My First Glimpse into Hematopathology
I did my two semesters of Pathology at Hospital México, the place that has been my home since I started my clinical years and where I fell in love with this magnificent field. As part of our first semester’s coursework, we had to prepare a case presentation, and our faculty advisor suggested an interesting hematopathology case. Since the hematopathology sections of our curriculum aren’t until the second semester, I was so eager to learn about this case that, naturally, I offered to be the one to head to the scopes and examine the slides along with our advisor. And it didn’t disappoint!
She showed me how the lymph node architecture was abnormal, how diffuse the pattern was, the proliferation in the parafollicular zone, and the vascular expansion surrounding it all. I saw eosinophils, histiocytes, endothelial cells, and interdigitating dendritic cells. All intertwined among medium-sized neoplastic cells seemingly drawn toward the vessels. I didn’t yet understand what I was looking at, but I could sense none of it was random. There was a story unfolding on that slide, one I didn’t yet know how to read, but I wanted to so bad.
I'd known what immunohistochemistry was since my ninth Histology class back in 2nd year, and I knew pathologists sometimes use different stains to narrow down a diagnosis. But when my advisor brought out the IHC slides, I felt overwhelmed. Slowly but surely, she walked me through how a hematopathologist like herself would approach the case, step by step, just as she had when it first came across her desk. It was a privilege to sit beside her and retrace that process, learning to see the case through her eyes. I felt incredibly fortunate to be there.
Days later, my group and I met to talk about the case. I shared what I had learned from pathology, while they walked me through what they had gathered from the radiology reports, bloodwork, and the oncologist’s notes. We started setting up our case report, diving more into the literature and finding more information around the hospital.
The day of the presentation came, and we were the first group to present. Our case was a nodal T follicular helper cell lymphoma, angioimmunoblastic type. My partners did an amazing job walking everyone through the case and its pathophysiology, and I was in my element sharing the histopathology. I still remember hearing a voice from the back of the room just as we finished. “María José should become a pathologist.” I smiled – It was the program director.
I still remember how those words made me feel. I was honored and humbled, but more than anything, I felt like I belonged in this field. I felt at home.
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