Pathology and Frustration

Sending a sample for histopathology should be a very starightforward thing, and there should not be any factor that can cause any frustration. At least, I thought so until forces far beyond my control proved otherwise. They used to send samples of endometrium and cervical biopsies in test tubes for histopathological studies. One sad day a few years ago the servant dropped the entire lot of the test tubes on his way to the pathology department. All the tubes broke and the tiny bits of endometrium fell on the ground. The operation theater people wanted to pick up the tiny bits and put them into new tubes. But I stopped them because we would not know which bits belonged to which patients, and all the bits had picked up dirt from the ground. None of the patients sued the hospital. We got the nurses to change the containers to small unbreakable bottles, and this unfortunate thing did not happen again. I thought no one would get frustrated with the act of getting samples to the histopathology laboratrory any more. I was wrong. I performed laparoscopy on a patient with an ectopic pregnancy two weeks ago. Her beta-hCG levels had been rising, but not doubling every 48 hours. Her uterus was empty on ultrasonography, and the sonographers had found a gestational sac of 5 weeks in the right fallopian tube. She would have done well with medical treatment, but insisted on surgical treatment. I found that she had convoluted fallopian tubes (as with a past inflammatory disease) without any evidence of a pregnancy in either of them. There was a disc measuring less than a centimeter in diameter on the back of the right broad ligament. It looked yellowish, and had a central compact part, making it look somewhat like a flat flower. I could lift its edges with my forceps quite easily. It came off easily, whout causing any bleeding from its bed. I removed it and sent it for histopathological study. I told them it could be primary abdominal ectopic pregnancy, and they should take extra care to see that it reached the pathology department properly. I was curious, because I had not seen such a lesion in 31 years. I got the histopathological report yesterday. It said the sample was completely autolysed and a report could not be given. The patient's endometrium sent in another bottle at the same time was not autolysed and showed decidua but no chorionic villi. Her beta-hCG levels started falling after the operation, and reached zero in less than a week. So in all probability it was indeed primary abdominal ectopic pregnancy. But I have no histological proof, and I know I am unlikely to get another case like this again. I wonder if there can be any more frustration possible for an academician?