>cholesterol crystals</b>)"),
    bullet("Porridge/toothpaste-like — from desquamated epithelium (found in <b>dermoid, epidermoid, branchial, sebaceous cysts</b>)"),
    sp(2),
    h3("2. False Cysts (Pseudocysts)"),
    make_table(
        ["Type", "Examples"],
        [
            ["Exudation cysts", "Pseudopancreatic cyst (lesser sac), tuberculous peritonitis fluid, vaginal hydrocele, bursa"],
            ["Degeneration cysts", "Central degeneration of malignant tumour (haemorrhage/ischaemic/colliquative necrosis); e.g. Apoplectic cyst"],
        ],
        col_widths=[60*mm, 110*mm]
    ),
    sp(4),
    h2("Type II: Congenital vs Acquired"),
    h3("Congenital Cysts"),
    make_table(
        ["Type", "Description", "Examples"],
        [
            ["Sequestration dermoid",
             "Develops at line of closure of embryonic clefts — dermal cells buried in fusion line",
             "Angular dermoid (outer angle of orbit); Midline neck cysts; Branchial cyst (persistence of precervical pouch)"],
            ["Tubulo-embryonic (Tubulo-dermoid)",
             "Develop in tract of ectodermal tube",
             "Thyroglossal cyst (from thyroglossal duct); Post-anal dermoid (from post-anal gut); Ependymal cyst; Pituitary cyst (from Rathke's pouch)"],
            ["Cysts of embryonic remnants",
             "From embryonic tubules/ducts that normally disappear",
             "Urachal cyst; Vitello-intestinal duct cyst; Hydatid of Morgagni (paramesonephric duct); Organ of Giraldes (mesonephric/Wolffian duct)"],
        ],
        col_widths=[45*mm, 65*mm, 65*mm]
    ),
    sp(4),
    h3("Acquired Cysts"),
    make_table(
        ["Type", "Examples"],
        [
            ["Retention cyst",
             "Obstruction of gland duct → retained secretion: sebaceous cyst, breast cysts, mucous cysts of lips/cheeks, pancreatic cyst, parotid cyst, Bartholin's cyst"],
            ["Implantation dermoid",
             "Squamous epithelium driven into subcutaneous tissue by penetrating injury; common in fingers/palm"],
            ["Parasitic cysts",
             "Hydatid cyst (Echinococcus granulosus); cysticercosis"],
            ["Distension cysts",
             "Abnormal distension of existing cavity: ganglion, hygroma, hydrocele, Baker's cyst"],
            ["Degeneration cysts",
             "Cystic degeneration of tumour/tissue"],
        ],
        col_widths=[60*mm, 110*mm]
    ),
    sp(6),
]

# INDIVIDUAL CYSTS
story += [
    h1("IMPORTANT INDIVIDUAL CYSTS"),
    sp(2),
]

# 1. Sebaceous
story += [
    h2("1.  Sebaceous (Epidermoid) Cyst"),
    bullet("Retention cyst from obstruction of sebaceous gland duct"),
    bullet("Contains: cheesy, foul-smelling keratin/desquamated epithelium (<b>NOT sebum</b>)"),
    bullet("Characteristic: <b>punctum</b> (blocked duct opening) on surface"),
    bullet("Sites: scalp (most common), face, neck, back, scrotum, vulva"),
    bullet("Multiple on scalp → <b>"Pilar cysts"</b>"),
    bullet("<b>Complications:</b> Infection → abscess; sebaceous horn; <b>cock's peculiar tumour</b> (ulceration + calcification — rare malignant change)"),
    bullet("<b>Treatment:</b> Complete excision including the entire sac wall (incomplete → recurrence)"),
    sp(3),
]

# 2. Dermoid
story += [
    h2("2.  Dermoid Cyst"),
    bullet("Contains: skin and skin appendages (hair follicles, sweat glands, sebaceous glands)"),
    bullet("Types: Sequestration dermoid (fusion line) | Teratomatous dermoid (ovary — most common benign ovarian tumour)"),
    bullet("Angular dermoid: outer angle of orbit — <b>does NOT transilluminate</b>"),
    bullet("<b>Treatment:</b> Excision"),
    sp(3),
]

# 3. Thyroglossal
story += [
    h2("3.  Thyroglossal Cyst"),
    bullet("Congenital; from non-obliterated thyroglossal duct remnant"),
    bullet("<b>Location:</b> Midline of neck, at or below hyoid bone"),
    bullet("<b>Moves upward on protrusion of tongue</b> (pathognomonic)"),
    bullet("May contain functional thyroid tissue"),
    bullet("<b>Treatment: Sistrunk's operation</b> — excise cyst + middle third of hyoid bone + tract up to foramen caecum"),
    sp(3),
]

# 4. Branchial
story += [
    h2("4.  Branchial Cyst"),
    bullet("From persistence of precervical pouch/branchial cleft (2nd arch most common)"),
    bullet("<b>Location:</b> Anterior triangle of neck; upper 1/3; anterior to upper sternomastoid; emerges between ECA and ICA"),
    bullet("<b>Contents:</b> Thick creamy fluid rich in <b>cholesterol crystals</b>"),
    bullet("Fluctuant, transilluminates"),
    bullet("<b>Treatment:</b> Complete surgical excision"),
    sp(3),
]

# 5. Ganglion
story += [
    h2("5.  Ganglion"),
    bullet("Distension cyst of a tendon sheath or joint capsule"),
    bullet("Sites: <b>dorsum of wrist</b> (most common); volar wrist; foot"),
    bullet("Contains: thick gelatinous fluid"),
    bullet("<b>Treatment:</b> Aspiration OR excision (recurrence common after aspiration)"),
    sp(3),
]

# 6. Implantation Dermoid
story += [
    h2("6.  Implantation Dermoid"),
    bullet("Squamous epithelium implanted by puncture wound → grows into subcutaneous tissue"),
    bullet("Site: <b>fingers and palm</b> (occupational — seamstresses)"),
    bullet("Contains: toothpaste-like desquamated epithelium"),
    bullet("<b>Treatment:</b> Excision"),
    sp(4),
    PageBreak(),
]

# ════════════════════════════════════════════════════════════════
# PART II — TUMOURS
# ════════════════════════════════════════════════════════════════
story += [
    part_banner("PART II:  COMMON TUMOURS & MISCELLANEOUS LESIONS  (Chapter 10, Pages 102–155)"),
    sp(4),
    h1("CLASSIFICATION OF SWELLINGS / TUMOURS"),
    body("<b>Broad Classification:</b>"),
    bullet("Benign tumours (neoplastic — non-invasive)"),
    bullet("Malignant tumours (neoplastic — invasive)"),
    bullet("Cysts (as above)"),
    bullet("Inflammatory swellings (abscess, lymph node enlargement)"),
    bullet("Traumatic swellings (haematoma)"),
    bullet("Physiological swellings (pregnancy uterus, hypertrophied muscle)"),
    sp(4),
]

# Benign vs Malignant master table
story += [
    h1("BENIGN vs MALIGNANT TUMOURS — MASTER COMPARISON TABLE"),
    sp(2),
    make_table(
        ["Feature", "Benign", "Malignant"],
        [
            ["Age", "Any age", "Usually after 40 years"],
            ["Size", "Usually small (occasionally enormous)", "Usually large"],
            ["Growth", "Slow; expansive; erratic progress; may stop growing", "Rapid; progressive; never stops"],
            ["Capsule", "Well circumscribed; capsule present", "Ill-defined; NO capsule; invasive"],
            ["Differentiation", "Well differentiated; resembles parent tissue", "Poorly differentiated; pleomorphic"],
            ["Mitosis", "Rare/absent", "Frequent; abnormal mitotic figures"],
            ["Invasion", "NO invasion of surrounding tissue", "Invasion = hallmark (hence 'cancer' = crab)"],
            ["Metastasis", "NEVER metastasise", "Almost always metastasise"],
            ["Ulceration/haemorrhage", "Rare", "Common"],
            ["Recurrence", "Rare after complete excision", "Common"],
            ["Effect on patient", "Pressure symptoms; hormone secretion", "Anaemia, cachexia, malnutrition; hormone secretion"],
            ["Radiosensitivity", "Variable", "Many carcinomas sensitive; sarcomas RADIORESISTANT"],
        ],
        col_widths=[48*mm, 67*mm, 60*mm]
    ),
    sp(3),
    star_box([
        "Capsule = benign | Invasiveness = malignant hallmark | Pleomorphism = malignant characteristic",
        "Sarcomas are almost completely RADIORESISTANT",
    ]),
    sp(4),
]

# Aetiology
story += [
    h1("AETIOLOGY OF MALIGNANT TUMOURS"),
    h3("Physical Agents"),
    bullet("Ionizing radiation (X-rays, radium, UV light)"),
    bullet("UV light → squamous cell carcinoma + rodent ulcer (BCC) of skin"),
    bullet("Chronic irritation"),
    h3("Chemical Carcinogens"),
    bullet("Aniline dye workers → carcinoma of urinary bladder (Group I)"),
    bullet("Carcinogenic azocompounds (Group II)"),
    bullet("Polycyclic hydrocarbons (coal tar, soot, mineral oils) → scrotal cancer in chimney sweeps (Pott, 1775 — first occupational cancer described)"),
    bullet("Betel nut + tobacco → carcinoma of cheek/mouth"),
    h3("Viral Agents"),
    bullet("EBV → Burkitt's lymphoma, nasopharyngeal carcinoma"),
    bullet("HPV → carcinoma cervix"),
    bullet("Hepatitis B/C → hepatocellular carcinoma"),
    h3("Hormonal Factors"),
    bullet("Oestrogen → carcinoma of breast, endometrium"),
    bullet("Testosterone → carcinoma of prostate"),
    h3("Genetic / Hereditary"),
    bullet("Familial polyposis coli → carcinoma colon"),
    bullet("Xeroderma pigmentosum → skin cancer"),
    sp(3),
    star_box([
        "First occupational cancer = scrotal cancer in chimney sweeps (Percivall Pott, 1775)",
        "Incidence of cancer increases with age — in >90 years it is about 100%",
    ]),
    sp(4),
]

# Spread
story += [
    h1("SPREAD OF MALIGNANT TUMOURS"),
    sp(2),
    h2("1.  Local Spread / Direct Invasion"),
    bullet("Along fascial planes, nerves, blood vessels"),
    bullet("Into adjacent organs"),
    h2("2.  Lymphatic Spread"),
    bullet("Most common in <b>carcinoma</b>"),
    bullet("Carcinoma shows particular tendency to invade lymphatics"),
    bullet('"Permeation" — continuous growth along lymphatics'),
    bullet('OR "Emboli" — discrete tumour clumps carried in lymph'),
    bullet("First to regional lymph nodes → then distant nodes"),
    h2("3.  Blood-borne (Haematogenous) Spread"),
    bullet("More common in <b>sarcoma</b> (appears VERY EARLY in sarcoma)"),
    bullet("Tumour cells invade thin-walled veins → carried in blood stream"),
    bullet("<b>Carcinoma:</b> Commonest site of blood-borne metastasis = <b>LIVER</b>; others = lungs, brain, bones, kidneys, adrenals"),
    bullet("<b>Sarcoma:</b> Commonest site = <b>LUNG</b>; skeletal deposits rare"),
    bullet("Special: Direct communication between bronchial veins + vertebral plexus → explains frequency of lung cancer → brain metastasis"),
    h2("4.  Transcoelomic Spread"),
    bullet("Tumour invades serosal layer → cells detach into cavity → 'seedlings' on walls"),
    bullet("Examples: gastric/colonic/ovarian carcinomata → peritoneal seedlings"),
    bullet("<b>Krukenberg tumour</b> = transperitoneal spread to BOTH ovaries from gastric/colonic/breast cancer; ovary enlarged with smooth surface; mucoid carcinoma"),
    bullet("Transpleural spread: lung and breast cancer"),
    bullet("Subarachnoid spread: <b>medulloblastoma</b> characteristic; also other gliomata"),
    h2("5.  Spread along Natural Passages"),
    bullet("Along bronchus, ureter → papilloma of renal pelvis → ureter → bladder"),
    bullet("Cancer of lower lip → opposing surface of upper lip"),
    h2("6.  Inoculation"),
    bullet("Clumsy surgical technique → implantation of cancer cells on incised tissues"),
    bullet("During biopsy"),
    bullet("Example: breast cancer → skin flap → tumour in thigh scar"),
    sp(3),
    star_box([
        "Krukenberg tumour = metastasis to BOTH ovaries (gastric/colonic/breast primary)",
        "Carcinoma spreads mainly by LYMPHATICS; Sarcoma spreads by BLOOD (early)",
        "Carcinoma metastasis commonest site = LIVER; Sarcoma = LUNG",
        "Medulloblastoma spreads by subarachnoid route (transcoelomic)",
    ]),
    sp(4),
]

# Carcinoma vs Sarcoma
story += [
    h1("CARCINOMA vs SARCOMA — COMPARISON"),
    sp(2),
    make_table(
        ["Feature", "Carcinoma", "Sarcoma"],
        [
            ["Age", "Middle and old age; COMMON", "All ages; COMMON IN YOUNG; less common overall"],
            ["Structure", "Groups and columns; well-formed stroma", "Diffuse sheets; poorly-formed stroma; extensive haemorrhage + necrosis"],
            ["Growth", "Somewhat slowly growing", "VERY RAPID growth"],
            ["Lymph node spread", "EARLY lymphatic spread", "Rare lymphatic spread"],
            ["Blood-borne spread", "Later; liver → others", "VERY EARLY blood-borne spread"],
            ["Commonest metastasis site", "LIVER", "LUNG"],
            ["Radiosensitivity", "Many highly radiosensitive", "Almost completely RADIORESISTANT"],
        ],
        col_widths=[48*mm, 67*mm, 60*mm]
    ),
    sp(6),
    PageBreak(),
]

# ── BENIGN TUMOURS IN DETAIL ─────────────────────────────────────
story += [
    part_banner("BENIGN TUMOURS IN DETAIL"),
    sp(4),
]

# 1. Papilloma
story += [
    h1("1.  PAPILLOMA"),
    bullet("Common benign sessile or pedunculated tumour"),
    bullet("Composed of squamous epithelium + core of connective tissue (blood vessels + lymphatics)"),
    bullet("Simple overgrowth of ALL layers of skin"),
    bullet("Arises from epidermis OR mucous membrane"),
    bullet("<b>Examples:</b> Warts (viral — HPV); skin tags; fibroepithelial polyps"),
    sp(4),
]

# 2. Lipoma
story += [
    h1("2.  LIPOMA"),
    bullet("Most common benign soft tissue tumour"),
    bullet("Composed of adult fat cells"),
    bullet("<b>Site:</b> Subcutaneous tissue anywhere; back of neck, shoulder, back (most common)"),
    h3("Characteristics"),
    bullet("Soft, lobulated, non-tender"),
    bullet("<b>Slip sign</b> (edge slips under examining fingers)"),
    bullet("Mobile; NOT attached to skin"),
    bullet("Pseudo-fluctuation present (NOT true fluctuation)"),
    bullet("<b>Strangulated (angiolipoma)</b> — tender lipoma"),
    bullet("<b>Diffuse lipomatosis</b> — multiple lipomas"),
    bullet("<b>Dercum's disease</b> — painful fatty deposits (usually in obese women)"),
    bullet("<b>Treatment:</b> Excision"),
    sp(4),
]

# 3. Fibroma
story += [
    h1("3.  FIBROMA (FIBROUS TISSUE TUMOUR)"),
    sp(2),
    make_table(
        ["Type", "Features"],
        [
            ["Hard fibroma", "Dense mature fibrous tissue; collagen-rich; slightly mobile; rubbery; firm"],
            ["Soft fibroma", "Loose myxomatous tissue; soft; myxofibroma"],
            ["Desmoid tumour", "Locally malignant; arises from muscular aponeuroses; very firm; NO capsule; does NOT metastasise but invades locally; recurs after excision"],
        ],
        col_widths=[50*mm, 125*mm]
    ),
    sp(3),
    h3("Desmoid Tumour (important details)"),
    bullet("Arises in: muscular aponeuroses, especially <b>rectus abdominis</b> (post-pregnancy) and extra-abdominal = region of shoulder, thigh, buttock"),
    bullet("May arise in <b>surgical scar</b>"),
    bullet("Extra-abdominal desmoids: most often in region of old scars"),
    bullet("Associated with <b>Gardner's syndrome</b> (familial polyposis + desmoids + osteomas)"),
    bullet("<b>Treatment:</b> Wide excision; high recurrence rate"),
    sp(4),
]

# 4. Haemangioma
story += [
    h1("4.  HAEMANGIOMA (BLOOD VESSEL TUMOUR)"),
    sp(2),
    star_box([
        "Haemangioma is often present since birth and it NEVER turns malignant — two key features",
    ]),
    sp(3),
    h2("A. Capillary Haemangioma — Three Subtypes"),
    sp(2),
    make_table(
        ["Subtype", "Features"],
        [
            ["(i) Strawberry/Raspberry Angioma",
             "Red mark 1–3 weeks after birth → grows for months → strawberry/raspberry like swelling; compressible; NOT pulsatile; INVOLUTES BY AGE 7–8 YEARS"],
            ["(ii) Port-wine Stain (Naevus flammeus)",
             "Present since birth; deep purple-red; face/shoulders/neck/buttock; NO definite swelling — diffuse vascular deformity; colour pales on pressure but takes time to return (feeding vessels also abnormal)"],
            ["(iii) Salmon Patch",
             "Present since birth; midline (forehead/occiput); DISAPPEARS before first birthday"],
        ],
        col_widths=[55*mm, 120*mm]
    ),
    sp(3),
    star_box([
        "Sturge-Weber syndrome: Facial port-wine stain + haemangioma of ipsilateral cerebral hemisphere → Jacksonian epilepsy",
    ]),
    sp(3),
    h2("B. Cavernous Haemangioma"),
    bullet("Multiple dilated <b>venous channels</b> → spongy swelling"),
    bullet("Compressible; empties completely on pressure → refills slowly on release"),
    bullet("Does NOT pulsate"),
    bullet("Does NOT transilluminate"),
    bullet("<b>Treatment:</b> Injection sclerotherapy; excision; embolization"),
    sp(3),
    h2("C. Arterial (Plexiform) Haemangioma"),
    bullet("Congenital arteriovenous fistula"),
    bullet("<b>PULSATILE</b> and associated with <b>BRUIT</b> (thrill on palpation)"),
    bullet("Warm; skin over it may show dilated veins"),
    bullet("<b>Treatment:</b> Surgical excision or embolization"),
    sp(4),
]

# 5. Neurofibroma / Schwannoma
story += [
    h1("5.  NEUROFIBROMA / NEURILEMMOMA (SCHWANNOMA)"),
    h2("Neurofibroma"),
    bullet("Arises from endoneurium"),
    bullet("Fusiform swelling ON nerve"),
    bullet("<b>Moves perpendicular to nerve axis ONLY</b> (not along it) — diagnostic sign"),
    bullet("Attached to nerve; cannot be enucleated without damaging nerve"),
    bullet("Part of Von Recklinghausen's disease in multiple form"),
    sp(2),
    h2("Neurilemmoma (Schwannoma)"),
    bullet("Arises from Schwann cells"),
    bullet("Eccentric on nerve; encapsulated"),
    bullet("Can be enucleated without damaging nerve"),
    bullet("<b>NEVER undergoes malignant transformation</b> (unlike neurofibroma)"),
    sp(3),
    star_box([
        "Neurofibroma: moves perpendicular to nerve — attached to nerve — CAN undergo malignant change",
        "Neurilemmoma (Schwannoma): eccentric — can be enucleated — NEVER malignant",
        "Von Recklinghausen's disease = multiple neurofibromas + café-au-lait spots (NF type 1)",
    ]),
    sp(4),
]

# Footer note
story += [
    hr(),
    Paragraph(
        "<i>Notes based on: A Concise Textbook of Surgery, Chapters 9–10 (Pages 94–155). "
        "Content cut off at Von Recklinghausen's disease — remaining sections to be added.</i>",
        S("FootNote", fontName="Helvetica-Oblique", fontSize=8, textColor=colors.grey,
          leading=11, alignment=TA_CENTER, spaceBefore=4)
    ),
]

# ── BUILD ────────────────────────────────────────────────────────
doc.build(story)
print("PDF generated successfully.")

Successfully replaced 1 instance(s) of the string in '/tmp/workspace/swellings-exam-notes/generate_pdf.py'