Gross pics

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yaah

yaah

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Worst specimen I saw this year. :scared:

tongue.jpg


It's a tongue from a 20 year old. That's the resection. :scared: I want to know what is left.
 
That was my first pathologic diagnosis I made on my own as a medical student during a neuropath elective. Verocay bodies. Of course a clinical history of a mass in the cerebellar pontine angle doesn't hurt.

That eye pic is just nasty. What kind of tumor did the poor person have where they have to take the orbit, eye, maxilla, and teeth for? How the hell did the ENTs cover that up with a flap?
 
Tongue and cheek taken out for a squamous cell (you can see the ulcer in the picture on the lateral tongue and base, it was pretty invasive)

Half the face was taken out for a sinonasal tumor (I think a melanoma - I didn't gross it in though).

I like this one because it's actually hard to guess the organ.

ick.jpg

ick2.jpg


It's an explanted lung for end stage Cystic Fibrosis. :scared:
 
What is the last one, benign kidney tumor??
 
I can't tell if it's in the kidney, or impinging on it. Doesn't look like a typical RCC. Looks almost like a leiomyoma, but the fact that it's hemorrhagic can't be good.

Guess we'll have to wait till yaah tells us.
 
OK, the next post on this page that references something like that and is off topic to this thread will be deleted. In fact, I may go and delete them anyway if I so decide. Use other threads for this, and for disgusting stuff, use the lounge please.

And yes, leiomyoma is actually a good guess. Except this one is a low grade leiomyosarcoma - patient had a history of abdominal radiation for Hodgkin's 20 years prior. It is not arising from the kidney, but from the IVC.

kidneymass3.jpg
 
yaah said:
OK, the next post on this page that references something like that and is off topic to this thread will be deleted. In fact, I may go and delete them anyway if I so decide. Use other threads for this, and for disgusting stuff, use the lounge please.

And yes, leiomyoma is actually a good guess. Except this one is a low grade leiomyosarcoma - patient had a history of abdominal radiation for Hodgkin's 20 years prior. It is not arising from the kidney, but from the IVC.

kidneymass3.jpg
Click to expand...

That's pretty cool. Bad for the patient, but that's a pretty cool picture demonstrating it.
 
There is just more fat than normal. I don't have a normal small bowel mesentary to show you, but basically it stops before it gets to 50% of the circumference. In this case, it is 100% of the circumference, and at the margin of resection the fat is spreading across the peritoneal lining. On the right edge of that picture, the surface should be totally smooth except for the top there, where the large blobs of fat are (mesentary is there). But it isn't. Fat is "creeping" away from it.

In the upper picture - the bowel is opened along the anti-mesenteric border, and there is fat there. This is abnormal. 🙂
 
Creeping fat was about the only interesting thing I saw on my surgery clerkship. I was on call one day and a 55 year old with no previous abdominal problems came into the ED with a small bowel obstruction. The CT scan looked like there could possibly be appendicitis, so we went to the OR. Almost immediately, the surgeon exclaimed, "well, ****, this guy has Crohn's. Look at all the creeping fat."
 
yaah said:
This thread is about gross pics. No filler!

This is a scary bad ass looking mofo.

kidneymass1.jpg


kidneymass2.jpg
Click to expand...


BEFORE you give us the Dx on the kidney...what's the clinical history???
 
yaah said:
That's subtle. 😉

Adhesion, torsion, or mesenteric clot?
Click to expand...

strangulated small bowel, thats all i know! its from one of my MS1 path powerpoints from last year. sorry I didnt have any more info, I just wanted to contribute a picture. 😀
 
yaah said:
Avascular necrosis
Click to expand...
Again, how do I know that it's avascular necrosis?

😳 Sorry, but you are talking to the likes of who picked up a bone marrow particle crush on her first day and said "Okay, so where do I look and what do I look for??"
 
You can see a wedge of pale, dense bone (almost triangle shaped) ending at the cortex which is separated (due to the retraction) from the underlying bone. It isn't the best example though.
 
This one turns out to be a sarcomatoid renal cell carcinoma

DSCN6399.jpg


It's invading the vein at the lower right (crappy picture with lots of glare, but our photo equipment is in the process of being replaced)

285b72b2.jpg
 
yaah said:
There is just more fat than normal. I don't have a normal small bowel mesentary to show you, but basically it stops before it gets to 50% of the circumference. In this case, it is 100% of the circumference, and at the margin of resection the fat is spreading across the peritoneal lining. On the right edge of that picture, the surface should be totally smooth except for the top there, where the large blobs of fat are (mesentary is there). But it isn't. Fat is "creeping" away from it.

In the upper picture - the bowel is opened along the anti-mesenteric border, and there is fat there. This is abnormal. 🙂
Click to expand...


But is that specific for Chron's or UC? What about other conditions, like chronic divertics or even the big CA
 
Nothing is ever 100% specific, but creeping fat is Crohn's until proven otherwise. Invasive cancers can create strange gross morphologies depending on the puckering and patterns they produce.
 
AndyMilonakis said:
dediff liposarcoma?

kinda looks like the state of michigan.
Click to expand...
Yeah, and flipped upside-down it could look like Louisiana.

I thought it looked like Jabba. It's got two eyes.

Last I heard it looked neural. Immunostains pending. In the they're-probably-out-but-I'm-off-site-so-I-haven't-heard sort of pending.
 
Where the f is that from?
 
Yeah too bad I don't have the X-ray. This was a dirt bike vs. tree. Patient was GCS 15, alert and talking at the scene.

Specimen label: "Foreign body, left neck". No ****.
 
I think that the gross appearance could easly have been an collecting duct CA. It has a moderately dense appearance that seems to be uniform. The lack of infiltration is a point against, but if it were a collecting duct that had a pushing rather than invasive border...
 
Also bumped for those interested. Again, redundant and unnecessary posts deleted for reasons which are obvious.
 
Jesus, how do you people do your jobs without running to the bathroom to vomit every five minutes? Holy crap!
 
souslepont said:
Jesus, how do you people do your jobs without running to the bathroom to vomit every five minutes? Holy crap!
Click to expand...

Ha this is nothing... now if I could find that bilateral buttockectomy gross pic...

I really am looking too, thought I it somewhere
 
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