Samson W. Fine, MD @rovingatuscap Twitter profile

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Samson W. Fine, MD

@rovingatuscap

3 years

Not every day that you get such a stunning view of metaphase/anaphase #mitosis Seen here in Adrenal Cortical Carcinoma #gupath #endopath #MedTwitter

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Samson W. Fine, MD

@rovingatuscap

4 months

Personal moment: so immensely proud of our son, Yonatan A. Fine, as he graduates @YUNews honored as Yeshiva College Valedictorian 🎓 & heads to @YaleLawSch #graduation2024

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Samson W. Fine, MD

@rovingatuscap

3 years

Uncommon pattern of high grade #prostatecancer The elusive 'hypernephromatoid' pattern #gupath

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Samson W. Fine, MD

@rovingatuscap

3 years

Evolution in Grading of #prostatecancer (PCa) PCa Variants not previously accounted for in original Gleason scheme were incorporated, including 'B9-appearing' ones [depicted below]: ✨Foamy ✨Atrophic ✨Pseudohyperplastic ✨Microcystic #ProstateCancerawarenessmonth #gupath 1/n

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Samson W. Fine, MD

@rovingatuscap

4 years

Benign spermatic cord finding #1 : Leydig cells involving nerves - a NOT uncommon finding that should NOT be misconstrued as tumor #gupath #testis #mimics

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Samson W. Fine, MD

@rovingatuscap

4 years

Classic finding of FH-deficient renal cell carcinoma - seen in context of Hereditary Leiomyomatosis-Renal Cell Carcinoma (HL-RCC) syndrome & otherwise: large nucleus w/prominent eosinophilic nucleolus, surrounded by clear halo: #kidneycancer #gupath

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Samson W. Fine, MD

@rovingatuscap

5 years

Especially with a fresh cohort of #pathology trainees out there, I thought it may be time for a #gupath refresher on #Prostate Anatomy ✴️ Did you know that its modern history can be attributed to Dr. John E. McNeal from @StanfordMed ?1/n

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Samson W. Fine, MD

@rovingatuscap

2 years

Special shout-out to my #gupath colleague and mentor, Dr. Victor Reuter @MSKPathology being honored with the Board’s Distinguished Pathologist Award #USCAP2022 for his long-standing contributions to @TheUSCAP

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Samson W. Fine, MD

@rovingatuscap

4 years

Potential pitfall in #gupath - von Brunn nests in upper tract (ureter; renal pelvis) are typically smaller than those in the #bladder & should not be confused with infiltrating #urothelialcancer - tangential sectioning can exacerbate the challenge!

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Samson W. Fine, MD

@rovingatuscap

4 years

"Order vs. disorder" - urothelial carcinoma in situ; note abrupt changes in architecture & cytology #gupath #bladdercancer

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Samson W. Fine, MD

@rovingatuscap

1 year

Chromophobe Renal Cell Carcinoma demonstrating classic features: 🔬'plant cell wall-like' membranes 🔬peri-nuclear halos 🔬bi-nucleation AND 🔬regions w/numerous micro-calcifications Ca++ may be seen in 30-50% of Chromophobe RCC (PMID: 18813125, 21602658) #kidneycancer #gupath

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Samson W. Fine, MD

@rovingatuscap

4 years

Metanephic adenoma of #kidney demonstrating a spectrum of architectural patterns including small acinar, tubular, papillary & associated with marked psammomatous calcification #gupath 1/2

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Samson W. Fine, MD

@rovingatuscap

3 years

Personal moment: so immensely proud of our daughter, Neima S. Fine, as she graduates @MaayanotYHS & after a gap year heads to @FIT_artdesign #betheenergyyouwanttoattract #designyourfuture

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Samson W. Fine, MD

@rovingatuscap

4 years

Abrupt transition from benign inflamed urothelium to urothelial carcinoma in situ #bladdercancer #gupath

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Samson W. Fine, MD

@rovingatuscap

1 year

#TooCloseToDiagnose (?) What say you #PathTwitter

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Samson W. Fine, MD

@rovingatuscap

2 years

With #USCAP2023 approaching, I have been conversing with @MSKPathology fellows about how to make the most of the meeting Thought I would share some ideas here (thread🧵): 1. Large professional mtgs can be overwhelming & IMO, require a strategy in order to maximize gains 👇🏻 1/

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Samson W. Fine, MD

@rovingatuscap

3 years

MITF Family Translocation-Associated RCC #1 TFE3 (Xp11.2) Rearranged 🧬Onset in childhood & younger age common 🧬Papillary w/clear cells 🧬Multiple partners w/TFE3 gene, incl. PRCC (1q21), ASPSCR1 (17q25), SFPQ (1p34) #gupath #kidneycancer #KidneyCancerAwarenessMonth 1/

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Samson W. Fine, MD

@rovingatuscap

3 years

Incidental finding in a pelvic lymph node at cystectomy 🌟ENDOSALPINGIOSIS: note the cuboidal & ciliated lining epithelium #beautyinbenign #gynpath #gupath

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Samson W. Fine, MD

@rovingatuscap

3 years

Excited to begin PGY 22 & Year 17 @MSKPathology - grateful to learn from & be supported by amazing colleagues, friends, & especially family Special shout-out to the love of my life, Dr. Chaya Fine, on our 25th anniversary celebration (6/30) Silver ✔️ next 🥅 = gold :)

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Samson W. Fine, MD

@rovingatuscap

6 months

Lifetime Achievement Award @GU_Path_Society to our @MSKPathology colleague and leader, Dr Victor Reuter for his myriad contributions to advancing #gupath #USCAP2024

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Samson W. Fine, MD

@rovingatuscap

6 years

Not your typical lesion to begin the day (a case in 3 tweets) - Bladder paraganglioma - classic "zelballen" morphology, vascularity and #IHC profile: chromoganin/INSM (+) #gupath #bladder #endocrinepath 1/3

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Samson W. Fine, MD

@rovingatuscap

4 years

Beautiful example of high grade prostatic intraepithelial neoplasia (HGPIN): tufted & micropapillary architectural patterns w/uniform cytologic atypia, most significantly - prominent nucleoli #gupath #prostatecancer

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Samson W. Fine, MD

@rovingatuscap

3 years

Eosinophilic Solid & Cystic Renal Cell Carcinoma 📊novel entity 📊most sporadic w/female predominance 🧬occasionally seen in pts. w/ Tuberous Sclerosis Complex (TSC) #gupath #KidneyCancerAwarenessMonth 1/

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Samson W. Fine, MD

@rovingatuscap

3 years

Pagetoid spread of UROTHELIAL CARCINOMA IN SITU Note the abrupt interface of DISORDER (architecture & cytology) with normal urothelium #gupath #bladdercancer

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Samson W. Fine, MD

@rovingatuscap

2 years

Seminoma & Embryonal Carcinoma in Transition Part 1: abrupt - note differences in cytoplasm and nuclear features & contrast in CD30 #IHC labeling #testicularcancer #gupath @TestesCancer

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Samson W. Fine, MD

@rovingatuscap

4 years

Central Zone glands #prostate 🌉complex architecture 🌉stratified eosinophilic cytoplasm 🌉prominent basal cell layer 🌉intra-luminal bridges ("Roman arches") 🌉mimic high grade PIN 🌉Rule of 👍🏻: in NB from mid-base, have higher threshold for HGPIN & r/o normal anatomy! #gupath

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Samson W. Fine, MD

@rovingatuscap

4 years

Nodular glomerulosclerosis (w/Kimmelstiel-Wilson lesions) in Diabetes Mellitus; PAS(+) #renalpath #kidney

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Samson W. Fine, MD

@rovingatuscap

2 years

Papillary Urothelial Carcinoma w/Pleomorphic Features #gupath #bladdercancer

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Samson W. Fine, MD

@rovingatuscap

3 years

MITF Family Translocation-Associated RCC #2 TFEB (6p21) Rearranged 🔬biphasic morphology: - larger epithelioid cells w/clear to eosinophilic cytoplasm - smaller cells clustered around nodules of basement membrane material #gupath #kidneycancer #KidneyCancerAwarenessMonth 1/

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Samson W. Fine, MD

@rovingatuscap

1 year

May is #bladdercancerawarenessmonth - important to recognize lesions which mimic #bladdercancer Nephrogenic metaplasia/adenoma: - various architectures (papillary, tubular/glandular, vascular-like...) - cuboidal to hobnail nuclear features - prominence of basement membrane

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Samson W. Fine, MD

@rovingatuscap

2 years

Eosinophilic variant Chromophobe RCC - Peri-nuclear 'halos', nuclear membrane irregularities, occasional multi-nucleation - Dense, eosinophilic cytoplasm - 🚨 rare single cells & clusters CK7+ #IHC (lower R) more akin to what is seen in renal oncocytoma #kidneycancer #gupath

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Samson W. Fine, MD

@rovingatuscap

5 years

#bladdercancer w/features diagnostic of superficial pT1 (lamina propria) invasion ▶️ small, irregular nests ▶️ "paradoxic differentiation"=tumor cells more pink cytoplasm than in non-invasive component ▶️ retraction ▶️ loss of capillary network/"cuff" around tumor nests #gupath

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Samson W. Fine, MD

@rovingatuscap

4 years

Although uncommon, sarcomatoid differentiation = poor prognostic sign in chromophobe renal cell carcinoma 'islands' of chromophobe RCC amidst a 'sea' of sarcomatoid morphology [pics] Incidence in a large series: #gupath #KidneyCancerAwarenessMonth

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Samson W. Fine, MD

@rovingatuscap

2 years

Always a challenge: #prostatecancer with extensive vacuolization #gupath How would you grade this: 4+3=7, 4+4=8, 3+5=8, 4+5=9, 5+4=9?

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Samson W. Fine, MD

@rovingatuscap

2 years

Personal moment: so incredibly proud of Dr. Chaya Fine, Director of Science & #STEM Education and 20 Years @SARacademy 🐝 and my most amazing life partner being honored as Faculty Awardee - so thrilled to be at @americandream #thewonderofitall

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Samson W. Fine, MD

@rovingatuscap

4 years

Clear cell-papillary renal cell carcinoma w/classic alignment of nuclei / CK7 diffuse (+) / CA-IX (+) in a "cup-like" (incomplete membranous) pattern - as first described here: #kidneycancer #gupath

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Samson W. Fine, MD

@rovingatuscap

2 years

Prominent example of ejaculatory duct/seminal vesicle amyloid in a #prostate needle biopsy specimen - associated with aging, not a systemic disease process #gupath

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Samson W. Fine, MD

@rovingatuscap

3 years

#MedStudentTwitter #PathTwitter What's going on here? #gupath

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Samson W. Fine, MD

@rovingatuscap

3 years

Minute focus of #prostatecancer Gleason score 3+3=6 / Grade group 1 Perineural invasion Extraprostatic extension #gupath

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Samson W. Fine, MD

@rovingatuscap

4 years

Newer insights in Renal Cell Carcinomas w/ "clear cell" features have yielded distinctive entities incl. clear cell-papillary RCC and an emerging group of tumors = RCC w/prominent fibromuscular stroma #gupath #kidneycancer #KidneyCancerAwarenessMonth 1/

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Samson W. Fine, MD

@rovingatuscap

2 years

Absolutely beautiful evening in #NYC 8.31.22 #urbanpalette 🎨

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Samson W. Fine, MD

@rovingatuscap

3 years

Evolution in #prostatecancer (PCa) What happened to Gleason grade/pattern 1 & 2? [depicted below] Multifactorial: i. In 1990s: PCa was increasingly diagnosed on NBx="circumscription" required for these patterns was more challenging #ProstateCancerawarenessmonth #gupath 1/n

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Samson W. Fine, MD

@rovingatuscap

2 years

Morphologic manifestations of Regression in Clear Cell Renal Cell Carcinoma - Cell drop out - Edema - Fibrosis/sclerosis - Vascular prominence #kidneycancer #KidneyWk #gupath

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Samson W. Fine, MD

@rovingatuscap

4 years

From #gupath consensus conference @MSKPathology - malakoplakia in the #bladder ; note the prominent Michaelis-Guttman bodies #PathTwitter

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Samson W. Fine, MD

@rovingatuscap

2 years

Thrilled to welcome another stellar group of Oncologic Surgical & Subspecialty #Pathology fellows to @MSKPathology for the 2022-2023 Academic year

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Samson W. Fine, MD

@rovingatuscap

3 years

Exaggerated Basal Cell Layer in Benign prostatic glands 🔬Multi-layered: mimicking HGPIN 🔬Blue-grey/slate stained basal cell nuclei vs. purple secretory cell nuclei 🔬Pinpoint (rather than prominent) nucleoli - even at this 20x magnification #gupath #prostate

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Samson W. Fine, MD

@rovingatuscap

6 years

PROSTATIC DUCTAL ADENOCARCINOMA: 1/ ▶️ large gland variant of #prostatecancer ▶️ may mimic papillary urothelial carcinoma on cystoscopy ▶️ typically seen together with usual acinar adenoCA ▶️ papillary & cribriform/papillary architecture (see pic) #gupath

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Samson W. Fine, MD

@rovingatuscap

2 years

Perineural Involvement by benign prostatic glands 🚨may mimic #prostatecancer #gupath

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Samson W. Fine, MD

@rovingatuscap

4 years

Older man with #bladder wall mass - Nephrogenic Adenoma; #IHC PAX-8 (+) - note capillary-like, papillary & hobnail features #beautyinbenign

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Samson W. Fine, MD

@rovingatuscap

4 years

Clear cell renal cell carcinoma: at 10x magnification, WHO/ISUP Nucleolar grade 2 (LEFT) vs. 3 (RIGHT) #gupath #kidneycancer

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Samson W. Fine, MD

@rovingatuscap

3 years

Angiomyolipoma (classic) #gupath 1/ Benign mesenchymal neoplasm "Triphasic" admixture of: - dysmorphic blood vessels - smooth muscle - adipose tissue Amount of each component is variable

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Samson W. Fine, MD

@rovingatuscap

3 years

Solitary Fibrous Tumor involving bladder Overlying benign urothelium #IHC STAT-6 (+) #gupath

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Samson W. Fine, MD

@rovingatuscap

5 years

Classic seminoma demonstrating a full range of features: ▶️ Fibrous bands ▶️ Chronic inflammation ▶️ Vague granulomatous inflammation (profound in areas) #testicularcancer #gupath @Williamson_SR @daniel_berney @SunnyKaoMD @Gleason4plus5

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Samson W. Fine, MD

@rovingatuscap

1 year

Nearing the end of a stellar year with OncSurgPath & Subspecialty #pathology fellows @MSKPathology - thank you for your dedication, congrats 🥳on graduation, & all the best in your next steps!! @saharjf @rufaida87 @Gagandeepk5MD @lorrainecolonmd @TheodoreVMD @BeaCaraballob

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Samson W. Fine, MD

@rovingatuscap

3 years

Four different views of the ejaculatory duct "complex" in mid-base prostate; note the large # of slit-like lymphovascular spaces - an excellent spot to identify LVI #gupath #prostatecancer

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Samson W. Fine, MD

@rovingatuscap

2 years

Classic example of Prostatic Ductal Adenocarcinoma in transurethral resection Note prominent papillary architecture w/stratified columnar cells [best in lower R], underlying the urothelium [best in upper R] Grading: akin to GS 4+4=8 in this example #prostatecancer #gupath

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Samson W. Fine, MD

@rovingatuscap

4 years

Atypical-appearing, yet benign changes in #prostate post-radiation therapy: ☢️ peri-glandular fibrosis ☢️ nuclei w/different shapes and sizes, including elongated/bizarre/degenerative-appearing ☢️ reactive nucleoli, at least some in basal cells ☢️ eosinophilic cytoplasm #gupath

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Samson W. Fine, MD

@rovingatuscap

1 year

Benign prostatic tissue with profound treatment effect post-RT - features include: - dense 'streaming' eosinophilic cytoplasm - peri-glandular fibrosis - variably sized cells with degenerative-type atypia - associated chronic inflammation #gupath #prostate #radonc

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Samson W. Fine, MD

@rovingatuscap

3 years

Sarcomatoid Differentiation in Chromophobe Renal Cell Carcinoma ✨Islands of ChRCC surrounded by sarcomatoid growth (best seen in R side pic) #gupath #kidneycancer

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Samson W. Fine, MD

@rovingatuscap

6 years

Let's tackle mucinous fibroplasia in #prostatecancer ▶️represents organization of extravasated mucin from PCa glands ▶️occasionally seen together (see PIC) ▶️ultrastructure: composed of collagen fibrils; hence, also known as "collagenous micronodules" #gupath @Gleason4plus5 1/

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Samson W. Fine, MD

@rovingatuscap

3 years

Renal Medullary Carcinoma 1/ Classic Associations: - Adolescent / young adult w/ Sickle Cell Trait - Highly infiltrative w/fibromyxoid & desmoplastic stroma - Necrosis & 'micro-abscesses' Clinically, aggressive w/poor outcomes #gupath #kidneycancer #KidneyCancerAwarenessMonth

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Samson W. Fine, MD

@rovingatuscap

3 years

…and…1st in person #gupath Consensus Conference @MSKPathology since early March 2020 (hybrid option included) @MoHumrani @behtashg @BinXu16 @Unclassified1 @h_alahmadie

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Samson W. Fine, MD

@rovingatuscap

2 years

Congratulations to @MSKPathology colleague, Dr. Cristina Antonescu who will be giving the Maude Abbott Lecture #USCAP2022 - very well deserved! Time/Date/Location in pic below #BSTPath #molecpath

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Samson W. Fine, MD

@rovingatuscap

3 years

Unusual “pseudo-cribriform” architecture in the #prostate L: corpora amylacea w/acute inflammation R: hair surrounded by histiocytes (post-transperineal biopsy) #beautyinbenign #gupath

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Samson W. Fine, MD

@rovingatuscap

1 year

Dense pink secretions & blue mucin are intraluminal contents (along w/crystalloids) that may identify foci suspicious for #prostatecancer , BUT may also be seen in a host of benign mimics, seen here in partial atrophy with attenuated cytoplasm & lacking prominent nucleoli #gupath

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Samson W. Fine, MD

@rovingatuscap

3 years

Seminoma extensively involving RETE TESTIS Pitfall: ubiquitinated protein accumulation in rete testis can mimic 'hyaline globules' seen in yolk sac tumor #gupath #testicularcancer

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Samson W. Fine, MD

@rovingatuscap

1 year

Pitfall in interpretation: in this oncocytic tumor, displaying low grade nuclear features and architecture suggestive of oncocytoma (in other foci, nuclear membrane irregularity, etc. beyond that typically seen in oncocytoma) - diffuse 2-3+ TFEB nuclear labeling 🚨🚨🚨 👇🏻 #gupath

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Samson W. Fine, MD

@rovingatuscap

7 years

#testicularcancer involvement of rete testis in a 'pagetoid' fashion #gupath

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Samson W. Fine, MD

@rovingatuscap

3 years

Large gland lesion in the #prostate - presume basal cell markers are (+) - what is your diagnosis? 🔥 Extra Credit: explain your rationale ✳️ Poll in Tweet below #gupath 1/

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Samson W. Fine, MD

@rovingatuscap

3 years

Overt Transition of Low-Grade to High-Grade Non-Invasive Papillary Urothelial Carcinoma (uncommon in my experience) #gupath ✨abrupt changes in cellular polarity ✨marked differences in nuclear size, shape, & color ✨in this ex.: accompanied by increased mitotic figures

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Samson W. Fine, MD

@rovingatuscap

2 years

Are you a #PathTwitter TRAINEE interested in #gupath ?? Join @GU_Path_Society at #USCAP2022 for GUPS Poster Walks - tour posters w/GUPS mentors who provide context, relevance, & discussion @pathmingzhou @Williamson_SR @SaraEWobker @surrealistNYC Dates/Times/Details 👇🏻👇🏻👇🏻

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Samson W. Fine, MD

@rovingatuscap

3 years

FH-deficient Renal Cell Carcinoma 🧬common in context of germline mutations/deletions of Fumarate Hydratase (chr. 1q43) 🧬part of Hereditary Leiomyomatosis-RCC Syndrome along with cutaneous/uterine leiomyomas 📊typically aggressive #gupath #KidneyCancerAwarenessMonth 1/

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Samson W. Fine, MD

@rovingatuscap

4 years

Poorly formed / fused glands in the anterior #prostate - Grade group 4? 5? other? #gupath

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Samson W. Fine, MD

@rovingatuscap

3 years

Classic findings in Testicular Seminoma Tumor cells with 'fried egg' appearance [large nuclei with prominent nucleoli surrounded by clear cytoplasm] Admixed chronic inflammatory cells and histiocytes/vague granulomas #gupath #testicularcancer 🍳🍳🍳

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Samson W. Fine, MD

@rovingatuscap

4 years

Granular cell tumor: 💠sheets & and clusters of round to polygonal cells w/granular eosinophilic cytoplasm (lysosome accumulation) + small, uniform nuclei 💠can display pseudoepitheliomatous hyperplasia 💠S100+ / CD68+ / can be calretinin/inhibin+ as here:

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Samson W. Fine, MD

@rovingatuscap

1 year

Mixed Germ Cell Tumor showing intertwined Embryonal Carcinoma (EC) & Yolk Sac Tumor (YST) EC: more cohesive,⬆️nuclear size, more apoptosis YST (central in pic): looser cells, clear cytoplasm #testicularcancer #gupath

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Samson W. Fine, MD

@rovingatuscap

4 years

Real-world example of #prostatecancer with profound treatment effect in a patient who received #radiationtherapy ☢️ note poorly formed gland & single cell architecture w/bubbly or foamy cytoplasm and small nuclei w/nucleoli; such cases are NOT graded #gupath

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Samson W. Fine, MD

@rovingatuscap

4 years

Urothelial papilloma: 🔆simple to elongated papillae 🔆preserved polarity 🔆BEWARE: umbrella cell atypia (smudgy chromatin, vacuolization) 🔆References: 🔆Associated w/ KRAS/HRAS mutations: #gupath

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Samson W. Fine, MD

@rovingatuscap

4 years

This one’s for Jerad @JMGardnerMD - May 25th (1812) - birthday of Italian anatomist Filippo Pacini who discovered Pacinian corpuscles (seen below) in skin and occasional other sites - #pathology

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Samson W. Fine, MD

@rovingatuscap

3 years

Thrilled to serve as Education Chair @GU_Path_Society following stellar work of inaugural Chair @evacomperat & Join @pathmingzhou @rajalbshah @priyaraomd et al in growing #gupath community Looking forward to: - growing existing offerings - innovation in #virtuallearning era

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Samson W. Fine, MD

@rovingatuscap

1 year

May 2023 is #bladdercancerawarenessmonth Urothelial carcinoma can invade the prostate, mimic high grade #prostatecancer & occasionally be sampled on needle biopsy (see PICS) #gupath

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Samson W. Fine, MD

@rovingatuscap

4 years

WHO/ISUP Grade 4 in Clear Cell Renal Cell Carcinoma: image on L demonstrating extreme pleomorphism, image on R demonstrating rhabdoid features #kidneycancer #gupath

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Samson W. Fine, MD

@rovingatuscap

4 years

Venous invasion of #adrenal gland by clear cell renal cell carcinoma - note contrast between nests/clusters of clear cell RCC & adjacent adrenal parenchyma (esp. in image #2 ) #kidneycancer AJCC Stage: M1

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Samson W. Fine, MD

@rovingatuscap

8 years

As we approach beginning of #USCAP2017 #platformpresentations really important to remember this chart regarding COMMENTS

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Samson W. Fine, MD

@rovingatuscap

4 years

OK #gupath interested folks - how would you evaluate this focus of #ProstateCancer - small well formed glands? poorly formed glands? 3+3=6? 3+4=7? any features that give you pause?

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Samson W. Fine, MD

@rovingatuscap

3 years

Dispersed PARAGANGLIA in lymph node dissection for #kidneycancer Small nests of cells with bland nuclei & variegated amphophilic/basophilic (purple-ish) to clear cytoplasm Often seen in proximity to nerves #PitfallAlert #gupath CAUTION: do not confuse w/metastatic carcinoma

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Samson W. Fine, MD

@rovingatuscap

3 years

Mixed Urothelial Carcinoma + Small Cell/Neuroendocrine Carcinoma #IHC = GATA3(+) UC component [upper R pic] Synaptophysin(+) neuroendocrine [lower R pic] #gupath #bladdercancer

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Samson W. Fine, MD

@rovingatuscap

9 months

May the fresh and sparkling lights of Chanukah 🕎 illuminate these dark times & inspire our minds, hearts, and acts of kindness as they have for millennia #ChagChanukahSameach to all those celebrating 🎉 🕯️

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Samson W. Fine, MD

@rovingatuscap

3 years

Beautiful evening in #NYC 8.3.2021

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Samson W. Fine, MD

@rovingatuscap

6 years

Flat carcinoma in situ of bladder - including: a) involvement of squamous metaplasia , b) a field with overlying umbrella cell layer, c) a contrast with normal von Brunn nest and d) hi power view of nuclear irregularity - this one's for you @evacomperat #gupath #bladdercancer

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Samson W. Fine, MD

@rovingatuscap

2 years

For many yrs, Papillary RCC classified as Type 1 or 2 **In WHO GU 2022, division eliminated secondary to many "Type 2" cases = molecularly-defined RCCs, including translocation-assoc., FH-deficient RCC, etc. #gupath #KidneyCancerAwarenessMonth #OrangeUp

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28

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Samson W. Fine, MD

@rovingatuscap

4 years

Feeling privileged, blessed & thankful to have received 1st dose of #vaccine 💉- thank you to @sloan_kettering & #msknurse Marisa for making the process easy & efficient - #igotmyshot - encourage all to do so as well!

7

1

82

Samson W. Fine, MD

@rovingatuscap

9 months

🚨🚨Pitfall alert: bladder biopsy with #prostatecancer undermining benign urothelium NOT to be confused with urothelial carcinoma in situ involving von Brunn nest #gupath Morphology: note enlarged uniform nuclei with prominent nucleoli #IHC : NKX3.1 (+) GATA3 (-)

2

35

82

Samson W. Fine, MD

@rovingatuscap

9 months

✨✨CLASSIC example of flat urothelial carcinoma in situ involving a von Brunn nest #gupath Note circumscription of nests & the capillary network surrounding the basement membrane, indicating a non-invasive process - clinically, classified as NMIBC #bladdercancer

4

33

80

Samson W. Fine, MD

@rovingatuscap

2 years

It’s almost time ✈️ NYC ➡️ #NOLA for #USCAP2023 - looking forward to a wonderful week of learning, (re-) connecting, & tweeting the meeting @MSKPathology

7

4

81

Samson W. Fine, MD

@rovingatuscap

4 years

Appendix testis (normal structure) - note the transition from simple mesothelial lining of the testicular tunica to the ciliated columnar epithelium of the appendix #gupath #testis #beautyinB9

2

27

80

Samson W. Fine, MD

@rovingatuscap

5 years

We typically urge caution in diagnosing #prostatecancer in the presence of inflammation; in unusual cases, cancer is seen in a background of a dense inflammatory infiltrate - using #IHC is useful & often necessary to make a definitive diagnosis in this scenario #gupath

6

33

79

Samson W. Fine, MD

@rovingatuscap

3 years

MITF Family Renal Cell Carcinoma #3 TFEB Amplified RCC 📊Older age than TFEB-Rearranged RCC 📊Freq. present w/locally advanced or metastatic dz 🔬Less distinctive morphology: - high grade/poorly differentiated #gupath #kidneycancer #KidneyCancerAwarenessMonth 1/

6

36

78

Samson W. Fine, MD

@rovingatuscap

6 years

Prominent intraductal carcinoma of the prostate in a radical prostatectomy specimen post-androgen-deprivation therapy: note cytoplasmic clearing & prominent nucleoli in the setting of readily-evident basal cells #gupath #prostatecancer

0

40

78

Samson W. Fine, MD

@rovingatuscap

1 year

Challenging "brass knuckles" pattern of perineural invasion in #prostatecancer - the proclivity of PNI to distort glandular architecture may lead to interpretive differences as pattern 3 vs. pattern 4 #gupath

4

22

79