Excerpts from Conversations with Pathologists

David Levison


PROFESSOR OF PATHOLOGY AT DUNDEE UNIVERSITY (RETIRED 2009)

[I performed] a postmortem on another [...] patients who'd died -- he'd come in to be investigated and they couldn't find anything, and the patient just got sicker and sicker and sicker and died. I was supervising the postmortem and presenting it, and I didn't know what the cause of death was – the organs were just a little bit swollen: the kidneys were swollen; the heart was a bit swollen; the brain was, but nothing definite to find. I said, "To be perfectly honest, I don't know what the cause of death was here." And he just stood there and said, "That's no help at all, David. That's absolutely useless; I don't know why we bothered to get a postmortem." And I said, "Now wait a minute Michael, we've still got to do the histology. You never know what you might find when we do the histology." Usually in these circumstances you don't find anything conclusive, because I've been in that position before. But anyway, I put the tissues through quickly... every single capillary stuffed with tumour cells. [...] every single blood vessel was stuffed with tumour cells. Then I put the lung section under the microscope, and every single capillary stuffed with tumour cells. There was no tumour, just tumour cells in the blood vessels. I put the kidney under… every single capillary stuffed with tumour cells. 

Excerpts from Conversations with Pathologists

Sebastian Lucas

PROFESSOR OF CLINICAL HISTOPATHOLOGY AT GUY’S, KING’S AND ST THOMAS' HOSPITAL, LONDON

 I was looking at a bowel biopsy, a rectal biopsy, late on a Friday afternoon when the rest of the department had gone home. It was the drought summer of 1976, June, and the case history said: 30 weeks pregnant, severe diarrhoea, query proctitis, query cause. It was a white woman, aged about 30. The usual diagnosis would be: nothing, or ulcerative colitis, or one of the standard diseases. But I looked at this biopsy and it wasn't any of these. It was inflamed, but it actually had amoebae in. Now I'd never seen amoebae before, but I knew what they should look like because I was vaguely interested in infectious diseases even then. So I looked at a book and there was a picture of amoebae. I looked down the microscope and there they were, and I said to myself: this has to be amoebic colitis; I've never seen this before, but that's clearly what it is. So I rang up the houseman who was a friend of the surgeon who'd sent it, and I said, "This is amoebiasis." What she answered was actually unprintable! Because, she said, the woman was in theatre at that moment having her colon taken out because it was perforated. And I said: "Oh…is she going to live?" "No, she's got peritonitis and she's probably not going to live." And she didn't.