Those Nasty Pathologists of Old

Talking to good friend and colleague, gastroenterologist Farrukh Jafri the other day, I got excited.

We were talking about a dear friend of mine, and patient of his, who just had a liver cyst drained. My excitement was because he added to my lexicon of the vile pathological food analogies. 

A slightly arcane excitement and arcane lexicon perhaps, but it always makes me wonder if pathologists of old were a bunch of gourmets, or did they just have a nasty sense of humor? 

Describing the skin lesions of neurofibromatosis as “Café au lait spots” perhaps isn’t too vile. 

Likening the effects of congestion of the hepatic veins as “nutmeg liver,” the morphology of lymphoma as “donut cells,” the changes of amyloid as “sago spleen” and the appearance of ovarian cysts containing old blood as “chocolate cysts” is a little off putting.

But anyone who has enjoyed roast lamb with redcurrant jelly is likely to be seriously disturbed by calling the bloody stools of intussusception, “redcurrant jelly stools.” 

We were discussing the causes of the nasty brown drainage this lady’s cyst produced, Farrukh casually threw in the possibility of this being an amebic cyst of the liver.

“That’s what you find in a cyst caused by an infestation of ameba from contaminated food or water you know” he told me. “Anchovy paste and all that.”

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