Similes & Metaphors in Pathology: Part 6

Rodent

Rodent Ulcer- Basal cell Carcinoma ( source)

Rodent: mammals with pairs of continuously growing, razor-sharp incisors. from Latin rodere, “to gnaw”

ulcer has an indurated edge and ulcerated centre.

It is slow growing but spreads deep

This is commonly known as rodent ulcer. Because of its “Gnawed” appearance i.e.to bite or chew/make a hole by chewing!

Bread and Butter

Bread Butter appearance- Fibrinous  pericarditis ( source )

It’s an exudative inflammation.

In acute stage of Rheumatic heart disease, there will be tenacious deposits of fibrin in the pericardium which resembles that of irregular surface of the buttered bread/ Bread butter appearance.

Also seen in uremic pericarditis

Cobble stone

Crohns disease- cobble stone appearance.(S0urce)

It’s a morphological appearance

Islands of intact, edematous mucosa which is surrounded by ulcers(Communicating fissures and crevices in the mucosa)s how the classic “cobble stone appearance.

Antler

Fibroadenoma: Antler horn configuration Source

Fibroadenoma: Antler horn configuration of ductal epithelial cells.

This is the finding seen in smears prepared from fine needle aspiration of fibroadnoma.

The aspirates will be hypercellular  with monolayerd sheets of ductal epithelial cells. These sheets are described as staghorn or antler horn configuration on the edges of these cellular sheets.

Diladipated Bricks

Hailey Hailey disease: Diladipated Brick appearance. Source

This disease is an autosomal dominant disorder with recurrent eruption of vesicles and bullae.

There will be suprabasal separation resulting in blister.  The intercellular bridges are lost leading to acantholysis, with few intact intercellular bridges results in “Diladipated Brick appearance”

Wire Loop

It is a  light microscopic finding in renal biopsy in Lupus nephritis where the capillary walls are thickened  due to subendothelial immune complex deposits.

capillaries stains deep red and appears as homogenous and “rigid” thickening of peripheral capillary loops.  This change is called the “wire loop” lesion.

Shish-Kebab

Candidiasis- Pap smear finding- Shish-Kebab appearance (source)

The candida are long filamentous organisms. The squamous epithelial cells, peculiarly aggregate around these filamentaous organisms, appears as if these cells are speared by these pesudohyphae, giving Shish- kebab appearance.

Fish mouth

Rheumatic heart disease: Fish mouth appearance ( Source)

Most of the patients with rheumatic valvular heart disease have an affected mitral valve.

There will be severe mitral stenosis due to marked thickening and fibrosis.This results in narrowing of its orifice to a slit, which resembles Fish mouth.

Owl Eye

Reed Sternberg Cell ( Source )

The characteristic features of the  nuclei of Reed Sternberg cells in Hodgkin disease.

These cells have symmetric mirror image bilobed nucleus which resembles that of owl’s eye.

The intranuclear inclusions in Cytomegalovirus-infected cells also looks like owl’s eye.