Diagnosing a Mystery
Diagnosing a MysteryBy Holly Berg, MLS(ASCP)
Everyone knows that when you are having chest pain and shortness of breath that it is time to see a doctor right away. What most people don’t know is that those symptoms aren’t always going to be as a result of a heart attack. So when Mr. Johnson came into the emergency room with these symptoms, the doctors ordered some laboratory tests to confirm or rule out a heart attack. Mr. Johnson’s routine laboratory work, including chemical analysis for cardiac markers that indicate a heart attack, all came back normal. We had a critical mystery to solve.
This doctor happened to notice that Mr. Johnson’s abdomen seemed a bit swollen and that he was retaining fluid. The fluid was brought to me, in Hematology, for routine analysis of the cells in the fluid. Sometimes the presence of a significant amount of red or white blood cells in a fluid can help point the doctor to a diagnosis. To the microscope! It wasn’t the amount of red or white blood cells that was abnormal, but the look of some of the cells. They looked “angry” and stained a deep dark blue instead of their normal lavender stain color. I knew that I might have found Mr. Johnson’s problem!
I ran down to the pathologist and asked him to look at these cells, and he suggested we send the cells to the cytology department for analysis. The cytotechnologist stained the cells with a special stain called a mucin stain and found that Mr Johnson’s cells stained positive for mucin. The abnormal cells were actually cancer. Previously, Mr. Johnson had a type of cancer called adenocarcinoma, which he thought was in remission, but unfortunately the cancer had spread.
Finding Mr. Jonson’s cancer in its earlier stage greatly decreases his need for chemotherapy and invasive surgeries, and greatly increases his chance for survival. By helping to solve the mystery of his diagnosis, I not only answered Mr. Johnson’s health mystery, but helped him along in his fight against cancer.
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