Blastomyces in a BAL. Rare broad based budding yeast hidden in alveolar macrophages. Can be easily missed if not carefully screened. Concurrent TBBx with granuloma and a budding yeast. Positive silver stain
Turning out to be a "Sarcoma" day - "Myxofibrosarcoma" is so eye-catching in its appearance and easy to photograph - myxoid stroma, plump spindled cells and pleomorphic MN giant cells. (thigh mass). See our old article - Acta Cytol. 2012;56(1):15-24. PMID: 22236741
📘 Juvenile Granulosa Cell Tumor:
➡️5% of ovarian tumors in children, 80% before age 20
➡️Micro: Diffuse to macrofollicular pattern, primitive-appearing granulosa cells with thecal component
➡️No Nuclear grooves or Call-Exner bodies
➡️IHC: Pos for Inhibin, calretinin, CD99, WT1
Speaking of pancreatic #intraductalneoplasms, this is a typical example of intestinal type intraductal papillary mucinous neoplasm (#IPMN) with an associated #colloidcarcinoma. Most main duct IPMNs are of intestinal type. Intraductal component resembles colonic villous adenomas.
Serotonin-producing PanNETs are rare but reveal a very typical morphology. Trabecular growth & extensive stromal fibrosis (rare in other PanNETs) are your clues. Dont let the entrapped B9 ducts -arrows- to mislead. Serotonin IHC is + in neuorendocrine cells only #PanNET
The Toxo Triad: follicular hyperplasia, monocytoid B-cell proliferation and clusters of epithelioid histiocytes - all in one image! Great! @KyleBradleyMD#CAPVirtualPath