Erik Kouba

Pathologist, GU pathology

[Erik Kouba @EKoubaMD]

Pediatric pathologist 😊 #pathology

[Gladell Paner, MD @GladellPaner]

It’s out …

International Society of Urological Pathology (ISUP) Consensus Conference on Current Issues in Bladder Cancer. Working Group 2

https://t.co/zAKdocqShu

@UroDocAsh @DrNetto @MuraliV72899596 @TheoKwast @LiangChengMD

Thanks @IntSocUropath for the opportunity! #GUPath

[Ali Alzughbi @AliAlzughbi]

Incidental kidney mass in 54 year old female, mucinous tubular and spindle cell carcinoma.
Good prognosis unless there is sarcomatoid differentiation.

[Behtash @behtashg]

Rare diagnostic pitfall
Bladder mass in a 70yo male.
Epithelioid cells with focal spindle cell morphology and atypical mitoses, marked variation in nuclear size and shape, hyperchromatic, occasional intranuclear inclusion.
Note the absence of in situ carcinoma.
see next tweet.

[Behtash @behtashg]

This is a case of metastatic melanoma to bladder. This mass was black in cystoscopy. Less than a 30 are reported in the literature, but the true prevalence is higher, autopsy series on melanoma patients reported 3-18% prevalence.
M : F = 15 : 8.
#gupath #pathology #bladdercancer

[Dr Travis Brown 🎧 @DrTravisBrown]

Histology flash card

Xanthogranulomatous pyelonephritis

Uncommon/rare
Destructive inflam process that may resemble RCC

Oft assoc with chronic pyelonephritis due to E. coli or Proteus

Histo
Extensive foamy histiocytes

#MedTwitter
#PathTwitter

[Liang Cheng, MD @LiangChengMD]

Just published! Great review by @SAMBITKMohanty1 @LoboAnandi and Sourav
Precision Medicine in #bladdercancer: Present Challenges and Future Directions https://t.co/yGY2AKuMgK

[Antonia Carmen Georgescu @LisieviciC]

Lipid-rich urothelial carcinoma

✔️frequently associated with conventional urothelial carcinoma
✔️ lipid nature of the vacuolar content has been confirmed by EM
✔️ poor prognosis
✔️ + CK7, CK20 (photo), 34betaE12
#gupath #pathology #uropathology

[Dr Travis Brown 🎧 @DrTravisBrown]

Histology flash card

Fibrous hamartoma of infancy (FHI)

Rare
Usually <2yrs (90% <1yr)

Oft solitary
Location: subcut or reticular dermis

Benign
Rarely recurs (16% and may be explained by incomplete excision)

Histo
Mature adipose tissue
Fibrous tissue
Myxoid & basophilic areas

[Ankur Sangoi @slusagar]

#GUpath #IHCPath textbook example showing how uroplakin2 > than uroplakin3

(outside case review from bx of urothelial ca metastasis)

[Dr. Luca @atman_ci]

#Pathology #PathTwitter #PathResidents a rare finding in neoplastic kidney #GUPath, much thanks @nandinipath for showing us!

[Samson W. Fine, MD @rovingatuscap]

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

[Gladell Paner, MD @GladellPaner]

Their presence can be subtle 🔬

Urothelial carcinoma with trophoblastic differentiation.

Note the syncytiotrophoblasts occasionally surround (cap) the urothelial cells and are thinned out.

See IHC in comment. #GUPath

[Dr. Luca @atman_ci]

#Pathology #PathTwitter #PathResidents a super rare finding in neoplastic kidney #GUPath, much thanks @behtashg for showing us!
#PathTweetAward

[Samson W. Fine, MD @rovingatuscap]

May 2023 is #bladdercancerawarenessmonth

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

[International Society of Urological Pathology @IntSocUropath]

Case of the month May 2023

47F with bladder wall mass

➕ GATA3, SYN, CG, INSM1
➖ CK AE1/AE3
S-100 protein highlights sustentacular cells

Authors: Katrina Collins (@SueEPig), Jessica L. Davis, Andres Acosta (@Andres_M_Acosta)
@IndianaPath #IUpath

[Ankur Sangoi @slusagar]

#GUpath nephrectomy:
renal oncocytoma, "invading" perinephric adipose tissue

✔️does not necessarily itself portend malignancy
PMID: 9255250
PMID: 21166703

[C. Christofer Juhlin @DrJuhlin]

Left-sided adrenalectomy in an adult. Localized mass, non-producing. White cut surface, firm, lobulated, with extraadrenal extension.

Histological images in the thread below!

[Erik Kouba @EKoubaMD]

Splenogonadal fusion; young man with testicular lesion #Gupath #pathology #PathTwitter

[Shahrokh F. Shariat @DrShariat]

Read this paper ! Great overview.