That is of course the Cytologists instinctive response; that we create in
our mind a library of evidence that we use to diagnose the abnormality.
Whilst I have for years accepted that I don't think its 'good science'.

 

If I may use your analogy, there are many varieties of dogs as there are
abnormal cells. The trick I suppose is to recognise the variety as it may be
useful to know if the animal that confronts you is a Pekinese (unlikely to
kill you) or a Pit Bull on supercharge (very likely to kill you); I'm
getting to like this analogy. If you camouflage the Pit Bull that's fine if
all Pit Bulls are camouflaged; if not you are in trouble, especially if it
learnt to fly.

 

Sorry to labour the point but I think introducing artefact as an aid to
identification is poor science; IMHO. With respect why just ask your
Pathologist colleagues? Don't we all have an input into Diagnostic Cytology;
well we do in the UK.

 

Kemlo Rogerson

Pathology Manager

Ext  3311

DD   01934 647057

Mob 07749 754194

 

"Following the line of least resistance makes both men and rivers crooked"

 

This e-mail is confidential and privileged. If you are not the intended
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-----Original Message-----
From: Stephen Peters M.D. [mailto:petepath@yahoo.com] 
Sent: Friday, March 03, 2006 12:28 PM
To: Kemlo Rogerson; Histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] FNA'S

 

Morning Rogerson,

 

The best way I can explain it is when you have seen hundreds of dogs in your
life 

 you learn what they look like and how they behave. Then one day you are
pretty 

sure you saw a dog fly over the roof of your house. One should be pretty
sure

before you decide it is a flying dog. It is a lot more likely that it was a
large 

bat!
Reading cytology is a lot like reading surg path through a pinhole. You use
all of 

your experience and instincts to put a puzzle together in your mind. By
diagnosing  

an oat cell without  any smearing one would be missing an important piece of


the puzzle and without it you may be looking at a large bat.

Do my pathologist colleagues disagree?
Kemlo Rogerson  wrote:

Maybe that is the problem on relying on an artefact to aid diagnosis? My
point is how you know if the artefact is just absent for an undisclosed
reason rather than the cells being unable biologically to submit themselves.

I am no expert but IMHO it must be better science to make sure what you see
reflects in vivo cells as much as is practicable. Despite the cells being
dead, dried, fixed, stained, um............. 

Kemlo Rogerson
Pathology Manager
Ext 3311
DD 01934 647057
Mob 07749 754194


"Following the line of least resistance makes both men and rivers crooked"



This e-mail is confidential and privileged. If you are not the intended
recipient please accept my apologies; please do not disclose, copy or
distribute information in this e-mail or take any action in reliance on its
contents: to do so is strictly prohibited and may be unlawful. Please inform
me that this message has gone astray before deleting it. Thank you for your
co-operation 




-----Original Message-----
From: Stephen Peters M.D. [mailto:petepath@yahoo.com] 
Sent: Thursday, March 02, 2006 6:50 PM
To: Histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] FNA'S

Hi Terry,

I agree with you about smear cells. Coincidently, yesterday a colleague
brought me 
a case he thought was oat cell. Nuclei were typical neuroendocrine salt
and
pepper, but there was no smearing at all, and many nice intact clusters.
I was 
very reluctant to agree with oat cell and questioned whether it was a
somewhat 
better differentiated neuroendocrine tumor or even an adeno masquerading.
I think the absence of this can also be a clue. 
I remember the smearing being referred to as Azzopardi Phenomenon in my
training but now that you mention it I have seen the changes you referred to
under this name.
I stand corrected. 

Stephen

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