But wait, there's more!

Sorry for the lack of updates folks, I've been getting started on this whole graduate school thing, which takes a large portion of my attention. But since people have been asking, I made some time to post, and with pictures no less!

Today, we'll take a look at some hysterectomies. Here's one that's probably average sized, possibly with a few small cancerous growths:


Along with these, we usually received the ovaries, which may not be attached. For reference, a normal one might be about the size of the pathologist's watch face in comparison to the uterus in hand.

This one was probably the largest ovary we received:


This was an ovarian cyst from a woman who had no idea it was there. Since it was mostly fluid, it didn't show up easily on ultrasound (I believe that was the test..). But when they looked into things to double-check, they found this monstrosity, with over 6 LITERS of fluid in it. That's over a gallon! How do you not notice this sort of thing? It is a mystery.

A few days later, we received another massive uterine-related cancer:

(Sorry for the lack of size reference, but if it helps, the container it's in was filling most of the sink. The blue is just ink that the pathologist put on before cutting in.)

When we first received it, the thing was labeled as a "pelvic mass". When the doc informed me of this, I responded, "They said it was a pelvic mass, but I didn't think they'd send an entire pelvis!" But no, indeed they didn't. This big timer was actually a single uterus with several large cancerous growths. How large? Well, let's just say we had to store it in 3 of the largest buckets we had.


Tune in next time morgue fans, when we take a closer look at colon cancer!

Just look at the bones!

You know what some of the most common surgeries are? Hip replacements (at least at our hospital). Old person breaks their hip, or is about to, and they need part of the joint replaced with a metal/plastic device that won't become brittle or grind bone against bone. What about the part that gets replaced? Well, it gets sent to pathology.

Femoral heads are cool in some ways, and annoying in others. For one, you can see the major load-bearing joint of the body, and from different aspects of it you can tell what problems this particular person had- osteoporosis, shaggy cartilage, bony surfaces smoothed from continuous grinding against the pelvic bone.

On the other hand, two of our three doctors insist on letting them sit in decalcifying solution for up to a week. Makes the bone soft enough to cut with a scalpel, but also makes the whole contents of the jar a smelly, greasy mess. But really, what other options do you have?

...

Hacksaw.

No, really. We have a hacksaw on hand for just such specimens, as well as a device specifically made for holding the bone in place while the sawing occurs. Given a choice between a week of nasty chemical treatment and sawing out a thin slice within a couple of minutes, I gladly choose the latter.

So yes, I can truthfully say that I have used a hacksaw on human bone. It's hard to get creepier than that on your resume, am I right? Although there was that one time where the bone was still attached to the limb... It's just that the limb wasn't attached to the person at the time.

(Bony sidenote- today we threw out a piece of maxillary bone that had been sent in a few weeks back. Teeth were very tempting, but too difficult to remove. I think I'm glad of that, actually.)

A good reason

So a few weeks ago we had a case come in with a big colon tumor, which managed to graft itself onto some of the small intestine as well. Along with it came this weird greenish section of skin, that looked a bit like a belly button. Turns out, these specimens had a story.

Consider this: a man in his late fourties, who is afraid of going to the doctor/hospital, for fear that they might give him bad news, that he might have some terrible illness. One day, this man notices something that feels like a lump in his stomach. Worried that a doctor might tell him it's a sign of something bad, he tries to ignore it, and hopes it will go away. Rather than going away, the mass gets bigger over time, and the man takes greater and greater efforts to ignore it.

One day, he notices a sore forming on his gut. It doesn't look like much, but it's red and it hurts to touch. Still afraid of the doctor, he tries to ignore it, and tells his wife it's probably just acne or something. Put a little polysporin on it, leave it alone for a while, maybe it'll go away on its own. When the sore starts leaking fluid, he tries to cover it up. His wife is more concerned, asking him to go to the doctor. Obviously he refuses.

Finally the day comes when the sore starts leaking feces. The wife forces her husband into the car, and drives him to the emergency room.

Turns out, that mass he discovered about 2 years ago was a colon tumor. If he had seen a doctor, it would have been easy to remove. Instead, he waited and allowed it to grow onto other parts of his body. It actually went so far as to eat away the wall of the abdominal cavity, which caused a sore to form that was basically a shortcut between his guts and the outside world.

Ladies and gentlemen, this is what happens when you suspect something si wrong, but don't see a doctor. Swallow your pride, overcome your fear, whatever. If there's a mass in your gut, it's probably worth getting checked on.

In with a Bang!

So I had expected to start this blog off with some gross story from a few months ago.. Or at least something with pictures. But today we received a specimen that has probably taken the cake for sheer disturbingness.

It was a leg amputation, below the knee so it wasn't exactly huge. There was a huge open area over the ankle, part of the inside leg and about half the foot. Covering the vertical portion of the gash and stitched into place was this weird.. patch. Like a bandage-looking cloth, stuck tightly to a lump of thick purplish material, then stitched to the edges of the gash. After a cut or two we found out that it was in fact muscle tissue, probably from the gluteus maximus. It seemed like such a weird Frankensteinian scenario, that you would use a chunk of muscle that's completely the wrong size and shape to help a wound heal, but I guess that's part of the practice. Heck, in one place it was actually starting to work.

But then when we moved that lump of muscle, there was another layer of horror. Below the obvious anklebone, there was a shining steel device that connected the metatarsal bone to the heavily-weathered heel bone. It had a number of screws securing it to bones, but it wasn't until closer inspection that I realized there was nothing UNDER that framework. The bone was just plain gone, leaving a gap in the flesh. I'm not sure exactly how they expected that to heal up.. Maybe it would have been a better place to graft some muscle? Either way, the screws that extended into the next bone-set over were decidedly creepy to look at.

Sidenote: This is the first specimen in a long while to give me the jibblies. While the doctor was looking it over and I held the leg in place with my left hand, my right was hiding behind me and twitching like mad, just to express the feelings of utter creepitude that had been witnessed!

Coming soon!

Since I seem fated to work face-to-face with entrails for a year or two, I figure it's a good perspective to bring to you, the public. Strange tales from the pathology lab will be posted here, as well as occasional pictures. (Don't worry, I'll just link the graphic stuff. If it is linked here, you can probably regard it as NWS, just to be safe.) Additional stories of rodent gore may come up as well, since I will be TA for a mammalian anatomy lab in the fall.

If you are interested in such strange/gross things as giant tumors, severed limbs and what exactly your insides look like, this is the place to be!