6Patterns

Maxwell Smith and Kevin Leslie discuss all things pulmonary pathology. Opinions are our own.

[6Patterns @6Patterns]

@Trupti2410 you raise the most important question! There are clinical trials with agents targeting this mutation. That’s the key take home lesson and why #pathologymatters

[Dr Trupti Pai @Trupti2410]

@6Patterns @LungPathGuys @howardm19 @smlungpathguy @raghupillappa So further management would be like any other non small cell carcinoma/ sarcomatoid carcinoma or on sarcoma lines?

[6Patterns @6Patterns]

@OkoyeIkechukwu2 @smlungpathguy @LungPathGuys @howardm19 @raghupillappa We went down that road too! Vascular markers negative.

[6Patterns @6Patterns]

56 y/o M with 70 pack year smoking hx. Poorly diff malignancy pos for keratin, CD34 and Focally for TTF-1. Dx or additional work up? @LungPathGuys @howardm19 @smlungpathguy @raghupillappa #pulmpath #carringtoncolbycollection

[6Patterns @6Patterns]

HG thoracic tumor + Keratin + CD34 = think about SMARCA4 deficient tumors. BAP1 loss confirms dx. TTF suggests lung adeno with acquired SMARCA4 deficiency. Nicely studies by @JL_Sauter and colleagues https://t.co/vUmTPbqEy3

[6Patterns @6Patterns]

TTF-1 clone SP141, the more sensitive but less specific clone compared to 8G7G3. If you don’t know what clone your lab uses, you should!

[6Patterns @6Patterns]

@SansanoValero @MaxwellSmithMD @LungPathGuys @howardm19 @smlungpathguy @raghupillappa SP141

[6Patterns @6Patterns]

@smlungpathguy @LizaMQuintana @steland011 @yro854 @jlrodriguezsar @TheKarenPinto @thoracicpath @mvmd0908 @PolancoMd @SansanoValero Have to love the asteroid body. Fun to look at but not much more... looks like #aspiration to me.

[6Patterns @6Patterns]

@LungPathGuys @smlungpathguy @howardm19 @MaxwellSmithMD There is no time like the present. In fact, there is an argument to address much of the ILD rad path terminology!

[Sanjay Mukhopadhyay @smlungpathguy]

Thank you for reading the article @6Patterns . Very much appreciate it!

Maybe some day we can band together with you guys and come up with better terminology for smoking-related parenchymal lung disease. Would be very cool if we could make it happen 🙏🏾

[6Patterns @6Patterns]

@howardm19 @JeffreyKanneMD @LucyModahlMD @jonherochung @smlungpathguy @LungPathGuys NSIP with pleuritis. Pt already meets criteria for IPAF but further CTD wk up suggested.

[6Patterns @6Patterns]

So true, all 5 reasons! Nice work.

[Sanjay Mukhopadhyay @smlungpathguy]

Five simple reasons to discard DIP, or why we should stop calling dolphins big fish - PubMed https://t.co/Sjlf5d40rI

[6Patterns @6Patterns]

#top25 #pearls of #pulmpath No. 24 Not all pulmonary fibrosis is usual interstitial pneumonia of idiopathic pulmonary fibrosis. This is a case of chronic hypersensitivity pneumonitis. #6Patterns https://t.co/RYp3mD7lRR

[6Patterns @6Patterns]

#top25 #pearls of #pulmpath No. 23 Aspiration induced injury may be more common than you think. #6Patterns https://t.co/tIrdGdx3tW

[6Patterns @6Patterns]

#top25 #pearls of #pulmpath No. 22 Your job is not finished if you make a diagnosis of diffuse alveolar damage/acute lung injury. Amiodarone induced acute lung injury. #6Patterns https://t.co/kzDsHOB9cI

[6Patterns @6Patterns]

#top25 #pearls of #pulmpath No. 21 Granulomas of sarcoid are distinctive. #6Patterns https://t.co/SKZIfsqPov

[6Patterns @6Patterns]

#top25 #pearls of #pulmpath No. 20 Necrotizing granulomas are almost always an infectious etiology. #6Patterns https://t.co/PgXyOBPoDu

[6Patterns @6Patterns]

#top25 #pearls of #pulmpath No. 19 Most blood is artifact, but when it is DAH, it requires a phone call. #6Patterns https://t.co/QArhX8R0Nm

[6Patterns @6Patterns]

#top25 #pearls of #pulmpath No. 18 Strict criteria should be used when diagnosing small cell carcinoma. #6Patterns https://t.co/S2NOxCn15Q

[6Patterns @6Patterns]

#top25 #pearls of #pulmpath No. 17 Some neoplasms are unclassifiable (but you have to think about others to diagnose them, Nut, SMARC A4). #6Patterns https://t.co/cl6To184JI

[6Patterns @6Patterns]

#top25 #pearls of #pulmpath No. 16 The diagnosis of malignant mesothelioma should be EASY! If you’re struggling, don’t go there. #6Patterns https://t.co/LoceRu7qFX

[6Patterns @6Patterns]

Pearl 15 – If the infiltrate is destructive, you should relay a concern for lymphoma, even if hematopathology can’t make a definitive diagnosis. Full video available here: https://t.co/7nbRpnTgS0