Bestest path histo pic ever
Started by yaah
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yaah said:
Gotta do your Derm! Gotta! It's F.U.N. 😍
Also, this little bugger is a Spitz Nevus, which are fascinating, but can be mightily difficult to differentiate from Melanoma. Unfortunately - for both the dermpath and the patient - they're quite rare, and you're not likely to see them often unless you get to see a lot of derm consultancies. 🙁
Trivia: they're named after Sophie Spitz, a MSKCC pathologist who first described them in 1948 - except that she classified them as Juvenile Melanoma, which is understandable but wrong. They're benign.
Trying to do mutational DNA-analysis on 'em, because there's no benign lesion that more closely mimics aggressive tumors, so they gotta be closely related somehow. 😎
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I sent the low-power to my class mailing list. Responses came back along the lines of "what the hell?"yaah said:
Only one guy saw it - and he was post-call. 🙄
Man I am SO glad I am in path.
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b&ierstiefel
your classmates just aren't as kewl as you.
I cannot decide if you are being sarcastic and taking me down a notch.AndyMilonakis said:
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b&ierstiefel
down a notch? from what?deschutes said:
From the sublime level of kewlness that I have achieved... 😎AndyMilonakis said:
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b&ierstiefel
huh huh you are sooooo kewwwwwllll.deschutes said:
I'm just sorry I didn't see this message thread until now!!! Great stuff, yaah!yaah said:Naw- you can't see anything grossly - this is all 1 mm or less. It's just an accident of histologic sectioning that not only is there a tumor, and this tumor is forming two round balls of cancer, but it is adjacent to a hair shaft, and conveniently the hair shaft is sectioned so that the end of it is showing sebaceous glands. And conveniently, adjacent to the sebaceous glands there is some wispy collagen. It's all absolutely perfect!
DasN said:
Umm....I'm good. How are you?? WHO are you!! 😕
deschutes said:
BTW, it is now posted on the shelves of the resident's room, next to all the silly dictation errors.
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I am hopeful that the resident group I join appreciates such humour!yaah said:
deschutes said:
Me too! That will have to be another question I ask during interviews
Yeah - just print it out, bring it with you, and ask if they find it funny. 🙂
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b&ierstiefel
Yeah, one should not ask the residents if they have a sense of humor. You should be able to pick that up by just observation. Lunch is a great time to see if the one or two folks you go to lunch with have a sense of humor.
Also, you could just whip out the picture at every interview, including the ones with the PD and the chair. Yes, that would be a splendid idea. And if they laugh their asses off and you consider sense of humor to be an important aspect of the program, then you've found your program
Also, you could just whip out the picture at every interview, including the ones with the PD and the chair. Yes, that would be a splendid idea. And if they laugh their asses off and you consider sense of humor to be an important aspect of the program, then you've found your program
Is it just me or is there also an adjacent face in the low power pic?
yaah said:You all have to see this to actually believe it. I stumbled on it today while perusing a massive cheek and ear-ectomy for a large DFSP. There was an incidental superficial basal cell carcinoma. Nature is funny sometimes.
Low power:
High power:
I have a feeling this one is going to make the rounds over here...
Okay. Now, this is just a personal pet peeve of mine, but the rem "kewl" really annoys me. It's aesthetically unpleasing and less efficient. Any true nerd would reject it for those reasons. I am a true nerd.deschutes said:
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b&ierstiefel
Not only did people note the smiley-face, a certain moderator decided to make the smiley-face his avatar!vetpath said:
vetpath said:
Parasites are good for looking like other things!
Placentas and umbilical cords are too. One resident found an area of fetal vessels that look like Edvard Munch's painting, "The Scream." Really kewl. (That was for banana) 😎
What kind of loser would do that?AndyMilonakis said:
*BONK!*yaah said:
"Kewl" is so not first class.
I am drinking Henry Winehard's Root Beer. Now, that is some good stuff!
I don't know? What kind are you?EvoDevo said:
The cancerous kind. 😀bananaface said:I don't know? What kind are you?
EvoDevo said:
Ironically, though, the smilie face is not part of the cancer. It's just a normal sebaceous gland with some hair follicle epithelium intertwined in a cute little fashion. The tumor is limited to the surface!
That's alright though - we can still consider it a tumor. 🙂
Why is that ironic?yaah said:
If the tumor were limited to the surface, it'd just be once cell layer thick, no?
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bananaface said:
No, not necessarily. It's a superficial tumor because it hasn't invaded deep into the dermis. Number of cell layers is not the way to think about it. Some tumors don't think in layers.
It's ironic because the smilie face is not a tumor. But I think we have different definitions of irony, as we have discussed before. It is one of the words where I do not always go with the literal interpretation. 😛
I didn't even think of it as a smiley face. I thought it was a snarley face. Or a PFO face.yaah said:
But maybe I am just being literal 🙄
These path pictures are really cool. I had a bigass ovarian tumor (serous cystadenoma - 12 cm - ouch!!) removed last year. I really wanted to see it and to see slides of it, but they said there was no way I could. Now I really wish I had - maybe there would have been a cool face or something. 🙂
beary said:
They said no way? That's not right. Anybody should be able to see their path slides. I guess it's just that they are worried for legal reasons and things will be misinterpreted.
Serous cystadenoma not likely to have smilie faces in it though. Single cell layer, some fibrous tissue underneath.
HIPAA says that you can access any part of your medical record. If you were to write a request citing HIPAA and the healthcare system's privacy policy, I'm pretty sure they'd have to release any history they have, graphical or textual.
I will concede on this point, only if you can grasp the concept of evolution as change over time, and separate from the concept of natural selection.yaah said:
yaah said:
I totally agree. They gave a copy of a text path report but there were no pictures. I just got the sense that it would be inconvenient for whoever (somebody would have to make a phone call, oh no) so they didn't want to mess with it.
beary said:
Well, if you contact the pathologist on the report, say you are interested in path, and want to see your slides, I bet they would be happy to.
I showed this to my boss at work today and she thought it was hilarious. 👍
You know, in the never ending tradition of naming diseases after the discoverers (Hashimoto's thyroditis, Ebstein-Barr virus), you shoulda named it Yaah's (<-- real name) penis BCC.yaah said:Skin cancer is no laughing matter.
Wait, yes it is.
BTW, for those not in the know, there is an entity called, "Basal Cell Carcinoma, circumscribed growth pattern." Hence where my name for it comes from.
Ew. You said "kewl".PathOne said:
Imma gonna request that be a censored word.
Well, I now have a reputation because I was looking at a slide with a senior resident today and he pointed out a mitotic figure that vaguely looked like a penis and he said I would probably be interested in it. 🙄
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b&ierstiefel
did you take a picture of that too, penis-boy?
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AndyMilonakis said:did you take a picture of that too, penis-boy?
It didn't really look like a penis. It looked more like a flying eagle.
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b&ierstiefel
a flying eagle with a penis?yaah said:
Yeah that's great. "Hey it's a penis! Go get yaah! He probably wants to see it!"yaah said:
AndyMilonakis said:
That would have required a higher level of magnification. Although it was a big mitotic figure and size does matter when it comes to mitotic figures.
I got a really cool SEM of a big biofilm today. Every single person I showed it too was very definitive about what it looked like, and they all thought something different. 🙂 I thought it looked like a bird. Also heard plane, fish, dinosaur, praying mantis, and many others. It was fun - felt like a Rorscach test.
