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Sugar Icing Spleen? Food for Thought


Why do pathologists see food in their work? Terms like sugar icing spleen (a thickened and whitish splenic capsule), nutmeg liver (chronic venous hepatic congestion), strawberry gall bladder (a bright red lining of the gallbladder dotted with yellow fat), oat cell carcinoma (small cells with scant cytoplasm in oat cell carcinoma of the lung), potato or rum nose (hypertrophy—enlargement—of the sebaceous glands at the tip of the nose associated with alcoholism), and donut cells (malignant cells with cytoplasmic pseudo-inclusions in large-cell lymphoma) are just a few of the dozens of food eponyms used by pathologists.


Because pathologists are so visual—much of the work in anatomic pathology is about pattern recognition—the diagnosis from a tissue biopsy (or when seeing the organ in its entirety) is generally written descriptively before being distilled into a line diagnosis. For example, when viewing an intact spleen, the pathology report might read, “There is a thickened layer of tan-white fibrous plaques covering the capsule of the spleen consistent with Hyaline perisplenitis.” Sugar icing spleen.



These visual associations with food (and drink) help cement the image in the brain for better memory retention. Everyday items in our life make pathological images more relatable. And perhaps there is a bit of whimsy in it too. So next time you use ‘maple syrup’ on a ‘pancake’ or have a ‘blueberry muffin,’ you could be on your way to a pathological diagnosis. Enjoy!


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