cut myself grossing positive nodes

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Rbrav

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I was just grossing some large (ie positive) lymph nodes on a patient with metastatic melanoma when I cut myself with the scalpel. It's not a deep cut, and I washed it immediately with soap and water. The specimen was in formalin, but only for about two hours (definitely not enough to permeate the specimen).

I got my blood drawn, and the patient will be consented, so the infectious concerns are being evaluated. I figure I'm probably not going to pick up melanoma from this, but I was wondering if anyone knew of any literature or other resources. Thanks.
 
i'd be about 100X more concerned about the infectious stuff than the possibility of getting melanoma. doubt you're gonna find much literature on this though.
 
Simplistically speaking, a person's body doesn't kill its own cancer cells because they are the person's own cells. If melanoma cells were introduced to your blood stream your immune system will just kill them. Every year a med student in gross lab asks me "If I eat this stomach cancer will I get stomach cancer?" and I'm like "Have you taken an immunology class?".

I'd be more concerned about the infectious risks. If the specimen has been in formalin a decent amount of time, then the formalin will kill HIV, Hep C, etc. If its fresh then all bets are off.
 
Simplistically speaking, a person's body doesn't kill its own cancer cells because they are the person's own cells. If melanoma cells were introduced to your blood stream your immune system will just kill them. Every year a med student in gross lab asks me "If I eat this stomach cancer will I get stomach cancer?" and I'm like "Have you taken an immunology class?".

Unless he was immunosuppressed for some reason.

At the ASC meeting, the Hopkins folks showed a case of a guy who recieved a lung transplant and later was found to have lung nodules consistent with a GBM, only his MRI scans were completely normal. Turns out the lung came from a donor who had a GBM. They diagnosed the case as Metastatic GBM, donor transmitted. Pretty crazy stuff.
 
Or severely inbred, like Tasmanian devils:

Proc Natl Acad Sci U S A. 2007 Oct 9;104(41):16221-6. Epub 2007 Oct 2.
Transmission of a fatal clonal tumor by biting occurs due to depleted MHC diversity in a threatened carnivorous marsupial.
Siddle HV, Kreiss A, Eldridge MD, Noonan E, Clarke CJ, Pyecroft S, Woods GM, Belov K.

Faculty of Veterinary Science, University of Sydney, Sydney, NSW 2006, Australia.

A fatal transmissible tumor spread between individuals by biting has emerged in the Tasmanian devil (Sarcophilus harrisii), a carnivorous marsupial. Here we provide genetic evidence establishing that the tumor is clonal and therefore foreign to host devils. Thus, the disease is highly unusual because it is not just a tumor but also a tissue graft, passed between individuals without invoking an immune response. The MHC plays a key role in immune responses to both tumors and grafts. The most common mechanism of immune evasion by tumors is down-regulation of classical cell surface MHC molecules. Here we show that this mode of immune escape does not occur. However, because the tumor is a graft, it should still be recognized and rejected by the host's immune system due to foreign cell surface antigens. Mixed lymphocyte responses showed a lack of alloreactivity between lymphocytes of different individuals in the affected population, indicating a paucity of MHC diversity. This result was verified by genotyping, providing a conclusive link between a loss of MHC diversity and spread of a disease through a wild population. This novel disease arose as a direct result of loss of genetic diversity and the aggressive behavior of the host species. The neoplastic clone continues to spread although the population, and, without active disease control by removal of affected animals and the isolation of disease-free animals, the Tasmanian devil faces extinction.
 
Thanks all for confirming the line of thinking I had after the "oh crap, I cut myself" rush of thoughts wore off. Stupid finger still hurts, though ... 😉
 
Unless he was immunosuppressed for some reason.

At the ASC meeting, the Hopkins folks showed a case of a guy who recieved a lung transplant and later was found to have lung nodules consistent with a GBM, only his MRI scans were completely normal. Turns out the lung came from a donor who had a GBM. They diagnosed the case as Metastatic GBM, donor transmitted. Pretty crazy stuff.

UNOS/whatever regional donor service accepts organs for transplant from cancer patients? Sounds like a bad idea, especially since the recipient will be immunosuppressed afterwards.
 
UNOS/whatever regional donor service accepts organs for transplant from cancer patients? Sounds like a bad idea, especially since the recipient will be immunosuppressed afterwards.

I thought that was crazy, too, but apparently they can accept organs from people with primary brain tumors. Guess because they rarely metastasize outside of the CNS?
 
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