Honey-colored crusts

Impetigo is a highly contagious superficial skin disease more common in children caused by bacteria usually Staphylococcus aureus and at times Streptococcus pyogenes. In impetigo, the lesions begin as a red skin area, blister formation follows; next, the blisters rupture and the drying blister contents leave distinctive honey-colored crusts.

Impetigo lesions usually heal without treatment and without scarring.

Reference:

Cole C, Gazewood J: Diagnosis and Treatment of Impetigo. Am Fam Physician, 2007  15;75(6):859-64. Go to reference

Impetigo

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Nutmeg liver

In heart failure, when the heart can longer pump blood forward effectively, the blood tends to stagnate and dams backwards congesting organs such as the liver - congestive hepatopathy. The sites in the liver surrounding veins containing this stagnant dammed blood appear red-brown while the other areas of normal liver look yellow. When seen with the naked eye, this speckling of red-brown against a yellow background gives the liver an appearance similar to that of a grated nutmeg – nutmeg liver.

Reference:

Bayraktar UD, Seren S, Bayraktar Y: Hepatic venous outflow obstruction: Three similar syndromes. World J Gastroenterol, 2007 7;13(13):1912-1927.Go to reference

Placenta – flat cake

In humans, the placenta (afterbirth) is disc shaped and it is so named because of this discoid shape – the word placenta originates from the Latin root for a flat cake.

During pregnancy, the placenta functions to supply nutrients and oxygen from the mother to the fetus and to remove wastes from the fetus to the mother. Additionally, the placenta produces hormones (chemical substances) which among other actions regulate optimal uptake of nutrients from the mother to the fetus. The placenta also protects the fetus from the mother’s immune system since the fetus is a foreign body and would normally be attacked by the mother’s immune system.

Reference:

Kliman HJ. From Trophoblast to Human Placenta (from the Encyclopedia of Reproduction). Available http://med.yale.edu/obgyn/kliman/placenta/articles/EOR_Placenta/Trophtoplacenta.html. Accessed 23-03-2011. Go to reference

Human placenta - flat cake

 Image from Wikimedia Commons

Strawberry gallbladder

In cholesterolosis, cholesterol accumulates in macrophages, which are cells of the immune system involved in engulfing material. This build up of cholesterol in macrophages (foam cells) found in the gallbladder wall, gives the inside of the gallbladder, an organ concerned with the storage, concentration and release of bile, a speckled appearance that resembles a strawberry – strawberry gallbladder.

Reference:

Kumar V, Abbas AK, Fausto N, 2005, Robbins and Cotran Pathologic Basis of Disease, 7th edition, Elsevier Saunders, Philadelphia, pages 37, 930 and 931. Go to reference

Grape-like vesicles

Sometimes, the father contributes excessive genetic material to the conceptus (the product of union of the egg and sperm). This occurs for example, when an ‘empty’ ovum (lacking the mother’s genetic material apart from mitochondrial genes) is fertilized by a single sperm which then duplicates its genetic material, or when two sperms fertilize an ‘empty’ ovum or further still when two sperms fertilize an apparently normal ovum. These situations in which there is surplus paternal genetic material may result in molar pregnancy (hydatidiform mole) characterized by a placenta with vesicles that resemble clusters of grapes – grape-like vesicles.
Placental mesenchymal dysplasia is another condition that can give grape-like vesicles

Reference:

Berkowitz RS, Goldstein DP: Clinical practice. Molar pregnancy. N Engl J Med, 2009 360(16):1639-45. Go to reference

Salt grains

In measles, a highly contagious viral disease spread mainly by airborne respiratory secretions, characteristic lesions may be seen in the mouth on the inner aspects of the cheeks that appear as if there are salt grains splattered against a red background. These lesions are known as Koplik spots, so named in honor of Henry Koplik the New York physician who described them.
Reference:

Steichen O, Dautheville S: Koplik spots in early measles. CMAJ, 2009 180(5):583. Go to reference

Measles virus (electron microscope image)

Image from Wikimedia Commons

Oat cell carcinoma

Small cell lung cancer also known as oat cell carcinoma is one of the types of lung cancer; it characteristically grows fast, spreads early to other organs and consequently has a poor outcome. It is associated with smoking cigarettes.

When viewed under the light microscope, the cells in small cell lung cancer are small with a relatively large nucleus giving them a look not unlike oat grains – oat cell carcinoma.

Reference:

Underwood JCE and Cross SS (eds.), 2009, General and Systematic Pathology, 5th edition, Churchill Livingstone, Edinburgh, page 349. Go to reference

Oat cell carcinoma

Image from Wikimedia Commons

Acetabulum - bowl

The hip joint is of the ball and socket variety. The head of the femur/thigh bone acts as the ball while the acetabulum, a deep ovoid hip bone depression acts as the socket by receiving the femoral head. The acetabulum is so named because it resembles a wide-mouthed vessel used in Greco-Roman times to store vinegar at the dining table from which diners would periodically dip their food – the acetabulum.

Reference:

Smith W (ed), 1870, Dictionary of Greek and Roman Antiquities, 2nd edition, 1870, Little Brown and Company, Boston, page 4. Go to reference
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 Acetabulum

 

Image from Wikimedia Commons

Rice-water stool

Vibrio cholerae, a motile bacterium produces a toxin, which causes intestinal cells to discharge large amounts of ions and water into the gut resulting in a profuse potentially fatal diarrhea that resembles rice water in appearance due to the presence of mucus and intestinal cells in the diarrheal fluid – rice-water stool.

Cholera can be transmitted by consuming food, water and other items contaminated with Vibrio cholerae, not uncommonly originating from human feces.

Reference:

Alexakis LC. Cholera-"Rice water stools". Pan Afr Med J, 2017. Go to reference

Rice water stool, rice water

Image from Alexakis LC. Pan Afr Med J, 2017

Image from Wikimedia Commons

Bean-shaped kidneys

The kidneys are paired organs located within the abdomen that are involved in the elimination of waste, regulation of the composition and volume of body fluids as well as hormone production.

As blood passes through the kidneys, removal or addition of certain materials occurs, while the kidneys form urine. In shape, the kidneys resemble beans – bean-shaped kidneys.

Reference:

Kumar PJ and Clark ML (eds.), 2002, Clinical Medicine, 5th edition, Saunders, Edinburgh, page 588. Go to reference
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Bean-shaped kidneys

Image from Wikimedia Commons

Spoon-shaped nails

The nails may curve inwards both along their length and width forming a depression such that they seem like spoons – spoon-shaped nails. This spooning of the nails known as koilonychia can occur in iron deficiency anemia, trauma and a variety of several other conditions.

Reference:

Fawcett RS, Linford S, Stulberg DL: Nail Abnormalities: Clues to Systemic Disease. Am Fam Physician, 2004 69(6):1417-24. Go to reference
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 Spoons

 

Image from Wikimedia Commons

Millet seeds

In disseminated (miliary) tuberculosis, the chest X-ray may have many tiny opacities resembling millet seeds that are scattered throughout the lung fields – miliary tuberculosis. This life-threatening condition, affecting several organs, is due to spread of the tuberculosis bacterium via the blood stream.
The presence of many tiny spots resembling millet seeds in shape and size is not unique to miliary tuberculosis, certain fungal infections and some cancers that have spread to the lungs, for example, may give this look on chest X-ray.
Reference:

Golden MP, Vikram HR: Extrapulmonary Tuberculosis: An Overview. Am Fam Physician 2005,  72(9):1761-8. Go to reference

Miliary tuberculosis

 

Image from Wikimedia Commons

Fried egg-like cells

Oligodendrogliomas are tumors thought to arise from oligodendrocytes, which are cells that insulate neurons in the brain and spinal cord thereby facilitating efficient transmission of nerve impulses.

When viewed under the microscope, the cells of oligodendrogliomas resemble fried eggs in appearance – fried egg-like cells.

Reference:

Vesper J et al: Retrospective analysis of treatment outcome in 315 patients with oligodendroglial brain tumors. BMC Neurol, 2009 16(9):33. Link

Fried egg-like cells

Image from Wikimedia Commons

Waiter’s tip deformity

The brachial plexus is a network of nerves, located in the neck, which supplies the upper limb(s) facilitating limb movement and sensation. This plexus can be injured in situations where the neck and shoulder are separated more than is usual, for example, during a difficult delivery when the shoulder is stuck within the mother’s pelvis and the head is pulled in an attempt at childbirth.

Stretching or tearing of brachial plexus nerves may occur resulting in paralysis of some upper limb muscles. The paralysed upper limb subsequently takes on a distinctive posture where it hangs limp, with the elbow straightened and the wrist bent akin to the posture a waiter’s hand assumes when asking for a tip – waiter’s tip deformity. Erb’s palsy is a synonym for the waiter’s tip deformity.

Reference:

Foad LS, Mehlman CT, Ying J: The Epidemiology of Neonatal Brachial Plexus Palsy in the United States. J Bone Joint Surg Am, 2008 90(6):1258-64. Go to reference

Chocolate cyst

Endometrial tissue normally lines the inside of the uterus providing a hospitable environment for pregnancy. However, in endometriosis, endometrial-like tissue is abnormally located outside the uterine cavity.
During menstrual periods (when pregnancy has not occurred) part of the endometrium is normally shed resulting in menstrual bleeds, but, in ovarian endometriosis, the endometrial-like tissue cannot be shed resulting in the formation and accumulation of dark brown blood that resembles chocolate in appearance – chocolate cyst.
Reference:
Fraser IS: Recognising, understanding and managing endometriosis. J Hum Reprod Sci, 2008  1(2):56–64. Go to reference

Chocolate cyst

 Image from Wikimedia Commons

Chocolate agar

Among other constituents, the culture medium blood agar contains sheep’s blood (or another mammal’s blood) in solid gelatinous agar. Heating blood agar results in red blood cell breakdown and the consequent release of factors essential for the growth of particular bacteria such as Hemophilus influenzae and Hemophilus ducreyi.

After aforementioned heat treatment, blood agar takes on a brown color reminiscent of chocolate – chocolate agar.

Reference:

Anand C et al: Pig and Goat Blood as Substitutes for Sheep Blood in Blood-Supplemented Agar Media. J Clin Microbiol, 2000 38(2):591-594. Go to reference

Chocolate agar

Image from Wikimedia Commons

Banana sign

On ultrasound scan performed prior to birth, the fetal cerebellum may appear compressed and curved like a banana. This banana sign may indicate the presence of spina bifida where the neural tube, the precursor of the central nervous system (brain & spinal cord), has failed to close, usually in the lower back region.
In the common form of spina bifida – myelomeningocele – patients may have bladder and bowel dysfunction, loss of sensation below the level of the lesion as well as an excess of cerebrospinal fluid in the brain’s ventricles (hydrocephalus).

Reference:

Benacerraf BR, Stryker J, Frigoletto FD: Abnormal US Appearance of the Cerebellum (Banana Sign): Indirect Sign of Spina Bifida. Radiology 1989, 171(1):151-3. Go to reference

Banana-shaped gametocyte

Plasmodium falciparum is a one-celled organism that causes a severe form of malaria. Distinction of Plasmodium falciparum from other malaria causing Plasmodia can be made by seeing, under the microscope, its gametocyte (sexual form) that is characteristically shaped like a banana – banana-shaped gametocyte.
Reference:

Talman A, Domarle O, McKenzie FE, Ariey F, Robert V: Gametocytogenesis : the puberty of Plasmodium falciparum. Malar J 2004, 3:24. Go to reference

Banana-shaped gametocyte

Image from Wikimedia Commons

Pizza pie appearance

Cytomegalovirus (CMV) retinitis is characterized by cell death and whitening of the retina, a pattern which looks like a pizza pie when viewed using special equipment to examine the interior of the eye. CMV retinitis is relatively common in patients infected with HIV.

The pizza pie appearance has also been likened to the look of cottage cheese and ketchup.

Reference:

Banker AS: Posterior segment manifestations of human immunodeficiency virus/acquired immune deficiency syndrome. Indian J Ophthalmol, 2008 56(5):377-83. Go to reference

Pizza pie appearance in CMV retinitis

Image from Wikimedia Commons

Spaghetti & meatball appearance

Pityriasis versicolor is a skin disease caused by fungi belonging to the genus Malassezia. These fungi exist in two forms, a yeast and a filamentous form, which resemble meatballs and spaghetti respectively when viewed under the microscope in a solution containing potassium hydroxide.

Reference:

Prajapati V, Mydlarski PR: Dermacase. Tinea versicolor. Can Fam Physician, 2008 54(11):1557-8. Go to reference

Go to spaghetti and meatball appearance of progressive multifocal leukoencephalopathy
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Spaghetti & meatballs

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Coca-cola colored urine

Several days following throat or skin infection by certain bacteria, inflammation of the glomeruli (tufts of capillaries in the kidney) may occur. This inflammation, called glomerulonephritis, may result in red bloods cells entering the urine where they breakdown releasing their contents thereby causing the urine to have a dark or smoky color resembling coca-cola – coca-cola colored urine.

Reference:

Tasic V, Polenakovic M: Acute poststreptococcal glomerulonephritis following circumcision. Pediatr Nephrol 2000, 15(3-4):274-5. Go to reference

Berry aneurysm

A berry aneurysm, also know as a saccular aneurysm, is an abnormal localized out-pouching of part of an artery or arteries in the brain that resembles a berry in shape and is usually found at arterial junctions and has a propensity to burst, at times with fatal consequences.

Reference:

Keeedy A: An overview of intracranial aneurysms. Mcgill J Med 2006, 9(2):141–146. Go to reference

Berry aneurysm

 Image from Wikimedia Commons