Jay Hwang @Path4People Twitter profile

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Jay Hwang

@Path4People

1 year

Who knew blueberries could teach us about healthy cells? 🫐😲. Today’s #IntroToPath , I use 'em to explain metaplasia (🖤 blackberries), hyperplasia, and hypertrophy 💪🏽. It's like a berry-licious journey through the world of pathology! 🌎 #Path4People #BerriesForEducation 🍓🍒🔬

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Jay Hwang

@Path4People

1 year

👩‍🔬👏 Mary Papanikolaou deserves as much praise as her better known husband. She underwent almost daily Pap smears 🔬~ 21 years for her husband's cervical cancer research 😧. Her dedication to advancing women's health is unprecedented + remarkable! #funfactsofpathology #path4people

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Jay Hwang

@Path4People

1 year

A pineapple🍍 is basically what a liver looks like under the microscope 🔬 🤷🏻 Blueberry- hepatic vein Strawberry -hepatic artery Lime skin - bile duct Pineapple Core - central vein

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Jay Hwang

@Path4People

1 year

#pathpoetrythursday Grab your ☕️ or 🍵 Today’s Subject: Placenta Placenta, oh placenta, a remarkable thing, 🤩 From embryo to baby 👶, it provides a crucial link. ⛓️ It feeds and it filters, it helps life to thrive, A temporary wonder, that keeps us all alive. 🤗

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Jay Hwang

@Path4People

1 year

Pathology is like a detective work for doctors. They use it to figure out what's causing your symptoms and find the best treatment. Think of it as a medical Sherlock Holmes! 🔍🩸 #Pathology #MedicalMystery #Healthcare

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Jay Hwang

@Path4People

1 year

Endocervical Curettage in a 45 y/o F Please don’t miss this (as I had 😣) Because with this Dx, there’s a change in management: Cold Knife Cone or Hysterectomy. Key Phrase: “Tall, Dark, and Dirty” Dx? #gynpath #pathtwitter #obgyn #hpv #medpath

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Jay Hwang

@Path4People

1 year

😮‍💨 took longer to make than anticipated But here are histologic clues for pancreatic cancer > chronic pancreatitis! #pathx #pancreaticcancer #surgoncx #gipath #path #pdac #medstudentx #gi #gastroenterology

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Jay Hwang

@Path4People

1 year

🩺💡 Rudolf Virchow, the father of pathology, recognized the importance of both cellular pathology and social medicine. His legacy inspires us to prioritize health and advocate for social justice. Let's continue his path for a healthier, more equitable world🙌🏼 #Path4People 🌍👨‍⚕️💉

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Jay Hwang

@Path4People

1 year

Am I the only pathologist that struggles 😅 #memesunday #pathtwitter #pathmemes

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Jay Hwang

@Path4People

1 year

Did you know that up to 70% of medical decisions are based on pathology? Join me every Monday for #introtopath on #path4people and discover the crucial role pathology plays in healthcare. Let's learn together about these unsung heroes and the impact they have! #healthcarestats

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Jay Hwang

@Path4People

1 year

🥦🌿 Cancer pathology simplified: cauliflower represents a gross specimen, cilantro as cancer. If cancer is at the stalk, it's not good news and requires further evaluation. Accurate diagnoses are critical. #Path4People #introtopath 💙🧬🩺

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Jay Hwang

@Path4People

11 months

Ovarian Tumor in a 7 year girl undergoing puberty Physical Exam Findings of Skin: Hyperpigmentation of lips Section of Ovary Below👇 Dx? #pathagonia #gynx #obgyn #gynonc #pathx #medx #pedsx #endocrinex #endocrine #fammed #internalmed #gyn #derm #dermx #surgx #gensurg

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Jay Hwang

@Path4People

5 months

Once you see Barrett’s Esophagus, the next thing you automatically need to think: • Neg for Dysplasia • Indefinite for Dysplasia • Low grade Dysplasia • High grade Dysplasia I find this extremely tricky. Here are some tips my staff have told me👇 #pathagonia #path4people

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Jay Hwang

@Path4People

6 months

I am extremely painful I am a metabolic disorder affecting soft tissue, skin and joints. I am strongly negatively birefringent and needle like on polarized light Who am I? #pathagonia #pathx #nephrox #dermpath #derm #medstudentx #medx #fammed #surgpath #medicalstudent #dermx

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Jay Hwang

@Path4People

9 months

p53: The "North Star"⭐️ of IHCs Uses: -Dysplasia in both Barrett esophagus and SSL -Pancreatobiliary neoplasia (esp small biopsy) -Urothelial CIS v. reactive -High grade serous carcinoma -dVIN -Neuroendocrine carcinoma -Diffuse astrocytoma and MORE! Credit: @IHC_guy link👇

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Jay Hwang

@Path4People

10 months

I am a rare bone lesion, generally appearing during the 3rd-4th decade I have a lytic appearing lesion on XR. I stain + for CD68, H3G34W, p63. Who am I? #pathagonia #bone #orthox #softtissuex #pathx #msk #ortho #hemeonc

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Jay Hwang

@Path4People

7 months

50 y/o F with chronic diarrhea Colonoscopy was normal Random biopsies taken. Dx? #pathagonia #pathx #gipath #gastroenterology #medstudentx #medicalstudentx #endoscope #colon #colonoscopy #pathology #bowel #colorectal #medx #medicine

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Jay Hwang

@Path4People

1 year

Here’s a general overview of stomach histology. Remember pits and glands? 😅. There are much more specialized cells that I did not label (eg other types of enteroendocrine cells besides G cells). #pathagonia #medstudents #gi #pathx

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Jay Hwang

@Path4People

1 year

I always/still get confused on moles. Complete v Partial Mole - Complete mole has greater risk of Choriocarcinoma - p57 (maternally imprinted gene) IHC can help differentiate - partial mole (XXY generally) and complete mole (XX or XY) #pathtwitter #medtwitter #obgyn #med

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Jay Hwang

@Path4People

7 months

Hemorrhoids are “Easy” to Read by Pathologists. Easy to Read, however, also sometimes mean Easy to Miss 😰😨 Here’s an HSIL involving a hemorrhoid. Credit: Michelle Williams, MD #pathagonia #pathx #gipath #obgyn #gynpath #hpv #medstudent #gensurg #surgpath #surgery #medx

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Jay Hwang

@Path4People

1 year

Chronic Endometritis Potential cause of pregnancy loss and infertility. Unclear etiology but some bacteria might be implicated in it. Diagnose: plasma cells in endometrial stroma Treatment: antibiotics like doxycycline #pathtwitter #gyntwitter #obtwitter #gyntwitter

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Jay Hwang

@Path4People

7 months

Paraganglioma v. Neuroendocrine Tumor 🤔 Both express neuroendocrine markers (eg. INSM-1), and nested architecture (see picture👇) However, paragangliomas are (generally): Cytokeratin negative GATA3 positive. #pathagonia #pathx #endocrinology #pedsx #medx #medicinex #gipath

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Jay Hwang

@Path4People

1 year

Have you ever wondered how surgeons know if they've removed all of a tumor? Pathologists look under the microscope to check if the edges of the removed tissue are clear or still have tumor. Clear margins mean better chances of success! 🔬👨‍⚕️👩‍⚕️ #Pathology #Histology #Surgery #Tumor

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Jay Hwang

@Path4People

3 months

Collagenous Spherulosis(Breast) •Benign •Histo: Round spaces w/ basement membrane material (PAS+) surrounded by myoepithelial cells •Ddx include malignant entities Adenoid Cystic Carcinoma; DCIS cribriform type •Watch out for LCIS w/ Collagenous Spherulosis! #pathagonia

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Jay Hwang

@Path4People

6 months

Among other hints, 2 histologic tips taught to me to identify Endometrioid endometrial carcinoma - Cribriforming glands - Meandering glands ⬇️ #pathagonia #pathx #gynpath #gynonc #obgyn #gynx #medx #medicalstudentx #pathology #gynecology #endometrium #endometrialcancer #embx

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Jay Hwang

@Path4People

3 months

Foveolar Metaplasia of Duodenum • Something I feel can be easily missed if not in the back of your mind • Considered a reparative/reactive process • May be associated with H Pylori gastritis, NSAID use, and Duodenal polyp. #pathagonia #pathx #pathtwitter #gipath #gi #medx

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Jay Hwang

@Path4People

6 months

I can be found on head, neck, abdomen and elsewhere I have nested architecture and salt and pepper chromatin INSM1 +, Pancytokeratin -, GATA-3 + Who am I?😵‍💫 #pathagonia #pathx #endocrinex #medx #surgpath #medicine #surgonc #gensurg #surgery #pathtwitter #endox #medicalstudent

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Jay Hwang

@Path4People

1 year

🔬Dr. Dorothy Reed, a trailblazer in the early 20th century, rocked cancer research! She found special cells 🦉(Reed Sternberg cells) in Hodgkin's lymphoma, helping Drs. diagnose it better. She broke many barriers 🛑, and is a true pioneer in medicine 🧫🥼🧍🏻‍♀️💪🏽

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Jay Hwang

@Path4People

10 months

63 y/o patient s/p liver transplant 20 years ago has new skin lesion on lower leg Further workups reveal positivity for HHV8 Top ddx/dx? #pathagonia #pathx #medx #medicine #fammed #gensurg #hemeonc #softtissue #dermpath

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Jay Hwang

@Path4People

7 months

Skin Histology🤓 Below is Acral Skin (eg. Palm, Soles) Acral skin has a stratum lucidum (Clear layer of dead skin cells). See below! Source: 👇 #pathagonia #pathx #dermpath #dermatology #medicalstudent #medstudent #medx #histology #histo #medicalstudents #skincare #skin

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Jay Hwang

@Path4People

6 months

Ovary Tumor removed in a 23 year old. Diagnosis? #pathagonia #surgpath #pathx #gynpath #pedspath #gynecology #gynx #obgyn #obgynx #medstudentx #pathology #ovary #teratoma #ent #entx #pathtwitter #obgynpath #ovarycyst #medx #medicinex

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Jay Hwang

@Path4People

7 months

Psoriasis: -A common presentation is well defined red plaques with silvery scales. - Etiology involves genetic, autoimmune, and environmental factors - Psoriatic arthritis affects~ 5-30% pts w/ psoriasis Factoid credit👇 Image credit: Kelly Hall, MD #pathagonia #psoriasis

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Jay Hwang

@Path4People

2 months

Ferruginous Body • Histologic pathologic findings suggestive of asbestos exposure

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Jay Hwang

@Path4People

22 days

Toxoplasma lymphadenitis • Localized presentation of acute infection by Toxoplasma gondii in lymph node 🔬 - 1) Follicular Hyperplasia - 2) Small clusters of epithelioid histiocytes in Cortex and Paracortex w. germinal center infiltration - 3) Prominent monocytoid B cells

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Jay Hwang

@Path4People

1 year

Immature Teratoma Grade based on how many Immature neuroepithelial elements you see on low power field Immature neuroepithelium is okay in a products of conception. NOT ok in Teratoma. High grade immature Teratoma requires surgery and chemotherapy #pathtwitter #obgyn #peds

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Jay Hwang

@Path4People

8 months

#Hashimoto 's is a risk factor for Papillary Thyroid Carcinoma (PTC) Warthin Tumor is the 2nd most common benign salivary tumor. There's a subtype of PTC that looks like Warthin Tumor. Associated more with Hashimoto's + Similar prognosis as conventional PTC #pathagonia

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Jay Hwang

@Path4People

1 year

Intranuclear Cytoplasmic Inclusions (INCIs): - invagination of cytoplasm into nucleus - may be seen in papillary thyroid cancer, IPMN, melanomas, hepatocellular carcinomas and others. #pathx #cytox #medstudentx #pathology #ent #gi #cytopath #derm #gipath #path

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Jay Hwang

@Path4People

3 months

Councilman Body • Eosinophilic globule representing fragment of apoptotic hepatocyte Mallory Denk Body • Cytoplasmic hyaline inclusion made up of p62, ubiquitin, and intermediate filaments Both can be seen in liver injury (of which there are many causes) #pathagonia #gipath

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Jay Hwang

@Path4People

1 year

🔬 The Showdown Begins! 🥊 In the left corner, the sleek melanocyte🥹 with a gray cytoplasm. And in the red corner, the terrifying melanoma with a cherry-red nucleolus! 😱 Stay skin savvy and aware! 💪🏽🔍. Prevent this fight altogether with sunscreen 🧴☮️ ⛅️ #HistopathHighlight

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Jay Hwang

@Path4People

6 months

I am a self-limited condition that may be mistaken for a more sinister process (epithelioid sarcoma->cytokeratin+) I may appear as an annular plaque I have granulomatous inflammation with mucin and necrobiosis (degraded collagen) Who am I? #pathagonia #dermx #dermpath #pathx

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Jay Hwang

@Path4People

6 months

This is one of the things I fear most as a pathology resident. There’s a saying (I don’t know who it’s attributed to) that there are 2 kinds of pathologist: Those who have missed this and those that have yet to. #pathagonia #pathx #surgpath #gipath #hemeonc #surgonc #medx

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Jay Hwang

@Path4People

1 year

🥬Vegetable = Cancer 🍉Watermelon = Patient tissue. Surgeon finishes patient’s surgery Surgical margin is negative for cancer Pathologist's choice: Which cut provides more info?🤔 #PathologyMatters #InteractiveLearning #path4people #introtopath

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Jay Hwang

@Path4People

2 months

Spermatocytic Tumor •Germ cell tumor unrelated to GCNIS • ~1% of testicular germ cell tumor; no ovarian equivalent • Mean Age:52-59 • Avg Size:5-6cm •R/o sarcomatous transformation; otherwise, excellent prognosis •IHC: 🛑OCT3/4 ✅CD117,SALL4 #pathagonia #gupath #urology

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Jay Hwang

@Path4People

6 months

I am a type of hemangioma I may become ulcerated I may pop up on mucosa or skin Who am I? #pathagonia #pathx #surgpathx #pathology #medstudentx #medx #fammed #pathtwitter #derm #dermatology #skin #medicalstudent #medicine #dermx #obgyn #ops #dental #dentistx #ent #usmle

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Jay Hwang

@Path4People

2 months

Clear cell sarcoma (CCS) of soft tissue • Mesenchymal neoplasm (5 yr survival ~60%) • Age: 3-4th decade • Size: Most 2-5 cm • Location: ~50% distal lower extremity, ankle, foot •🔬: nested growth, epithelioid cells, +/-melanin • IHC: S100, HMB45+ •🧬t(12;22) EWSR1-ATF1

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Jay Hwang

@Path4People

9 months

The power of CK7 and 20🤯 40 y/o F with suspected low grade appendiceal mucinous neoplasm (LAMN) and incidental ovarian mucinous cystadenoma However, both were CK7 - (not shown) and CK20 + Dx: Metastatic LAMN Credit: Dr. Melody Smith #pathagonia #pathx #gynx #medx #surgx

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Jay Hwang

@Path4People

6 months

I am an ovarian epithelial tumor I am associated with endometriosis. I am CK7, Napsin A, HNF1B + Who am I? #pathagonia #pathx #ovary #gynpath #gynx #obgynx #pathology #surgpath #medx #medstudentx #hemeonc #gynonc #gyn #surgpathx #medical #medicine #surgonc #medicalstudent

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Jay Hwang

@Path4People

4 months

Spironolactone Bodies • Concentric lamellations 👇 • Seen in adrenal tissue of pts with primary hyperaldosteronism (Conn syndrome) treated with aldosterone anatogonists (eg. Spironolactone) • Adrenalectomy done as medications were ineffective #pathagonia #pathx #pathtwitter

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Jay Hwang

@Path4People

9 months

Recently, I shared a post about testicular mesothelioma. There were great questions asked and made me appreciate how histology -> understanding pathology eg. Tunica vaginalis has a parietal and visceral layer made of mesothelial cells (which can give rise to mesothelioma!)

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Jay Hwang

@Path4People

1 year

Chromophobe RCC 👀 low power: solid sheets 👀 high power: plant like cells; raisinoid nuclei; 2 cell types IHC: Hale Colloidal Iron, CKIT and CK7 🧬: if oncoytoma + chromophobe think Birt-Hogg-Dube syndrome Ddx: Clear cell RCC; Oncocytoma #gupath #kidney #pathx #gu #nephro

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Jay Hwang

@Path4People

29 days

Rete Testis • System transporting sperm🏊🏊🏊from which seminiferous tubules empty; then its delivers🏊to efferent ductules+epididymis where sperm🏊can mature • Female analogue: Rete ovarii • Pathology: Testicular tumors invading rete testis is still limited to testis (pT1)

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Jay Hwang

@Path4People

9 months

I generally appear during childhood/adolescence I arise by a post zygotic GNAS missense mutation I generally appear in the craniofacial bones or femur and on radiology appear "ground-glass" like Who am I? #pathagonia #pathology #pathx #medx #entx #orthox #medstudent #pedsx

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Jay Hwang

@Path4People

3 months

Atypical Fibroxanthoma (AFX) • Dermal based neoplasm w unknown histogenesis • Generally behaves in low grade fashion • Arises on sun-damaged skin in elderly, esp head+neck as single nodule •🔬Cellular, pleomorphic, frequent mitoses, no necrosis, only in dermis • IHC: CD10+

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Jay Hwang

@Path4People

7 months

Lichen Sclerosis Symptoms: intensely itchy Risk: Can lead to HPV independent vulvar intraepithelial neoplasm and SCC Diagnosis👇 Treatment: corticosteroids (1st line) Credit ⬇️ #pathagonia #pathx #obgyn #medx #gynonc #dermpath #dermatology #dermx #pathology #medstudent

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Jay Hwang

@Path4People

1 month

Biphenotypic Sinonasal Sarcoma (BSNS) • Exclusive to sinonasal tract • Low grade w👍prognosis • Rare; Mean age 53; Female predominance •🔬:Bland, monotonous spindle cells w/fascicular architecture w entrapped foci of entrapped hyperplastic epithelium •🧬:PAX3 rearrangement

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Jay Hwang

@Path4People

5 months

A very cool section, cut by yours truly 🙂‍↔️ #pathagonia #pathx #path4people #gipath #surgery #surgonc #medicalstudent #anatomy #histology #medx

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Jay Hwang

@Path4People

6 months

I am a rare skin cancer and may be associated with a polyoma virus I may arise on head and neck, esp in > 60 y/o Caucasian males. Sadly, one generational singer recently passed away from it What am I?(Histo hint below) #pathagonia #dermx #dermpath #medx #pathx #medstudentx

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Jay Hwang

@Path4People

7 months

Basal Cell Carcinoma (BCC) Here are some key histologic findings of BCC. Granted, there are many subtypes The histo is of superficial (multifocal) BCC #pathagonia #derm #dermx #basalcellcarcinoma #dermpath #medx #fammed #medstudent #medstudentx #skincancer #pathx #surgpath

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Jay Hwang

@Path4People

5 months

Reactive Gastropathy AKA Chemical Gastritis — due to long term contact that irritates stomach lining like 1) NSAIDs 2) Alcohol 3) Bile reflux (eg after weight loss surgery) Some features to 👀 for 👇 #pathagonia #path4people #pathx #gipath #pathtwitter #medstudent #pathology

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Jay Hwang

@Path4People

1 year

😃Today’s #clinicalpathologycorner : Behind every test result shared by your clinician, there's another team 🩺🔬 Pathologists and radiologists work behind the scenes to uncover vital insights. 🤓 Check out this informative article about pathologists!😄 🔬

Pathologists: The Unseen Doctors of Your Medical Team - The Patient Story

Kamran Mirza, MD, PhD, explains the role of pathologists, delays in getting results, and how patients can understand their own reports.

thepatientstory.com

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Jay Hwang

@Path4People

2 months

Sertoli cell tumor • Sex cord neoplasm • Composed of Sertoli cells • Average age+size: 30,8 cm •🔬Tubular architecture, cuboidal/columnar cells w. pale/lipid-rich/eosinophilic cytoplasm, bland oval-round nuclei • IHC: SF1, calretinin, cytokeratin+ #pathagonia #pathx #gyn

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Jay Hwang

@Path4People

3 months

Mycosis Fungoides • Primary cutaneous T cell lymphoma • Occurs in sun protected areas “bathing trunk” distribution • Presents initially as patches to plaques • CD2,3,4,5 + • CD8 - and CD7 dim/partially lost. #pathagonia #dermpath #pathx #derm

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Jay Hwang

@Path4People

5 months

Pilomatrichoma • I will never forget this story 😦 • It’s a benign skin tumor that can differentiate toward basaloid matrical cells👇 • I heard an FNA showed only mainly those basaloid cells (which can have mites!) and a ddx was “small round blue cell tumor”😧 #pathagonia

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Jay Hwang

@Path4People

7 months

More for the pathology residents, non path residents, and med students: Remember the 3 M’s! Molding Margination Multinucleation Here we have HSV infection of the skin #pathagonia #pathx #medstudent #medstudentx #pathology #hsv #medx #infectiousdisease #surgpath #herpes

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Jay Hwang

@Path4People

1 year

Tenosynovial Giant cell tumor Arises from synovium (joints; bursae; tendon sheath) Due to CSF1 mutation Localized type usually on the fingers Treatment of localized: surgical excision #pathtwitter #pathsig #orthotwitter #medtwitter #MedStudentTwitter #softtissue

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Jay Hwang

@Path4People

9 months

Breast mass. Three things 👇found on histology. This is called? 🤓🔬 #pathagonia #breast #pathx #breastpathology #breastca #medx #hemeonc #surgonc #breastsurg #medstudentx #pathology

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Jay Hwang

@Path4People

11 months

Reactive Pneumocytes can mimic carcinoma 😱 They can be enlarged, binucleated, and have macronucleoli Tip: 👀 for @natasharekhtman ’s“Napoleons Hat Sign” in reactive pneumocytes Her Article 👇 #pathagonia #pathx #pulmx #medx #pulmx #cytopath

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Jay Hwang

@Path4People

10 months

42 year old female Lymphadenopathy x 4 months Biopsy shown below ⬇️ IHC: S100 + Dx? #pathagonia #pathx #hemeonc #heme #medx #medstudent #fammed #hemepath #softtissuepath

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Jay Hwang

@Path4People

4 months

Partial Mole • Distinguishing partial mole from complete and nonmolar specimens may be difficult on histology alone (ref ⬇️) • p57 can help differentiate complete mole • Molecular testing is needed to diagnose partial mole (as per WHO5e) #pathagonia #path4people #pathx

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Jay Hwang

@Path4People

3 months

Appendiceal Goblet Cell Adenocarcinoma • Amphicrine (both endocrine + exocrine) tumor; CK20, SATB2, Synaptophysin/Chromogranin + • Grade I-III based on proportion of low and high grade pattern • Ddx: Appendiceal adenocarcinoma + Well-diff NET Photo credit: Evan Tweed, MD

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Jay Hwang

@Path4People

3 months

TFE3-rearranged Renal Cell Carcinoma •~40% of pediatric RCC •🔬papillary architecture w/ epithelioid clear cells and many psamomma bodies •IHC: strong nuclear TFE3 PAX8+ -/+ cytokeratins, melan A, HMB-45 +/- Cathepsin K •Similar prognosis as Clear Cell RCC #pathagonia

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Jay Hwang

@Path4People

1 month

Fibrolamellar Hepatocellular Carcinoma •Rare liver cancer (<1% of 1º liver cancers) •Seen in younger patients (usu. 2-3rd decade). •Occurs ONLY in non cirrhotic livers •Average size on dx: 10 cm •🧬: DNAJB1-PRKACA •IHC: HepPar1, CK7, CD68+ •Trt: Surgery • 🔬+DDx:⬇️

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Jay Hwang

@Path4People

10 months

I (usually) have a BRAF gene mutation and stain with WT1. I can be seen in pediatric and older adults. I may cause polycythemia. Who am I? #pathagonia #gupath #kidney #pathx #medx #hemeonc #pedsx #medicine #urologyx #urology #heme #genitourinary #nephrology #nephrox

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Jay Hwang

@Path4People

3 months

Gastric Xanthoma • Benign • Endoscopically 👀 as yellow-white nodules • Most common location-Antrum • Foamy macrophages in lamina propria • Etiology unclear • Associated with background gastric pathology #pathagonia #path4people #gipath #pathx #gi #gastroenterology

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Jay Hwang

@Path4People

28 days

Brenner Tumor • Benign ovarian tumor (5% of benign ovarian epithelial tumor) • Age: Often 5th-7th decade • Size: Most <2cm • Well circumscribed, Firm, rubbery •🔬👇 • IHC: GATA3, CK7, uroplakin+ • Ddx: includes Walthard rest (will NOT have dense fibromatous stroma)

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Jay Hwang

@Path4People

3 months

Trichoepithelioma • Benign adnexal tumor • Recapitulate features of germinative hair bulb and associated mesenchymal stroma • May mimic basal cell carcinoma • If multiple, may be associated with Brooke-Spiegler syndrome Photo credit: Kelly Hall, MD #pathagonia #pathx

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Jay Hwang

@Path4People

1 month

Non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) •👍 Prognosis •🩺 Asymptomatic nodule detected during PE or imaging •Mean Age is 5th decade; M:F 5:1 •🧬: RAS mutations (most common) •🔬: Encapsulated with PTC-like nuclei #pathagonia

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Jay Hwang

@Path4People

1 year

I am a kidney mass. Well circumscribed. But have a central +\- stellate scar I am CD117/CKIT + Dx? #pathagonia #pathx #gux #gupath #urox #urology #medstudentx #pathology #histology #kidney #nephrology

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Jay Hwang

@Path4People

1 month

Papillary Urothelial Neoplasm of Low Malignant Potential (PUNLMP) • Neoplasm occurs mainly in bladder • Often Males+6-7th decade • Requirement:No hx of urothelial cancer • 🔬:Papillary structures w/ thickened urothelial layer wherein cells are monotonous • DDx: LGPUC

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Jay Hwang

@Path4People

1 year

Blueberries 🫐 can teach us the #cytopathology of #mesothelioma - 3D with knobby/morular borders - usually > 10 cells. - macronucleoli and or multiple nucleoli (imagine these 🫐 have big/multiple seeds) #pathagonia #medx #medtwitter #pathtwitter #pulmx #oncology #mesothelioma

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Jay Hwang

@Path4People

6 months

I am a benign pancreatic tumor, more common in females Microcystic pattern is my most common type I can have a central stellate scar and rarely may be associated with VHL syndrome. Who am I? 🤔 #pathagonia #pathx #gipath #geneticsx #medx #medboards #surgpathx #surgpath #med

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Jay Hwang

@Path4People

6 months

Pleomorphic LCIS Oftentimes associated with an invasive lobular carcinoma Look for nuclear pleomorphism and nuclei size > 4 x lymphocyte ⬇️ #pathagonia #hemeonc #breastcancer #breastpath #pathology #surgpath #medicalstudent #gensurg #surgonc #pathx #pathtwitter #mammo #medx

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Jay Hwang

@Path4People

2 months

Sjögren syndrome • Chronic autoimmune disorder of salivary+lacrimal glands • F:M=9:1 • Bimodal Distribution:3rd-4th decade--6th decade • Etiology: unknown •🔬: focal lymphocytic sialadenitis • ⬆️40x risk of lymphoma compared w gen population •🧪+anti-Ro,-La #pathagonia

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Jay Hwang

@Path4People

3 months

Endocrine mucin producing sweat gland carcinoma (EMPSGC) • Low grade neoplasm of sweat gland origin • Predilection for eyelid+periorbital skin • Precursor to mucinous adenocarcinoma w neuroendocrine differentiation • INSM-1, ER, PR + Photo credit: Kelly Hall, MD #pathagonia

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Jay Hwang

@Path4People

3 months

Epithelioid Hemangioendothelioma •Malignant vascular neoplasm •Cords/nests of epithelioid cells against myxohyaline stroma •Can occur in any organ but more common in soft tissue, lung, liver •CD31, 34,D2-40, FLI1,ERG + •Cytokeratin-/+ •👀for blister cells⬇️ #pathagonia

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Jay Hwang

@Path4People

4 months

HSIL • Nucleoli can be tricky because it can be seen in reactive conditions. • But sometimes they can be seen in HSIL esp when it involves endocervical glands #pathagonia #pathx #path4people #gynpath #obgyn #hpv #hsil #pathtwitter #pathology #gynx #obgynx #surgpath #medx

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Jay Hwang

@Path4People

6 months

I usually am a slow growing mass arising most commonly in the lower leg I am more common in females than males I am painful. Who am I? (Be subtype specific!)🤔 Courtesy: Ryan Smith, DO #pathagonia #pathx #bstpath #dermpath #surgpath #medx #fammed #medicine #medstudentx

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Jay Hwang

@Path4People

7 months

Lipomatous Tumors include: Well differentiated Liposarcoma/Atypical Lipomatous Tumour Dedifferentiated Liposarcoma Pleomorphic Liposarcoma (Pics ⬇️) #pathagonia #pathx #medx #medicinex #softtissuepath #medstudent #bst #ortho #orthopedics #msk #msktumour #hemeonc

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Jay Hwang

@Path4People

4 months

Tubular adenoma • Is at least low grade dysplasia by definition and a precursor to invasive Adenocarcinoma • Look for tubular adenoma with high grade dysplasia b/c changes management 👇 #pathagonia #path4people #gipath #pathx #pathtwitter

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Jay Hwang

@Path4People

1 month

Adenomatoid Tumor • Mesothelial Benign Tumor • May arise:Uterus, Fallopian Tube, Ovary, Epididymis, Spermatic Cord,[Adrenal, Peritoneum+Pleura (RARE)] •🔬: Architecture-Slit like, tubular, cystic. Cytology - cuboidal or flat with thread-like🧵bridging strands⬇️ #pathagonia

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Jay Hwang

@Path4People

5 months

Tubulovillous Adenoma (TVA) •👀 like a Tubular Adenoma (TA) but with Villous Architecture (20-80% Villosity) • if >80% villosity ➡️ Villous Adenoma Why is it important?👇 1 TA < 10 mm: Post Surveillance in 7-10 yrs 1 TVA: in 3 yrs #pathagonia #path4people #pathx

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Jay Hwang

@Path4People

2 months

Low Grade Endometrial Stromal Sarcoma •🩺AUB+/-pelvic pain •Mean age: 52 •Risk Factor: estrogen,tamoxifen, pelvic☢️ • Avg Size:5-10 cm •🔬Prolif.-phase like-endometrial stromal tumor cells permeating myometrium (tongue-like)+/-LVI •IHC: CD10, IFITM1, ER,PR+ #pathagonia

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Jay Hwang

@Path4People

9 months

60 year old M with PMHx of alcoholism, cirrhosis and esophageal varices. Colonoscopy due to + fecal occult blood test but no polyps noted. Random biopsy below 👇 Dx? #pathagonia #pathx #gipath #gastroenterology #medx #liverx #path #medicalstudent #fammed #surgx #hepatology

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Jay Hwang

@Path4People

2 months

Calcifying Aponeurotic Fibroma • Rare benign tumor • Location: palmar surface of hands+fingers; plantar surface of feet+toes • Age: Usually 5-15y/o • Size:~1-3 cm, ill-defined •🔬:1) fibromatosis-like infiltrative portion 2) nodular calcified portion #pathagonia #pathx

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Jay Hwang

@Path4People

5 months

I wish prostate cores were easy to read. This is one reason why it can be hard. Beware the Foamy Gland Variant of Prostate Cancer 😳😱 Credit: Dr. Daniel Hagen, MD #pathagonia #path4people #gupath #urology #prostatecancer #prostate #surgpath #medx #urologyx #pathx

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Jay Hwang

@Path4People

6 months

I may have a positive Nikolsky’s sign I usually occur < 6 y/o I have an excellent prognosis What am I? #pathagonia #pathx #pedsx #pediatrics #infectiousdisease #dermpath #dermatology #fammed #medx #medicalstudent #medstudent #peds #surgpath #pathology #bacteria #nikolsky

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Jay Hwang

@Path4People

5 months

I am a rare uterine cervical cancer and highly malignant. I am associated with HPV, particularly 18 subtype Usually, you might see me in the lung. IHC: Chromogranin and p16 + Ki-67: “high” CD45 - Who am I? 🤔 #pathagonia #path4people #surgpathx #obgyn #gynpath #pathx

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Jay Hwang

@Path4People

5 months

This colon biopsy was a neat case for 2️⃣ reasons for me: 1) It illustrated importance of getting recuts 👇 2) Schwann Cell Hamartomas can look like polyps. — arise in lamina propria — S100+👇 Ddx: Neuroma, Ganglioneuroma, Schwannoma, Perineurioma, Vanek Tumor. #pathagonia

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Jay Hwang

@Path4People

7 months

15 Subtypes "Shades" of Meningiomas: And can be CNS WHO Grades 1-3 Clear Cell and Chordoid subtype->WHO Grade 2 Papillary and Rhabdoid subtype->WHO Grade 3 Other criteria exist that may get you to Grade 2 or 3 (eg. Mitotic Count, Brain Invasion, Molecular, Histo) #pathagonia

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Jay Hwang

@Path4People

7 months

When I started residency, I thought GATA3 was specific for metastatic breast cancer Little did I know about GATA3...cue Nelly Furtado's song, Promiscuous 😹 GATA3 is + in BCC Choriocarcinoma Mesothelioma Paraganglioma Parathyroid Urothelial Ca. + MORE! #pathagonia

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