June 15, 2009

High school student diagnosis self with pair of “fresh eyes”

BY Dr. Keith J. Kaplan

While I do not like the statement "Pathologists also sometimes miss important findings for other diseases, says Dr. Mark Graber, chief of the medical service at the Northport VA Medical Center in New York", its context can be found in an article with an amazing story I came across on Lab Soft News with some valid comments.

In this particular instance, inflammatory bowel disease can be difficult to diagnose and manage as the biology and causes are still poorly understood.  Histologically, the findings may be non-specific and granulomas are actually rarely present on endoscopic biopsies (less than 30% of cases and perhaps much less than that).  And not all granulomas are Crohn's disease.  Nonetheless, Jessica became an active participant in her health care and is clearly a bright student who now has some answers to questions long unanswered.

Perhaps Jessica Terry is a future pathologist with a keen eye for detail that is required.  I think the article also points out opportunities for pathologists to engage high school students and educate them about medicine and pathology.  It also points out the power and effectiveness of direct pathologist-patient communication, as in this case, with the power of second consultation with "fresh eyes". 

OR

Comments (1)

  1. Mark D. Pool, M.D.

    On the other hand, the student had the “ultimate” clinical history available and may have been specifically looking for features of Crohn’s disease. The pathologist, if (s)he received any clinical history at all with the biopsy, probably got something like “ABH” or “polyps, hemorrhoids.”
    Just sayin’

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