Similes & Metaphors in Pathology: Part 2

Slippers

 Epitheloid cells with pale, slipper shaped nuclei ( source)

• The Nuclei of epitheloid cells are slipper shaped. The epitheloid cells are modified macrophages , which have abundant eosinophilic cytoplasm and pale elongated/slipper shaped nuclei. The collections of epitheloid cells is called as granuloma.

Tennis Racquet

Birebeck granules: Electron microscopy ( source)

• Birebeck granules: these are cytoplasmaic organneles which are tennis raquet shaped and are exclusively seen in Langerhans cells. This is an electron microscopic finding.
• in case of langerhan cell histiocytosis, a rare type of histiocytosis, the presence of birebeck granules helps in differentiating from other proliferative disorders.

Sausage

Sausage/Banana shaped Gametocyte of plasmodium Falciparum

• It denotes the shape of the gametocyte of the protozoan parasite, Plasmodium Falciparum. It can be banana/crescent/sausage shaped.

Cauliflower

• The word used to describe the gross appearance of certain malignant tumors, where the growth is fungating and cauliflower like. Usually seen in squamous cell carcinomas, Although any malignant tumor can show this morphologic appearance.

Anchovy Sauce

Anchovy sauce like pus collected from liver abscess ( source)

• It is the appearance of the pus drained from amoebic liver abscess, caused by Entamoeba histolytica.
• Anchovies are of small, common salt-water forage fish, and the sauce made out of is Anchovy sauce!

Swiss Cheese

cystic hyperplasia-endometrium ( source)

Adenoid cystic carcinoma-cribriform pattern (source)

• Swiss cheese is a name given to variety of cheese in North America which resembles the cheese that originated in Switzerland. Hence the name ‘Swiss cheese’. The distinctive feature of this cheese is the presence of ‘holes’ or ‘eyes’ in them, which develops due to fermentation.
• A variety of histological entities resemble this pattern the most common ones are
• Swiss cheese pattern of endometrium: Seen in cases of simple cystic hyperplasia. Previously it was called as cystic glandular hyperplasia.
• Adenoid cystic carcinoma- cribriform pattern. A type of malignancy which arises in secretory glands, more commonly in salivary glands. Swiss cheese pattern is sometimes used to describe this histological entity

Fingers

Squamous papilloma ( source)

Papillary carcinoma thyroid ( source)

• The villi of small intestines are often described as finger like projections
• in pathology, ‘finger like’ is use to describe papillary projections in squamous papillomas and papillary carcinomas

Chocolate

Chocolate cyst of ovary ( source )

• We all know what chocolate is!
• Chocolate cysts: it is a type of ovarian cyst resulting due to endometriosis. Also called endometriotic cyst/endometrioma.
• these cysts contain thick brown fluid which is chocolate colored. This is due to the presence of old blood

Honey comb

Bronchiectais ( source)

• In Bronchiectasis , on gross examination the lobes shows honeycomb pattern. This is because of the dilatation of bronchi and bronchioles.

Orphan Annie

Ground glass nuclei in papillary carcinoma thyroid ( source)

Ground glass nuclei.   it means the chromatin is finely dispersed and optically clear. This appearance is also known as “Orphan Annie Eye” appearance. Annie is a character in an American comic strip “little Orphan Annie”.    Vacant circle for eyes was one of the distinguishing feature of Annie. The nuclei being clear looks like an eye of Annie!