Skin problems?

<< Previous Message | Next Message >>
Content-Type:text/plain; charset="US-ASCII"

One of you inquired if pathologists notice desquamated keratinocytes in 
tissue sections. - My reply would be that I occasionally see them, but 
probably miss most of them. They're more of a nuisance in Pap smears.

One's ability to ignore the unexpected is amazing. Several years ago I was in 
my first day in a small lab in a galaxy far away. Most of what they processed 
was small skin bumps, with a few hospital specimens. I chanced to notice an 
extraneous object outside the outline of a small skin section, and saw that 
it was a malignant acinus, obviously shed from a papillary adenocarcinoma. 
There were more of them. I looked back through the slides I'd already 
finished with, and found a few more. I had quite ignored them, because they 
were outside the confines of what I was looking at. I then fast-forwarded 
through the rest of the day's work and found a total of 26 cases with acini 
in them. 

The day's first specimen - grossed by someone else the previous Friday before 
I got there - was a lens-paper packet containing a cell button from an 
abdominal fluid specimen from a paracentesis. (For some reason I didn't see 
this case first in the morning's work.) The packet had fallen open and 
spilled some of its contents into the surrounding solution (in an old 
open-bucket Technicon, I believe I remember). 

I phoned the submitting physician, who told me that he hadn't suspected 
cancer at all strongly when he submitted the specimen, but that his patient's 
ascites must have been caused by advanced cancer of the ovary.

Russ, it's spelled either "artifact" or "artefact", with the first being more 
common - it's one of those unusual English words (like canteloupe) that has 
no standardized spelling.

Bob Richmond
Samurai Pathologist (and 1951 grade school spelling champion of the R.C. 
Archdiocese of San Antonio TX which was pretty good for an Episcopalian)
Knoxville TN

<< Previous Message | Next Message >>