Tuesday, December 12, 2006

A week in the life...Thursday

Luckily for Cecil he could finish off the EQA slides this morning as their senior biomedical scientist put the small biopsies in for processing, after which Cecil cut up the bigger specimens. The kidney he’d opened yesterday was still quite pink on the inside so he left the blocks he cut in formalin for another day before they would be put in for processing. The gastrectomy was better fixed and had an irregular ulcerating tumour like the one in this picture.

The last specimen was a gallbladder and the biomedical scientist showed him the specimen pot which had a different patient’s name on it than the name on the accompanying card, although the address and date of birth were the same. They left that specimen undissected so one of the surgeons could sort out whether the histology form and specimen definitely belonged together and what the patient’s name was.

After lunch he made a start on some of the research slides he was supposed to be looking at, but grading the immunohistochemical expression of receptors on a stack of very similar breast carcinoma cases was pretty repetitive and always got pushed aside in favour of more urgent diagnostic work.

He spent the rest of the afternoon reporting more cases with one of the registrars. The extra slides on the bronchial biopsy showed more of the odd looking cells appearing in groups in the sections cut further into the tissue. The cells were large with big, abnormal nuclei and Cecil reported the biopsy as non-small cell carcinoma. There was a series of colonic biopsies from a patient with ulcerative colitis which showed minimal inflammation and no dysplasia, a tray full of normal duodenal biopsies, a gastric biopsy with inflammation and Helicobacter, and a breast biopsy from a patient thought to have definite carcinoma clinically, which turned out to be a benign granular cell tumour.

The interesting cases at today’s slide meeting included a thyroid gland from a patient with both Hashimoto’s thyroiditis and papillary thyroid carcinoma.

Picture from the Pathology Education Instructional Resource.


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