[Histonet] FNA'S

[Stephen Peters M.D.]

Morning Rogerson,
   
  The best way I can explain it is when you have seen hundreds of dogs in your life 
   you learn what they look like and how they behave. Then one day you are pretty 
  sure you saw a dog fly over the roof of your house. One should be pretty sure
  before you decide it is a flying dog. It is a lot more likely that it was a large 
  bat!
Reading cytology is a lot like reading surg path through a pinhole. You use all of 
  your experience and instincts to put a puzzle together in your mind. By diagnosing  
  an oat cell without  any smearing one would be missing an important piece of 
  the puzzle and without it you may be looking at a large bat.
  Do my pathologist colleagues disagree?
Kemlo Rogerson <kemlo.rogerson <@t> waht.swest.nhs.uk> wrote:
  Maybe that is the problem on relying on an artefact to aid diagnosis? My
point is how you know if the artefact is just absent for an undisclosed
reason rather than the cells being unable biologically to submit themselves.

I am no expert but IMHO it must be better science to make sure what you see
reflects in vivo cells as much as is practicable. Despite the cells being
dead, dried, fixed, stained, um............. 

Kemlo Rogerson
Pathology Manager
Ext 3311
DD 01934 647057
Mob 07749 754194


"Following the line of least resistance makes both men and rivers crooked"



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-----Original Message-----
From: Stephen Peters M.D. [mailto:petepath <@t> yahoo.com] 
Sent: Thursday, March 02, 2006 6:50 PM
To: Histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] FNA'S

Hi Terry,

I agree with you about smear cells. Coincidently, yesterday a colleague
brought me 
a case he thought was oat cell. Nuclei were typical neuroendocrine salt
and
pepper, but there was no smearing at all, and many nice intact clusters.
I was 
very reluctant to agree with oat cell and questioned whether it was a
somewhat 
better differentiated neuroendocrine tumor or even an adeno masquerading.
I think the absence of this can also be a clue. 
I remember the smearing being referred to as Azzopardi Phenomenon in my
training but now that you mention it I have seen the changes you referred to
under this name.
I stand corrected. 

Stephen

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