ANGEL NAZCO

Patólogo en Hospital Universitario Nuestra Señora de Candelaria

[ANGEL NAZCO @AngelNazco]

@octaarce @tlabiano Hola Octavio. Una observación correcta, pero llegó en “patera” a las costas de Canarias. No se sabía su procedencia con certeza.

[ANGEL NAZCO @AngelNazco]

Lesión vesical. Varón, 17 años, procedente de África.

Bladder injury. Male, 17 years old, from Africa.

[Sanjeev Sethi @SethiRenalPath]

Sometimes a simple stain can make a pathologist’s day. In this case, positive NELL1 in a case of membranous nephropathy today.

Dx: NELL1-associated MN.

79 yr-old smoker with 2 grams proteinuria. Cr 1.7

Will need malignancy work up, as NELL1-MN often associated with malignancy.

[Sanjeev Sethi @SethiRenalPath]

Good teaching case today.

Severe arteritis, with large # lymphocytes under endothelial cells

Arteritis, involves entire 100% circumference=V2 lesion

V2=>25% per criteria

Dx:Acute cell mediated rejection, Banff 2B

C4d neg

45 yr old 1 month post transplant ⬇️immunosuppression

[Laura G. Pastrián MD @DraEosina]

🪱SYPHILITIC PROCTITIS🪱
🚩ALWAYS advise to rule out ITS in rectal chronic active proctitis! And remember: a negative Treponema stain is not enough.
😮Can mimic CANCER or IBD but it is benign & easily treated.
📋https://t.co/mdvDHMHZY4
#GiPath #Pathology

[Boonyarit Cheunsuchon, MD @roboonya]

Glomerulitis in an allograft biopsy with active antibody-mediated rejection #renalpath

[Sanjeev Sethi @SethiRenalPath]

When you get a diagnosis of idiopathic MPGN-look again, the dx may be staring you in face.

60 yr man, dx of idiopathic crescentic MPGN for many yrs, treated with immunosuppression.

Rebx: IF=3+ IgA

Dx: IgA nephropathy, mesangial & endocapillary hypercellularity (MPGN pattern)

[ANGEL NAZCO @AngelNazco]

@SethiRenalPath Dr. Sethi, from Tenerife, you are the nephropathology guru for us.

[ANGEL NAZCO @AngelNazco]

@edusqo @SEAP_IAP @SECitologia @Histopatolomon @DraEosina @martiponi @steland011 @ijexpafo @nucleololailo @dr_MPrieto @crazylymphocite @lara_pijuan @tlabiano Que equipazo!

[Priya Alexander, MD @MPAlexanderMD]

The kidney bx of a 40yr woman who presented with hypertensive crisis.
There is TMA of arterioles: "Onion-skin" suggests a chronic TMA. Glomeruli: Ischemic
The differential diagnosis is broad. I love this article from #MayoClinicProceedings with a nice algorithm.
@AshimaMakol

[Jonathan Zuckerman MD PhD @JZRenalPath]

Time zero implantation biopsy with nodular medial hyalinosis of an arteriole. Typically considered a sign of chronic CNI tox. But as illustrated, not always specific. #renalpath #PathTwitter

[Priya Alexander, MD @MPAlexanderMD]

Answer: Interstitial foam cells. I have not seen so many on IF. Sharing the images.
Bx showed membranous

Middle aged lady biopsied for increasing proteinuria. What’s that on the IF (arrows) ? Foam cells +++++

[Carles Saus @carles_saus]

⚡️Cholesterol crystal emboli
✍️Glomerular colesterol microemboli , rare , easy to miss (usually seen in intelobular or arcuate arteries )
✍️Multisystemic disease
🏥Usually iatrogenic
🧠🦶👁️Clinical presentation diverse
💣Poor long-term outcomes
#pathology #kidneydisease

[Jonathan Zuckerman MD PhD @JZRenalPath]

A patient with no significant PMHx is found to have acute kidney injury. The biopsy shows the light microscopy findings below. For those of you preparing for your path boards, what's your differential diagnosis? #renalpath #pathtwitter

[Sanjeev Sethi @SethiRenalPath]

Pronase IF to the rescue

LM: MPGN=mesangial & endocapillary hypercellularity, double contours, lobular tufts.

IF: All medulla.

Did IF on paraffin: IgG+++ kappa+++ lambda neg

Dx: Proliferative GN with monoclonal Ig (PGNMID), IgG kappa.

68 yr-old, rise in Cr, UA=RBC & protein.

[ANGEL NAZCO @AngelNazco]

Acaba de publicar una foto https://t.co/YMARyg6pvn

[ANGEL NAZCO @AngelNazco]

Comenzamos un nuevo camino, un proyecto único y sin precedentes en Canarias, pioneros en la digitalización en el archipiélago, la patología digital es una realidad. ANATOMÍA PATOLÓGICA RED CANARIA.

[ANGEL NAZCO @AngelNazco]

@PalexMedical Gracias @PalexMedical, a su gran trabajo y apoyo. Extraordinarios profesionales y maravillosas personas.

[Jonathan Zuckerman MD PhD @JZRenalPath]

Rare case of bone fide crescentic IgA nephropathy (>60% cellular crescents). Occurs in ~5% of IgAN cases. Be sure to rule out ANCA in these cases as well. IF shows IgA staining. #renalpath #pathtwitter