fanbotao

pathologist

[Dr Rupam Manna MD @DrRupamOncology]

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

[Sanjeev Sethi @SethiRenalPath]

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.

[Dr Rupam Manna MD @DrRupamOncology]

🧬 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

[Int J Surg Pathol @IJSPjournal]

🚨📜🔬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

[Raza Hoda, MD @RazaHoda]

What’s the diagnosis in this axillary sentinel lymph node? 🕵️ 🔬

Poll in comments 👇

Answer revealed on Monday 🔮

#PathX #PathTwitter #breastpath

[Janira Navarro @Janiranavarro]

***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

[Fouad Boulos @fouad_boulos]

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_

[Human Pathology @Human_Pathology]

New in #HumPathol: TFEC-rearranged renal cell carcinoma. https://t.co/o7nXDnAKVm #pathology #PathTwitter #PathX #GUpath

[Human Pathology @Human_Pathology]

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

[Human Pathology @Human_Pathology]

New in #HumPathol: TSC gene-associated lesions of the lung. https://t.co/8Nin5hxAgx #pathology #PathTwitter #PathX #pulmpath

[Janira Navarro @Janiranavarro]

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

[Zemplén Pataki, MD, PhD @ZemplenPataki]

Can you stomach this one? What is your diagnosis? 🔎

Poll below 🗳️👇

#PathPuzzle 🕵️‍♂️
@UMichPath #Pathology #PathX #PathTwitter

[Modern Pathology @ModernPathology]

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.

[Reza Eshraghi @rezaesh58]

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.

[Int J Surg Pathol @IJSPjournal]

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

[Human Pathology @Human_Pathology]

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

[Felipe Templo Jr. ,MD, MBA 🕊 @thejourneymate]

A Systemic Approach to Histopathology Slides 🔬

[Elizabeth Montgomery, MD @LizMontgomeryMD]

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.

[Janira Navarro @Janiranavarro]

Lung
**Reactive pneumocytes vs malignant cells**

Reactive
- Spectrum of atypia
- Cytoplasmic vacuolization
- Maintained N/C ratios
- Cytology: Napoleon hat sign

Dr. Sauter #USCAP2026 #pathology #PathX #PathTwitter

[gulcin guler simsek, MD @glinglerimek]

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.