Diagnosis of Chronic Lymphocytic Leukemia (CLL) – High-Yield Summary
CLL diagnosis is based on the iwCLL criteria:
• Absolute clonal B-cell count ≥ 5 × 10⁹/L in peripheral blood
• Present for at least 3 months
• Characteristic immunophenotype on flow cytometry (CD5⁺ CD19⁺ CD23⁺ with dim CD20 and weak surface Ig)
Flow cytometry is the most important diagnostic test. The hallmark is co-expression of CD5 and CD23.
This infographic also covers:
• Typical peripheral smear findings (including smudge cells)
• Matutes/CLL scoring system
• When bone marrow biopsy is indicated
• Essential molecular testing (especially TP53/del17p before treatment)
• CLL vs Monoclonal B-cell Lymphocytosis (MBL)
Save this for exam preparation.
#CLL #ChronicLymphocyticLeukemia #MedicalOncology #Hematology #ExamPrep
Kidney biopsy: Great teaching case
Severe inflammation and necrosis with abscess formation.
Look carefully=you see cells with large nuclei in the mix of inflammatory cells.
IHC= Positive staining for ADENOVIRUS.
DX: Adenovirus-associated interstitial nephritis.
55-yr old with kidney &
heart transplant, fevers, rise in serum creatinine.
🧬 HER2-mutant NSCLC is entering a new era.
While trastuzumab deruxtecan remains the current standard after platinum-based therapy, #Zongertinib is emerging as one of the most exciting next-generation HER2-targeted agents.
🔹 Highly selective HER2 tyrosine kinase inhibitor
🔹 Response rates approaching 70% in early studies
🔹 Encouraging CNS activity
🔹 Improved tolerability compared with older pan-HER inhibitors
🔹 Potential to move earlier in treatment algorithms
For years, HER2-mutant lung cancer lagged behind EGFR and ALK in targeted treatment options. Zongertinib may help close that gap.
A drug to watch closely in 2026 and beyond.
#LungCancer #NSCLC #HER2 #ERBB2 #HER2MutantNSCLC #ThoracicOncology #PrecisionOncology #TargetedTherapy #Zongertinib #MedicalOncology #Oncology #CancerResearch #CancerEducation #OncoTwitter #MedTwitter #OncologyUpdates
🚨📜🔬IJSP interesting case report of the day -->
EWSR1::FEV-rearranged prostatic Ewing sarcoma mimicking high-grade neuroendocrine carcinoma, showing AR and focal NKX3.1 positivity (link: https://t.co/O5i72O8Z87)
Pathology is indeed challenging!
#PathTwitter#GUPath#BSTPath
***Lepidic pattern is not limited to primary lung tumors***
- Female patient with history of breast cancer now with lung lesion (pic 1 and 2): Mesothelioma, epithelioid type
- Melanoma (pic 3)
- Cholangiocarcinoma (pic 3)
Practical lession: Lung tumors that looks like carcinoma but negative for TTF-1 and p40, add Claudin 4 and WT-1 to exclude the possibility of mesothelioma
Dr. Sauter #USCAP2026 #pathology #PathX #PathTwitter
Happy to share the news that our E-cadherin article received enough views to be a Top Viewed Article in Histopathology.
Read it here https://t.co/r02lExjV9J #TopViewedArticle@wileyinresearch@RezaTaha_
New in #HumPathol: Metastatic Malignant Non-Cervical Gynecological Tumors Involving the Genitourinary System: A Contemporary Clinicopathologic Analysis of 27 Patients. https://t.co/kJIctgKYQU #pathology#PathTwitter#PathX#GUpath
Cutaneous tumors - Head and neck tumors
***Same histology - Different terminology***
Chondroid syringoma: Common adnexal tumor. Malignant transformation is extremely rare.
Pleomorphic adenoma: Most common salivary gland tumor. Recurrences are common and can undergo malignant transformation.
Both have mutations in PLAG1 genes.
Dr. Ivan #USCAP2026 #pathology #PathX #PathTwitter
There might be a CISH, but finding hemosiderin deposition is a poor man's clue.
Dulken BW, et al. CHRNA6 RNA In Situ Hybridization Is a Useful Tool for the Diagnosis of Extraskeletal Myxoid Chondrosarcoma. Mod Pathol. 2024 May;37(5):100464. PMID: 38447752.
60 yo female with invasive ductal carcinoma , NHG3.
S/P mastectomy and SLN excision.
Lymph nodes with non-specific stain pickup for melanocytic markers by melanin-laden macrophages, not melanoma or melanocytes. The keratin is also not positive-that's just the background melanin. This pattern of melanin in the interfollicular/subcapsular region is seen in dermatopathic lymphadenopathy which is reactive lymph node enlargement in the setting of a rash/skin disease in the skin draining to that LN.
Please ensure that the condition is not referred to as metastatic carcinoma or melanoma.
Rare tumors find their way to IJSP --> what does #PathTwitter think about this primary uterine tumor in an older F👵🏼?
Here's a hint: desmin+++
Check out this Case Report by Ahmed et al. and see if you got it right! Link: https://t.co/c2VieuBGgK
#PathX#gynpath#bstpath
New in #HumPathol: Thymic hyperplasia with lymphoepithelial sialadenitis-like features A single-institution series of 21 new cases. https://t.co/BS3Fnk9Y3k #pathology#PathTwitter#PathX#ENTpath
Horrible treatment (radiation) associated epithelial changes in duodenal mucosa. The p53 can be ignored, probably reflecting upregulation rather thana mutational event. The same can be seen in the stomach.
Hutchings DA, et al PMID: 36843539; PMCID: PMC10460459.
I want to consult a case of my friend , dr Ferhat Ozden’s case: 60 yo M, temporal lesion. He said that he saw many mitoses. What’s your diagnosis ? I remained undecided.