I'm starting a YouTube playlist of short, high-yield videos for the AP boards (5 minutes or less).
It's still small at this point, but it's going to get bigger 💪🏽
If you're interested, check it out:
#PathTwitter
#pathboards
#pathresidents
🎉It's finally here: an organized list of all of my educational pathology content
👇🏽 Here you'll find pics, digital slides, short reviews, videos & more covering almost all subspecialties!
Many thanks to
@JMGardnerMD
for being such an inspiration!
Enjoy!
Maybe you don't know this yet, PGY1 path residents, but for whatever reason, no matter if you love or hate
#dermpath
(although, let's be honest, what's to hate about it?), this 👇🏽 will soon become one of your favorite spot diagnoses.
So, what is it?
#PathTwitter
#pathresidents
Pop quiz - Endometrial tumor ♀️🔬
1. What's your (differential) diagnosis?
2. What is one IHC marker you would order to confirm the diagnosis?
3. One frequent molecular alteration?
Have a great weekend! 😊
#PathTwitter
#GynPath
During my time at
@UABPathology
I got the chance to engage more with adrenal gland neoplasia, so today I'm sharing with you my wall-hanger 🔬 on adult adrenocortical carcinoma (ACC).
I hope it will prove useful for your practice 😊
#PathTwitter
#Endopath
#GUPath
First video of my Genitourinary Pathology Series is up on
#YouTube
and available here:
In it, I discuss an algorithmic approach to a common pitfall in the evaluation of TURBT specimens.
Enjoy! 😊
#PathTwitter
#GUPath
#Bladdercancer
Middle-aged female with a mass in the ...
One image, one organ, one diagnosis.
Can you get it right? 😉
Hint: of all tumors arising in this organ, this is a rare one (<1%)
Answer & a short review:
#PathTwitter
#pathresidents
#ENTPath
For all
#breastpath
enthusiasts, a case of a rare entity.
60 y/o F of Asian descent presents with a 3 cm breast mass.
What's your diagnosis? 🔬
Any differentials you would consider?
More images here:
Answer & short review later on KiKo, link👇🏽
#PathTwitter
Here's another exceptionally rare one for the annals of
#PathTwitter
.
Presenting as a colonic polyp endoscopically, histology revealed the following lesion 👇🏼
What's your diagnosis? 🔬🔍
Would you order any additional stains?
#GIpath
Testis -
#GUPath
classic 🔬 Short 🧩 with 3 ❓
1. Diagnosis?
2. Can you name two common differentials?
3. What IHC stains would you use for confirmation?
Bonus question: what is one commonly associated finding in the adjacent testicular parenchyma?
#PathTwitter
14 y/o male w/ a later neck mass. What's your diagnosis? Hint: this one is a name-alike but not a look-alike of another lesion. Would you order any IHC to confirm?
#PathTwitter
#BSTPath
Last quiz of 2022! This one's juicy. Middle-aged F, tumor nodule in the oral mucosa. Can you guess what it is? Differentials?
IHC & Answer will be posted on
#KiKo
next year😄😉
Have a great new year,
#PathTwitterFamily
! 🍾🥂 May 2023 bring even more learning opportunities! Cheers
Aneurysmal bone cyst (ABC)
➡️multiloculated blood filled cyst
➡️septa composed of a proliferation of bland fibroblasts
➡️osteoclast-like giant cells
➡️hemorrhage - fresh and old (hemosiderin-laden Mf)
➡️new bone formation (osteoid-like material, woven bone)
#PathTwitter
#BSTPath
#GUPath
enthusiasts, you are going to ❤️ this one.
One high-power 📸 of a 🔪predominantly cystic renal mass.
What is your first diagnostic impression?
#PathTwitter
Hot off the microscope stage
#BSTPath
case. Middle-aged M w/ a subpleural lung mass. Which 2 IHC stains you would definitely want to 👀🤔? What's the most common 🧬fusion seen in these tumors?
Answer later on KiKo, link will be posted in the 🧵👇🏽
#PathTwitter
Adult-type granulosa cell tumor of the ovary (SCST)
▶️Diffuse growth of uniform cells w/ angulated nuclei
▶️Reticulin stain shows fiber staining around groups of cells rather than around individual cells - DDx. Fibrothecomas
▶️Calret, Inhibin A, FOXL2 +, EMA-
#pathology
#GynPath
Synovial sarcoma refresher
📖 mono- (most) or biphasic (=spindle+epithelial)
🔬 spindle cells, but nuclei rather ovoid, high N:C ratio, densely packed in sheets; epithelial comp may form glands
🔬EMA+, CD34-
Unique 🧬 t(X;18)(p11;q11), mostly SS18:SSX1 => no pleomorphism
#BSTPath
PGY1 path residents, remember this one 👇🏽
Esophagus, biopsy. Classic viral cytopathic effect!
The three Ms of HSV:
✅ Multinucleation
✅ Molding
✅ Margination (of chromatin)
Dx. HSV esophagitis
Remember to order IHC if in doubt.
#PathTwitter
#GIPath
#HSV
One photo to illustrate a benign entity
#beautyintheb9
Two questions to stimulate the mind.
1. What's the organ?
2. What's the diagnosis?
Check link for answer & short description 👇🏽
#GUPath
#Endopath
Mega Case Indexes are an invaluable virtual learning resource, freely available @ !
What's in my Mega Index?
📸Lots of photomicrographs
🔬WSI digital slides
📚Short reviews of the illustrated entities
📘Cases covering ~all subspecialties.
Check it out!👇🏽
This is one of those
#pulmpath
cases where you have to take a step back & call your clinician.
A lesson in not rushing to conclusions.
Middle-aged F with a lung mass. Bx was performed 👇🏽
More images in the comments.
A poll, IHC & answer down in the 🧵
#PathTwitter
Continuing the series of
#SalivaryGlandTumors
here's another common entity. Frequently seen in middle aged adults (♀️>♂️).
What's your diagnosis? 🔍
What IHC would you order? 🔬
Diagnostic hint: PNI is a hallmark of this T.
🗨️Further info later in the 🧵
#PathTwitter
#entpath
How sneakier can it get?😲
Invasive lobular carcinoma masquerading as lymphocytic infiltration in a reexcision for positive margin
🔬Always watch out for what seem to be lymphocytes around ducts👉🏽periductal targetoid growth of ILC cells
🎨PCK lights up like 🎄
#Breastpath
Traditional serrated adenoma
Serrated colon polyp, precursor of BRAF-mut MSI CRC
➡️Typically (tubulo)villous
➡️Slit-like serrations
➡️Abundant ectopic crypts
➡️Pencillate dysplastic(-appearing) nuclei like in a typical TA, but☝🏻 with eosinophilic cytoplasm
#GIPath
#PathTwitter
Here's a classic! Myrmecia wart - marked acanthosis and beautiful eosinophilic intracytoplasmic inclusion bodies, just like in the textbooks 📖🔬
#PathTwitter
#dermpath
#pathoutpic
A classic
#BSTPath
case! 38 y/o M w/ a deep thigh mass. These tumors tend to metastasize to all sorts of weird locations. What is your diagnosis? 🔬🤔
What is the characteristic 🧬fusion?
Is the area in the 3rd image concerning?
Answers & review later on KiKo, link in the 🧵👇🏽
Just some Giardia lamblia trophozoites hanging around at the surface of the duodenal mucosa.🦠 As my parasitology professor from university used to say when referring to these little protozoans: look at those fine ladies!💃
Middle-aged F, tumor involving axial skeleton (C7)🦴
What's your diagnosis?🤔
What is the characteristic IHC profile of this entity?🔬
Any underlying molecular abnormality?🧬
Could you name two DDx?🗨️
Answers & more pics:
#PathTwitter
#BSTPath
Happy to share that I'll be (now officially) attending the USCAP meeting in Baltimore this year 🎉 It'll be my first 😎 Looking forward to meet many
#PathTwitter
folks!
See you in Baltimore 👀
Fat-poor pleomorphic lipoma.
➡️ Notice floret-like multinucleated giant cells 🌸
Next to wiry collagen bundles & bland spindle cells in a "school of 🐟" growth pattern.
Oh, the oximorons of pathology.
#BSTPath
#PathTwitter
Curettage, uterine corpus.
Low-grade (FIGO G2) endometrioid carcinoma.
Then this area 👀 (last 2 images).
Any idea what this could represent?
Some mitoses present on H&E 🔬
CK - ; E-Cadherin - ; Desmin - ; PAX8 - ; p53 -
#PathTwitter
#gynpath
Wrapping up 2022 with a last quiz & tweetorial, this time on
#Breastpath
!
70 y/o F with a breast mass (BI-RADS 5). Core needle biopsy shown.
(1/8) Follow the 🧵👇🏽 for some MCQs. A short review of this entity & more pics on KiKo, link in the last post.
#PathTwitter
Uterus tumor extending into parametrial soft tissue and showing characteristic placental-like gross features.
What's your diagnosis on
#extremelylowpower
?
H&E photos after the weekend! 😎🍹
#PathTwitter
#GynPath
#gynpath
frozen, ovarian tumor, elderly female.
I only got to see the permanents, no struggle there. Attending showed me the frozen, thought it was pretty cool & educational!
Care to take a guess?
I'll post H&E from surgical specimen later.
#PathTwitter
There's no better place to read
#GUpath
from one of my favorite
#pathology
book series than at the Greek seaside.
Sorry to miss y'all in Dublin.
This September it's all about swimming & renal cancers.
Have a great Sunday evening everyone!
♂️ 28 y/o. Testicular mass. What's your diagnosis🔍?
What immunostains would you order?
🗨️Further discussions & info later in the chat.
#PathTwitter
#GUPath
Hello
#PathTwitter
, I come bearing gifts. An ugly, aggressive, and rare
#GynPath
tumor to please the 👀. 80-something F, endometrial curettage.
What are your thoughts?
The IHC might surprise you.
2nd set of H&E images 👇🏼
Curious to hear what the expert pathologists of the
#PathTwitter
family think about this case of a middle-aged F with pathologically enlarged inguinal lymph nodes. Here is one of them. No other relevant clinical Hx, no abdomen/pelvis CT available. 2nd set of images 👇🏽
No history this time. Just two images. What's the organ? What would be on your differential?
Any IHC?
Answer, IHC + more pictures here:
An organized list of all my educational pathology content here:
#PathTwitter
#GIPath
#BSTPath
Esophageal biopsy, a rare occurrence: sebaceous gland heterotopia.
➡️ Polygonal cells with clear vacuolated cytoplasm
➡️ Sometimes excretory duct lined by squamous epithelium is seen
➡️ No associated hair follicles
#GIPath
#PathTwitter
#pathoutpic
#pathbasics
📚
#PGY1
When assessing for the presence of lymph node metastases, be sure to not confuse sinus histiocytes (1st pic) with true invasive tumor cells (2nd pic 👉🏽 in this case: LN met of an invasive urothelial carcinoma).
#PathTwitter
#PathX
#pathresidents
#GUPath
What are these cells with bubbly cytoplasm called? 🤔
In which
#BSTPath
tumor can they be found? 🔬
Read more about it here:
An organized list of all my educational pathology content can be found here:
Colon polyp. What are the findings depicted in the images? Could you name one differential diagnosis?
IHC, answer & short review on KiKo, link will be posted in the 🧵👇🏽
#PathTwitter
#GIPath
#BSTPath
Middle-aged man 👨🏽 with a sharply circumscribed, greyish, elevated plaque on the lateral neck.
What is your Dx? 🤔
What subtype(s) of this common non-melanocytic
#dermpath
lesion do you see? 🔬
Answer & a short review will be posted on KiKo, link 👇🏽
#PathTwitter
#pathresidents
Eosinophilic myenteric ganglionitis:
🤔 Rare cause of chronic intestinal pseudo-obstruction (CIPO)
👶 Most common in children
🔬 Infiltration of the myenteric plexus by eosinophils => impaired motility
📖 Some cases may show admixed T lymphocytes
#GIPath
Work's been crazy the last couple of months so I had to take a bit of a break from
#PathTwitter
, but here's a pretty
#GIPath
#Liverpath
case for a neat Saturday night. What's your diagnosis? Would you order any IHC?
Answer the poll 👇🏽 or scroll directly further down for answers
Ulcerated mass in the colon.
▶️Geographic necrosis
▶️Lots of mitoses & apoptotic bodies
▶️Sheet-like & trabecular growth
▶️Highly atypical nuclei w/ prominent nucleoli
▶️Eosinophilic cytoplasm
Based on 🔬H&E morphology, what is your diagnosis?
#PathTwitter
#GIPath
Junior
#pathology
trainee pitfall alert 🚨
1️⃣ Brunner's glands can be intramucosal, especially in the duodenal bulb
2️⃣ Crushed Brunner's glands may mimic an intra-/submucosal neural proliferation 👇🏻
#beautyintheb9
#GIPath
#PathTwitter
From the same repertoire of short quizes:
Biopsy, stomach, antrum:
1. What's happening in this biopsy?
2. Can you name one confirmatory IHC stain?
3. What would you have to rule out?
💎 Answer & pearls will be posted in the comments.
#PathTwitter
#GIPath
High power image of an esophageal biopsy showing lots of inflammation. Let's play a little bit of hangman.
Three words to best describe these nuclei?
M _ _ _ _ _ _ _ _ _ _
M _ _ _ _ _ _ _ _ _ _ _ _ _ _
M _ _ _ _ _ _
What's the microorganism causing this? 🦠
#GIPath
#PathTwitter
35 y/o ♀️, peritoneal biopsy.
What's your diagnosis?🔍
Any IHC you'd like to see?🔬
Apart from the morphological clues, are there any stains that could help us here distinguish between benign and malignant?
💡🗨️Answer and further info later in the chat
#GynPath
#PathTwitter
Am I too late? 🛬 in Baltimore, MD, for
#USCAP2024
🎉 Can't wait to connect with educators & fellow trainees from around the 🌎 while learning as much as possible! 🤩🔬
See you there,
#PathTwitter
!
Here's a case of solitary fibrous tumor (SFT) occurring in the central nervous system. Haphazardly arranged spindled to ovoid cells around prominent staghorn vasculature, variably collagenous stroma. NAB2-STAT6 gene fusion. +ve IHC surrogate: STAT6.
#PathTwitter
#neuropath
Presenting a poster @ Tri State Pathology Conference in Ocean Springs, MS, then
working out at the beach 🏖️🌴😎 w/ Kesley Green & Sarah Anderson in the afternoon.
Great
#BSTPath
lecture on low-grade myxoid tumors!
Excellent talk on pitfalls in
#BreastPath
by
@fouad_boulos
. It