Greetings to all my fellow pathologists. Yes, I thought to pen down my experience where everything seen under microscope has to story to tell. Definitely they are evidence to a story, it could be normal, abnormal whatever. Our eyes are well trained to understand the language spoken by cells, their attire, their surroundings and of course their pattern.

Yes, we have had a known friend’s mother whom I did an FNAC, diagnosed with carcinoma breast, later operated and recovered. I felt happy that she is completely disease free at the end of 3rd year also. However, she was subjected to compulsory annual checkup and this time , our gynaecologist simply as a routine, included PAP smear also.

That evening, I reported the PAP smear. I found everything ok but for one isolated cluster of 8 to 10 cells, ? atypia. Immediately clarified from gynecologist that there is no problem and colposcopy was normal. Reluctantly I had to sign off that there are suspicious cells though our gynecologist was not ok with ? Atypia and I advised follow up. My report differed completely from the expected report for the clinician who happens to be my UG student, I was quiet, not able to justify the presence of these cells.

A month later as I was entering my lab the gynecologist came and told me that the same patient came with acute abdominal pain and emergency laparotomy revealed enlarge fallopian tube almost looking like an extreme degree of hydrosalpinx which has been sent for HP examination.

To my joy!! Sorry… not for the patient, it turned out to be adenocarcinoma of the fallopian tube with a tiny exophytic growth and lumen markedly dilated and filled with fluid. This fluid had trickled down the uterine cavity and these cells were the ones which were seen on the PAP smear.

Lesson learnt: Each cell has a story to tell. If we have detected something we must stick to our findings and sooner or later we will reap the harvest ,in term of accuracy.