Donut Forest

On the way home from getting donuts this morning Henry asked if we were going to the donut forest...heck yeah we are! Another perfect toddlerism. 

A trick of the light

Sometimes we can be transported to another time and space while performing the most mundane tasks. By turning the polarizer just so I serendipitously stumbled upon these gorgeous landscapes. Glittering and mesmerizing. No longer merely histologic sections of lung or even debris at the edge of a slide. I see aerial views of planets and nighttime cityscapes and topography as seen through an airplane window.

What do you see?

Upper esophageal nodule...What is it?

Spotted a small nodule (0.4 cm) in the upper esophagus with pinpoint central erosion...

Below the strip of squamous epithelium, which is focally ulcerated with patchy inflammation, is a circumscribed collection of cardiac-fundic-type glands comprised by parietal (plump pink) and chief cells along with scattered foveolar-type epithelium (not shown here). 

Turned out to be ectopic gastric mucosa (stomach tissue) or ...

Gastric heterotopia of the upper esophagus!

Also called "inlet patch", this lesion is thought to be congenital and is usually located near the upper esophageal sphincter. The majority are asymptomatic and incidentally found; however, gastric acid secretion (those darn parietal cells!) is possible and dysphagia reported by some. Rare complications can include stricture, perforation, and, rarer still, adenocarcinoma.

The decedent died of hypertensive and atherosclerotic cardiovascular disease with evidence of remote infarct with potential acute component (histology pending).  Cardiac work-up a few months prior to death was inconclusive and the patient continued to complain of and self-treat "heartburn" symptoms.  Possible that heart was entirely the source of the symptoms misinterpreted as heartburn.  Also possible that, although quite small, the lesion could have contributed to the symptoms the decedent experienced in months prior to his death. 

Art from Artifact

Beauty in the unexpected

In pathology, an artifact is an artificial change introduced as a result of some step in tissue manipulation. Tissue processing -progressive dehydration and paraffinization - produces reproducible "artifacts" as a result of inherent properties of some tissues lending their "classic" appearance under the microscope (e.g. "fried egg" appearance of oligodendrocytes, "orphan Annie-eye" nuclei in follicular thyroid carcinoma).  In general, though, artifact is something to be avoided -an unwanted result of some misstep in the tissue handing process...improper fixation, air drying, or the dreaded air bubble under the coverslip.  These artifacts can physically obscure the tissue and even alter the appearance of cells.  Sometimes the effect is small like tiny flecks of black formalin pigment in the background.  At its worst, artifact can make tissue sections nearly uninterpretable (e.g. cautery artifact or "cooked" tissue, ice crystals in frozen section).

As I was looking at sections of frontal cortex today for a research study, many of the slides had fallen victim to the plight of too little mounting medium causing air bubbles everywhere!! These bubbles produce black masses (highly refractile without the condenser) under the microscope obscuring the tissue beneath. As I was fighting with the bubbles, I began to notice the amazing arrangements they made as the air dissected along the tissue surface -these beautiful ice crystal-like organic structures forming tiny forests on the microscopic surface of neurons, glia, dendrites, axons, capillaries and arterioles...little rivers formed by negative spaces between gyri.

More strange little planets and unexpected landscapes.

Here's to finding the unexpected beauty in the artifacts of life.

 

Wriggly worm

Henry met his first earthworm today. The poor guy was wriggling on the doormat as we walked up to ring the doorbell at daycare. (sidenote: this is a common hazard of rainy Seattle weather as you often have to watch your step for beached worms). "We" placed him in the grass, rescuing him from almost certain demise. As we did, Henry tried out his new word, "wohm!".  When Faduma opened the door, he exclaimed "Wohm, Wohm!" and then said "Thank you, Mama!" ...and my heart melted.

That is all. Have a good night :)

Magpie in the house

Henry has turned into a regular magpie, pilfering and stashing treasures in all kinds of hidden places. Things mysteriously go missing and then I remember, "oh yeah, we have a toddler in the house".  Then it all makes sense in the way that toddlers make no sense at all, being the completely unpredictable creatures that they are. Latest missing item...my hairbrush. Eh well, that's what pony tails are for. Here's to life with silly toddlers and the magic they bring. Thanks for making our lives so interesting.

I love you my little magpie.

Up in the sky!

A little fun with toddler plane-spotting. Original photo courtesy of Dad.

Our son is obsessed with pointing out each plane that flies overhead. "MaHn!!", he exclaims. I'll always cherish those sweet first words.