The Captain's Haus Seite
D. Ross McLean MD, Laboratory Medicine Consultants,
Department of Laboratory Medicine, Royal Alexandra Hospital, Edmonton, Alberta,
Canada (email: rmclean@gpu.srv.ualberta.ca)
Coronary stents post CPR. This
74 year old patient suffered cardiac arrest 30 minutes after stents were placed
in his right coronary artery and circumflex. At autopsy both stents were sitting loose within the
coronary artery, no longer expanded and presumably compressed secondary to
CPR. Click here to see crushed coronary stents.
Acute atherosis in pregnancy induced
hypertension. Colleague Dr. Rob West found this excellent
example of atherosis in pregnancy induced hypertension. Fibrinoid necrosis of the vessel is evident as well as
lipid containing macrophages. Sections of the membranes should be taken
near the placental margin to increase the likelihood of finding these changes.
Tumour
Infiltrating Lymphocytes and CRC
I have added to my website
an interesting example of colonic adenocarcinoma with increased numbers of
tumour infiltrating lymphocytes (TILs). I picked this up after a
retrospective review of 46 hemicolectomies in our region (the last 32
months). A total of 6 patients were less than 60 years of age. I
reviewed all 6 for TILs but this case stood out among the others with >100
TILs per 10 high power fields. The higher the number of TILs the greater
the chance there is inherited colon cancer (HNPCC). MSI testing will
hopefully be up and running within the region shortly. Germline testing
as it stands now is too expensive to be used as a screening tool, regardless,
the wait is long for genetic counseling followed by testing (18-24
months). Another bottleneck occurs for family members at risk since it
can take up to 2 years for screening colonoscopy of an asymptomatic family
member following identification of an index case with the gene. Worst
case scenario is that it could be 4 years from the time an index case has had a
colonic resection until the time a family member can be screened. This
doesn't happen of course since common sense dictates that family members in
suspect cases of HNPCC are screened by gastroenterologists upon
speculation without waiting for a positive genetic test. Regardless a
negative gene test in a family that meets Amsterdam criteria requires q1-2 year
colonoscopic screening. Initial H and E screening followed by MSI and IHC
could go a long way to at least exclude non-MSI tumours while IHC could be
virtually diagnostic for HNPCC in some situations. Adenocarcinoma with high TIL count
This Bowel Buddy is For You
These
cookies pack a powerful punch.
Total Mesorectal Excision
Gross photos of resection specimens of
colon cancer demonstrating completeness of mesorectal
excision. Perhaps this is something we should try to assess in our
surgical pathology reports. This page also details Quirke's graded
assessment of mesorectal excision and shows pertinent anatomy. Quirke's
method of dissection of colorectal adenocarcinoma is
demonstrated. Additional examples of mesorectal graded assessment are shown.
Mucous Neck Cells
Signet
ring carcinomas are felt to originate in these cells. An example is shown
of benign metaplastic mucous neck cells in which
these cells are not only similar to signet ring cells on H and E but also show
evidence for acid mucin production. Don't be afraid to get down and get
sticky for this mucous filled slime fest.
She shells G cells by the seashore
Lets be
clear about this before anyone breaks into a cold sweat over the prefix
"G". This is about G cells not G men, namely gastrin producing
cells in the gastric antrum. Photomicrographs are available at this page G cells H and E and gastrin immunoperoxidase
(approx 250k jpg). Any comments or testimonials would be appreciated.
A Worm's Life
The
purpose of these pages are to demonstrate a unique case and show to those
interested the movie making abilities of the Nikon coolpix 990. The pictures
were taken handheld through the eyepiece of a 5 headed Olympus microscope.
This 45
year old HIV negative patient from Fiji was treated with chemotherapy for CNS
lymphoma. Ten days after the onset of chemotherapy he developed diarrhea. A
diagnosis was made from stool samples. Three days later he developed severe
respiratory distress requiring intubation. The QuickTime movie and still
photographs were taken from a wet mount of a sputum sample. Following treatment
the patient's CXR cleared and he was discharged from the ICU.
Worms at work, pre-treatment CXR (jpeg 256k)
It's a fabulous night for a wormdance
(QuickTime mpeg 1.3 Mb, QuickTime player will be necessary to view this
film) SORRY FILM DOWN TEMPORARILY.
download
QuickTime player for PC or Mac
Worms at rest, wet mount of sputum, our diagnosis (jpeg
180k)
Worm graveyard, post treatment CXR (jpeg
284k) NOT AVAILABLE TEMPORARILY.
Coolpix set up: Leitz eyepiece vs Optem
This page
compares different ways of attaching the Nikon Coolpix 990 to an Olympus
microscope. The Olympus BH2 setup is mine while the Olympus BX51 setup is
from a researcher at our university. It would nice to compare the Leitz
vs the Optem setup on the same microscope but unfortunately not possible.
I think the images differ mainly from the connection though, not the
microscope.
Go to Leitz vs Optem (2 jpeg images approx. 260k
total).
Injury Prevention Week
Examples of my failure as a father to guide my
children in avoiding significant injury. You need Quick time player for
this. The Evil Knievel movie shows my eldest son jumping over his
friends. Notice how he flies over their lower extremities to reduce the
possibility of abdominal trauma. Evil Kneivel
This
is why these kids should wear helmets. Surprisingly his marks actually
started to improve after this. Sk8er Boi
Photogallery
My camera, my marigold, my bee (jpeg
396k, one big bee)
Vexillologist's dream - Flags from around the
world taken at the 2001 World Track and Field Championships, Commonwealth
Stadium, Edmonton, Alberta (jpeg 1.3 Mb, sorry there were a hell of a lot of
flags)
These are a few of my favourite things
Scalextric USA
Superman's
song, Crash Test Dummies, MP3 (4.1 MB, sorry no room in my directory)
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