Saturday, April 2, 2011

Skin and liver and spleens, oh my!

My dog, who is healthy**
Spleens. Seriously, spleens. Who knew, right? Prior to working for a veterinary pathologist I never knew splenectomies were so common. We've gotten one to two spleens a night for the past two weeks solid, which is a lot even for us. I would have to double check but I think after skin with attached subcutaneous tissue they are our most common specimen type.

Hm, maybe liver though because usually if they take the spleen for hemangiosarcoma they send liver since that's where mets would show up and then we also get liver as a specimen on its own. Okay, so I've revised it: skin > liver > spleens > everything else. On the upside spleens aren't hard to gross, they are just big and bloody.

Even formalin fixed splenic masses are messy
Plus the vet specimens are interesting/challenging*. With human specimens we usually get things that are taken as part of an outpatient procedure with occasional mastectomies, legs, or buckets full of bowel for the on-call doctor to cut in, but with vet specimens it could be a jaw, testicles, an eye, a reproductive tract full of puppies, a snake necropsy, bowel intussusceptions, limbs, toes, and pretty much every internal organ you can think of. And those I actually get to gross right now instead of having to call someone in. Of course, after I'm finished with PA school, I'll be signed off and trained on all of the human equivalents (um, not that here is a human equivalent to a snake necropsy) and I'll have a much broader understanding of why I am submitting the sections I am submitting and what diseases are likely for the tissues I'm grossing.

I'm good at my job, but I'm ignorant. I know how to gross things because I've learned that on this particular specimen type I submit this, on another type I submit that. Ink here, section there, etc. Brute memorization with some ability to apply previous knowledge to new situations. 

This is one of the reasons I wanted to become a pathologists' assistant. I want to know why I do the things I do, not just the how to gross part I have on some things now.

*Like fitting all the necessary sections in three 3 x 2 x .5 cm blocks from a mass the size of a grapefruit. 

**I am aware that because of the massive amount of hair on my dog he could actually be covered in mast cell tumors and I wouldn't know until we shaved him for the summer.

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