What is Rosai Dorfman Disease ? [Pathology Infographic]

Rosai- Dorfman Disease is a rare benign histiocytic disorder in which patients present with painless cervical lymphadenopathy, fever and leukocytosis. The classical findings include emperipolesis and histiocytes staining positive for S100 protein and CD68 and negative for CD1a.



Visit: Histopathology-india.net.

Floret Cells in Pleomorphic Lipoma [Pathology Infographic]


Pleomorphic lipoma occur in adults and are more common in males.
These are located on the back of the neck, upper back or shoulders.
These tumours usually present as a solitary, painless, slow growing, lobular mass with an average diameter of 5 cms. Rarely multiple lesions may develop.
Cut surface has a yellow or grayish – yellow colour. Sometimes mucoid areas are present.
There are overlapping features with spindle cell lipoma.

This tumour should not be mistaken for a  liposarcoma.



Is your hairdresser having respiratory problem? Do you know the reason?



Is your hairdresser coughing, sniffing and has a chronic respiratory problem?  Are you concerned about her health? She should consult a doctor immediately.

According to  a study  by Ümran Toru et al  smoking may aggravate occupational airway disease in hairdressers. Smoking increase both  respiratory complaints and decreased respiratory functions in this profession.

In a study by Brisman et al. that was performed with the aim of evaluating the wheezing, dry cough, and nasal congestion in hairdressers, the survey on respiratory symptoms, atopy, smoking, and job history was answered by three thousand nine hundred and fifty-seven female hairdressers and four thousand nine hundred and five reference women from general population. When compared with references, the ratios of all three symptoms in hairdressers were found to be high and hairdressing was correlated with an increased incidence of respiratory symptoms. The combined effect of hairdressing and smoking was found to be lower than expected and it was proposed that smoking has negative modifying effect.

In a study by Slater et al., the occupational respiratory symptoms in hairdressers were examined. A survey was done on a hundred hairdressers and employees of one hundred and six offices and stores   covering their respiratory symptoms, demographic data and smoking habits. Respiratory functions were measured before each shift. Asthma symptoms, diagnosis, and asthma attack prevalence of hairdressers in the previous twelve-month period were found to be high.  High symptom prevalence in hairdressers was associated with high smoking ratios and average pulmonary function values were found to be low.

According to the study  cough, phlegm, and chest tightness were  noted more in smokers compared to nonsmokers. Rhinitis was also more in smoking hairdressers.

“In conclusion, hairdressers were determined as an occupational group the majority of which was formed by women, in which respiratory complaints and rhinitis history were frequently observed in the subgroup in which cotinine was above 500 ng/mL and where both occupational and smoking status had an additive effect.”

Cutting off smoking could help in this profession.


  • Ümran Toru, Peri Meram Arbak, Kezban Özmen Süner, Özlem Yavuz, and Naciye Karataş, “Relationship between Respiratory Tract Complaints, Functional Status, and Smoking in Hairdressers, Auto Painters, and Carpenters,” The Scientific World Journal, vol. 2014, Article ID 802705, 7 pages, 2014. doi:10.1155/2014/802705
  • “The incidence of respiratory symptoms in female Swedish hairdressers,” The American Journal of Industrial Medicine, vol. 44, no. 6, pp. 673–678, 2003.
  • “Occupational respiratory symptoms in New Zealand hairdressers,” Occupational Medicine, vol. 50, no. 8, pp. 586–590, 2000.

Think before you drink – Beware of Holiday Heart Syndrome [Pathology Infographic]


Everyone was in a festive spirit. He was a healthy 50 year old man  dancing,  drinking and enjoying with his friends. One glass of wine was not enough. He consumed many glasses of alcohol  in a short span of time. Suddenly he started sweating, complained of cardiac pain, severe palpitations and respiratory distress. Finally he lost  consciousness and collapsed on the floor.

What happened to him ? 


Locally Aggressive Adnexal Tumour – Microcystic Adnexal Carcinoma [Pathology Infographic]

A slow growing locally aggressive adnexal tumour  presented as a plaque on the cheek of an elderly male.

 Just on Hematoxylin and eosin stain search for ductal structures, perineural invasion and deep invasion into the subcutaneous fat.

Immunohistochemistry will finally establish the diagnosis. Pathology of Microcystic Adnexal Carcinoma



Leonardo Da Vinci -When Art meets Medicine


portrait“Science comes by observation, not by authority” Leonardo Da Vinci

Presumed Self-portrait

Leonardo Da Vinci – 1452- 1519


Leonardo Da Vinci : Superficial anatomy of the shoulder and neck (recto) –  1510  image courtesy: wikimedia-commons
Image Courtesy – wikimedia commons

Leonardo Da Vinci,  son of Caterina, a peasant girl and Ser Piero da Vinci, a Florentine notary, is one of the most amazing men who have ever lived. He is considered to be the greatest geniuses of the Italian renaissance. Not only was he a great painter, whose pictures the “Mona Lisa” and “The Last Supper” are among the most famous in the world, but also a sculptor, an architect, a poet and a composer music.

He was a genius of another kind too, for he was a pioneer in science, he studied mathematics and engineering and his ideas and the discoveries he made in work were hundreds of years in advance of his time.

His studies of human anatomy was based on meticulous dissection and showed great knowledge which was far superior to his contemporaries in medical profession.

According to Dr Kenneth D Keele’s strong words -” thus in anatomy as in so many aspects of life’s work, Leonardo was a man who awoke too early in the dawn of the Scientific Renaissance whilst others still slept”

He is an inspiration to many doctors and several interesting medical articles have been written analysing his exquisite  illustrations of human anatomy.

To his remarkable knowledge was added his skill unique skill in recording his findings in paper. These are not only important scientific diagrams but also superb works of art.

The studies of the skeleton and muscles completed between 1508 and 1510 are among his most impressive and beautiful drawings. These beautiful illustrations emphasize the fact that a good diagram will tell more than a thousand words.

The Spine (1508 -10) shows the beautiful natural curve of the vertebral  column, with the vertebrae of each part correctly numbered for the first time.

His drawing “Superficial muscles and veins of  arms shows also the superficial veins of the chest and abdomen.


Leonardo Da Vinci : Studies of Embryos by Leonardo da Vinci (Pen over red chalk 1510-1512) Image courtesy : wikimedia-commons

Leonardo Da Vinci (1452–1519) and reproductive anatomy: Arch Dis Child Fetal Neonatal Ed 1997;77: Peter M Dunn – 
He was the first to observe and comment on the fetal membranes—the chorion,  amnion, and allantois.  His drawing of a fetus in the womb is altogether remarkable and was not bettered for more than two centuries. Of that drawing, he wrote:

“In the case of this child the heart does not beat and it does not breathe because it lies continually in water. And if it were to breathe it would be drowned, and breathing is not necessary to it because it receives life and is nourished from the life and food of the mother.

The navel is the gate from which our body is formed by means of the umbilical vein… This umbilical vein is the origin of all the veins of the creature that is produced in the matrix, and it does not take its origin in any vein of the pregnant woman, because each of these veins is entirely separated and divided from the veins of the pregnant woman, and the veins and arteries are found together in pairs; and it is extremely rare for one to be found without the other being in company with it, and the artery is almost always found above the vein because the blood of the artery is the passage for the vital spirit, and the blood of the veins is that which nourishes the creature…. (the unborn child) is nourished from the same cause as the other members of the mother, and its vital powers are derived from the air which is the common living principle of the human race and other living things.”


Leonardo da Vinci: The Proportions of the Human Figure (Vitruvian Man) – (1490; Pen, ink and watercolour over metalpoint)Image courtesy: wikimedia-commons



Leonardo Da Vinci : Anatomy of the Neck – 1515 Image Courtesy – wikimedia-commons

In the course of dissection of the skull and brain Leonardo made many discoveries like maxillary and frontal sinuses (1489).

He was interested in ophthalmology and was probably first to draw the optic chiasma and to demonstrate the path of vision from the back of the eyeball to the base of the brain as in the “Optic Chiasma and cranial nerves”  (1506 -1508).

Leonardo Da Vinci described eye as the “window of the soul.”


Leonardo Da Vinci : Studies of human skull ( Pen, ink and black chalk on paper – 1489) Image Courtesy – wikimedia-commons 


In the 1490s, Leonardo Da Vinci began to investigate the heart and its work. This sketch was part of his study of the human anatomy and the circulation system. Image Courtesy – wikimedia-commons


Leonardo Da Vinci : Study on the proportions of head and eyes – pen and ink – second half of 15th century. Image Courtesy – wikimedia-commons


Leonardo da Vinci the anatomist” from McMurrich. Image Courtesy – wikimedia-commons


The Principle Organs and Vascular and Urino-Genital Systems of a Woman  (c. 1507) is a drawing by Leonardo da Vinci. Image Courtesy – wikimedia commons


View of a Skull (c. 1489) is a drawing by Leonardo da Vinci   Image Courtesy – wikimedia commons


Leonardo da Vinci, Drawing of the comparative anatomy of the legs of a man and a dog. Image Courtesy – wikimedia commons

Leonardo Da Vinci (1452–1519) and reproductive anatomy: Arch Dis Child Fetal Neonatal Ed 1997;77: Peter M Dunn 
He believed strongly in health care. His instructions have a remarkably modern ring:

If you would keep healthy, follow this regimen: do not eat unless you feel inclined, and sup lightly; chew well, and let what you take be well cooked and simple. He who takes medicine does himself harm; do not give way to anger and avoid close air; hold yourself upright when you rise from table and do not let yourself sleep at midday. Be temperate with wine, take a little frequently, but not at other than the proper meal-times, not on an empty stomach; neither protract nor delay the (visit to) the privy. When you take exercise let it be moderate. Do not remain with the belly recumbent and the head lowered, and see that you are well covered at night. Rest your head and keep your mind cheerful; shun wantonness, and pay attention to diet.

“As a well spent day brings happy sleep, so life well used brings happy death.” Leonardo da Vinci