Bruce D. Leckey Jr., D.O.

BC AP/CP & DP | Former #Dermpath fellow @Mayoclinicpath | Former #BSTpath fellow @UPMCpath | Former AP/CP @DukePathDept | T/RT not medical advice

[Bruce D. Leckey Jr., D.O. @BruceLeckeyJr]

@ScottBikeethan @CCFPathRes @CLEClinicLabs Undifferentiated pleomorphic sarcoma or myxofibrosarcoma like pattern of pleomorphic liposarcoma

[Bruce D. Leckey Jr., D.O. @BruceLeckeyJr]

@ScottBikeethan Low-grade dedifferntiated liposarcoma always bothered me. If you're going to call it dedifferentiated liposarcoma at all then by FNCLCC grading they cannot be low-grade (grade 1) as the lowest composite score will always be 4.

[Bruce D. Leckey Jr., D.O. @BruceLeckeyJr]

@Dermpathl @HENRYY_MD @JacobSmalberger @ArjunRamaiya1 @Cristina_VargAP @atman_ci @EssaoudiMohamed @MitulModiMD @ChristineJKoMD @joaquinnieves55 @DrGeeONE @PIorfino @TristanRutland7 @et565 @DKalodimou @VHNguyenMD @redsnapperpath @alegru18 @GeronimoJrLapac @SGottesmanMD @JMGardnerMD Even without IHC, these are pretty classic to me for pleomorphic lipoblasts. Clear vacuoles with scalloped nuclei, which in this case happen to be pleomorphic. Either this is dediff lipo with homologous differentiation or pleomorphic liposarcoma.

[Bruce D. Leckey Jr., D.O. @BruceLeckeyJr]

@ArjunRamaiya1 If MDM2 negative, pleomorphic liposarcoma.

[Bruce D. Leckey Jr., D.O. @BruceLeckeyJr]

@DoveMenCare Thought he looked familiar. Went to med school with Dr. Maxfield, seems like forever ago.

[Alejandro Gru (Ale) @alegru18]

67 year-old woman, history of CLL, presenting with progressive lymphocytosis (the IHC shown is CD3) and disseminated rash

[Bruce D. Leckey Jr., D.O. @BruceLeckeyJr]

@alegru18 Great case! I have seen a few present like this during my training, tricky lesions.
https://t.co/Y1jq6GqfnT

[Bruce D. Leckey Jr., D.O. @BruceLeckeyJr]

@KarinaFurlan7 Was STAT6 done? SMA won't necessarily help you distinguish between these two entities as ~20% of SFTs are SMA positive.

[Bruce D. Leckey Jr., D.O. @BruceLeckeyJr]

@HENRYY_MD @et565 @JMGardnerMD @david_terrano @tonitatirado @DCSkipperDO @DiegoMoralesN @gonzadetoro @SGottesmanMD @ChristineJKoMD @DrAldehyde @kabeerkshah @PIorfino @TristanRutland7 @kis_lorand @FionaMacPath @SumantaDas_7 @DrGeeONE @HongjieLiMD @Pathology36 @MarcelaSaebL @redsnapperpath Reminds me of either a cellular df or a cellular neurothekeoma (although location and necrosis is a bit odd for neurothekeoma)
https://t.co/MEwvNvbX0A

[UPMC Pathology Residency Program @UPMCPath]

#Week21 #AP 50 YOF with a known history of neurofibromatosis type 1 and a number of previously resected neurofibromas, presented with an enlarging right flank mass. CT demonstrated a cystic mass measuring 7.4 cm within the right abdominal wall with areas of calcification.

[Barry McGinn @DrBMcGinn]

Forgive me @smlungpathguy

[Bruce D. Leckey Jr., D.O. @BruceLeckeyJr]

@MarkEvanUy1 @Cristin28431328 @TristanRutland7 @FionaMacPath @DCSkipperDO @david_terrano @et565 If SMARCA4 is retained it would be interesting to see if there are any melanoma-compatible mutations (BRAF, NRAS, KIT) for dedifferentiated melanoma

[American Board of Pathology @TheABPath]

ABPath announced today that all future Primary and Subspecialty exams will be administered exclusively at commercial testing centers. Read the full announcement at https://t.co/vAfbtC1ERY #pathology #pathboards

[Sam Khader, MD @SamKhader]

Pleomorphic Liposarcoma in an older man presenting as a thigh mass. Highly pleomorphic spindle cells with abundant atypical mitotic figures and multivacuolated atypical lipoblasts. Areas with necrosis and myxoid material are present. MDM2 FISH test is negative for amplification.

[Bruce D. Leckey Jr., D.O. @BruceLeckeyJr]

@SamKhader @pranavp01 @SaeedAsiry @A_MatloobMD @Baskotacytopath @TEwaJonesMD @haesunla @JMGardnerMD @EHJPathDiva @PoojaSMD Was MDM2 truly +? If so, I think this would be classified as dedifferentiated liposarcoma with homologous differentiation? Hope you are all well!

[UPMC Pathology Residency Program @UPMCPath]

Not only our trainees! Our faculty are also showing a strong presence in poster sessions at #USCAP2021
#9. Dr. Karunamurthy @ariv2013 is presenting an abstract on tumor mutation burden and UV molecular signature characteristics of Desmoplastic melanoma in comparison with MPNST

[UPMC Pathology Residency Program @UPMCPath]

We are starting a series of tweets featuring our trainees and attendings presenting at #USCAP2021. Take some time to visit their presentations! Our current #BSTPath fellow @BruceLeckeyJr Dr. Bruce Leckey is presenting two abstracts as posters on Monday from 5:15 pm-6:15 pm.

[Miguel Reyes-Múgica @mreyesm]

Our new contribution to #PediPath and #BSTPath EWSR1-ATF1 Fusion in a Myoepithelial Carcinoma of Soft Tissue With Small Round Cell Morphology: A Potential Diagnostic Pitfall - Bruce D Leckey, Ivy John, Miguel Reyes-Múgica, Rana Naous, 2021 https://t.co/RVOhLu1gFM

[Bruce D. Leckey Jr., D.O. @BruceLeckeyJr]

@CaDxPath Was MDM2 done on this case? That morphology doesn't strike me as high-grade myxoid liposarcoma (usually round cell change) and dedifferemtiated liposarcomas can have amplification of DDIT3... https://t.co/d7BaDWRvqA

[Bruce D. Leckey Jr., D.O. @BruceLeckeyJr]

@JamesSampson123 I would have to stare at that case for awhile with that clinical/radiologic/histologic picture lol. WHO claims up to 20% of ECD co-exists with other histiocytosis like LCH and may have both in the bx , so I wonder if that might be the case here. Either way, very interesting!