Starting neuropathology fellowship on neuromuscular + autopsy, so I’ll be sharing some muscle pathology pearls along the way.
Here’s a nice example of skeletal muscle fiber necrosis with macrophage-mediated phagocytosis.
The arrow highlights the affected fiber on H&E, with CD68 highlighting the infiltrating macrophages.
Necrotic fibers are a nonspecific injury pattern seen in inflammatory/immune-mediated myopathies, muscular dystrophies, and toxic/metabolic injury.
More muscle pathology to come. 🔬💪
Parasitic thyroid nodules = non-neoplastic thyroid tissue that has separated from the main gland
Seen in marked chronic lymphocytic thyroiditis (CLT) or nodular hyperplasia
In CLT they can closely mimic metastatic PTC:
• Dense lymphoid infiltrate + germinal centers → looks like a lymph node
• Reactive follicular atypia → mimics PTC nuclear features
True lymph nodes have a fibrous capsule + subcapsular sinus. The main thyroid will also show CLT
Pitfall ⚠️They are usually sent as "lymph nodes" on frozen sections
Dr. Scognamiglio #USCAP #pathology #PathX #pathtwitter
BAGP Case of the Month 🔬
Not your average polyp! ✨
A 48-year-old woman presents with menorrhagia. An endometrial polyp is identified and she proceeds to hysterectomy + BSO.
Macroscopic: Cream, polypoid endometrial mass measuring 30mm, appearing to extend into the superficial myometrium.
🧠 Diagnosis next Friday!
#BAGPCaseoftheMonth #BAGPCotM #GynaePath #GynPath #PathTwitter #PathQuiz
Follicular adenoma with papillary architecture🤔
In the WHO 5th edition of Endocrine & Neuroendocrine Tumors, follicular adenoma with papillary architecture (FA-PA) is now recognized as a variant of follicular adenoma.
✅ Benign, encapsulated/well-circumscribed
✅ No capsular or vascular invasion
✅ Often a solitary “hot” (hyperfunctioning) nodule, more common in women
🔬Cystic with mixed papillary & follicular growth. Nuclear features of PTC are absent.
🧬Unlike conventional follicular adenoma (RAS), FA-PA frequently shows activating TSH-receptor mutations (~70%) and occasional GNAS mutations
Dr. Scognamiglio #USCAP #PathX #pathology
Tenny Parker change in placenta ➡ excessive formation of syncytial knots ➡ what's that ➡ aggregation of nuclei of syncytiotrophoblasts
Usually ⬆ knots ⬆ gestational age
But are ⬆⬆⬆⬆⬆⬆ in uteroplacental malperfusion
#pathology#placenta#gynpath
Credits: @DrGeeONE
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Inspired by the guru @smlungpathguy here's my first tweetorial. What do you guys think of this submandibular salivary gland? But wait for it - I'm in a generous mood, 3 images!
When you see the entire pill family together.
Presenting to you a family of Sevelamer (fish scales, anyone?) + crospovidone (pink core and purple coat) and microcrystalline cellulose (clear). Latter two act as pill fillers. Sevelamer was the culprit for gastric ulcer here!
@mustashib Aslında bunun önüne asistanların hocalarını eğitim/davranış yönünü değerlendirdiği ve bunun da bir sonucu olduğu bir sistem kurarak (ABD gibi) geçilebilir.