I was a 1 st year PG student at my college. It was during my first posting of histopathology. One
of our mam gave us a histopathology slide to identify and make a diagnosis. No history was
given. Biopsy site was also not mentioned.
Low power view showed few tubular structures dispersed between the stroma.
High power view showed few ill formed bigger tubules like structures and few smaller tubular
structures, some cysts and stroma.
I went back to my histology book. Looked at the structure of kidney. The histology showed
glomeruli, tubules, interstitium and blood vessels. Now I started comparing it with the slide that
was handed over to me. The slide showed few ill formed glomeruli - that means the glomeruli
were not formed properly or were formed properly and then due to disease they underwent
changes. The tubules looked somewhat primitive and very few in number. The interstitium
looked different. It looked like primitive mesenchymal tissue. There were few cysts lined by
flattened epithelium.
I went back to my staff and told her that it is some kidney pathology. She didn’t give me the
answer instantly. She triggered me to dig more and find the answer. This further increased my
curiosity. I went again and started reading and referring the books. There were no inflammatory
cells. So I thought it couldn’t be inflammatory. There were no florid tumour cells. So, I thought
it couldn’t be neoplastic. All the tissues looked somewhat not well formed or very much
primitive. So I referred to cystic diseases of the kidney. There I got the answer. This experience
was first of its kind. Throughout this experience there was a curiosity and later a joy of arriving
at the diagnosis. I was and I am thankful to my staff who instilled curiosity in me and guided me.
Renal dysplasia was the answer.
How important it is to have a guide/teacher in every phase of life! How the teacher stimulated
my thinking to get the answer out of me was very important, which formed the base to my
approach for any patient.
I remember James Hillman’s quote: “Pathology is not the problem to be solved but the soul’s
way of working on itself”. So truly said. Pathology poses so many questions like what, when,
how and most importantly why. This can be applied to many walks of life.
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