Jim Lewis Jr.

Academic Head and Neck Pathologist; Specialist in HPV and Squamous Cell Carcinomas

[Jim Lewis Jr. @LewisPath]

@ihartpathology @VUMCPathology Love that you tweeted our case!

[Jim Lewis Jr. @LewisPath]

@HeadandNeckPath Super articles and presentations from USCAP!

[Jim Lewis Jr. @LewisPath]

@VUMCPathology Welcome all!!! We are thrilled to have you training with us!

[Jim Lewis Jr. @LewisPath]

@HeadandNeckPath Did you hear about the woman who grew vocal cords in the laboratory? The results speak for themselves!

[Lester Thompson @HeadandNeckPath]

A basic unit of laryngitis = 1 hoarsepower!
I just couldn't resist the pun for my buddy @LewisPath

[Jim Lewis Jr. @LewisPath]

@HeadandNeckPath I will forward that to my friend Lary…Lary N Gitis.

[Jim Lewis Jr. @LewisPath]

Please share: we welcome additional applicants and look forward to learning and practicing with you all. #path_SIG

[Jim Lewis Jr. @LewisPath]

We would love to see your applications, budding surgical pathologists!

[Jim Lewis Jr. @LewisPath]

@travisakers Imagine how good she’ll be at “raising“ children! #Lewispath

[Jim Lewis Jr. @LewisPath]

@megothelioma You post great path pics Dr. Megothelioma!

[Jim Lewis Jr. @LewisPath]

@KStashekMD Pleomorphic “liver”sarcoma? Lipids everywhere!

[Jim Lewis Jr. @LewisPath]

@megothelioma @VUMCPathology Thanks for a lovely example of a benign curiosity lesion.
Here is the rare massive version on CT imaging from a middle aged patient. The entire abdomen is myelipoma!

[Megan Smith @megothelioma]

Now this is a cool diagnosis - myelolipoma. A thin rim of adrenal cortex lines an area of mature fat and hematopoietic elements. This case even had some osseous metaplasia. #PathTwitter #MSGPath

[Jim Lewis Jr. @LewisPath]

Tricky tumors when they arise in the thyroid gland because they can resemble papillary carcinoma, showing papillae, abortive nuclear irregularities like PTC, and PAX8 expression. Must look for the secretory material!

[Lester Thompson @HeadandNeckPath]

An important consideration in thyroid gland pathology: Secretory Carcinoma of the Thyroid Gland https://t.co/Tz6VyyD6jC
#HeadNeckPathol #HNPJ #HeadandNeckPath #Pathology #ENTPath #SalivaryGland #Carcinoma #PathologyTweet

[Jim Lewis Jr. @LewisPath]

This was a great event - thanks to CAP for supporting the Guidelines process and this event. @bfaquin @LewisPath #capchat @Pathologists

[Jim Lewis Jr. @LewisPath]

@Pathologists @bfaquin Thanks all for attention. The most important thing we can do as pathologists is to be consistent in what tests we do for pts with head and neck SCC. The guidelines are a start for this - and can shift in time as the field shifts. #capchat @Pathologists @bfaquin @LewisPath

[Jim Lewis Jr. @LewisPath]

Nuclear only or cytoplasmic staining only does not count, no matter the intensity or distribution - must be nuclear and cytoplasmic. For any equivocal p16 stains (borderline), your can do HPV-specific testing to resolve (RNA ISH best). #capchat @LewisPath @bfaquin @Pathologists

[Jim Lewis Jr. @LewisPath]

@Pathologists @bfaquin p16 should be positive in >70% of tumor cells, in both nucleii AND cytoplasm, and with at least moderate intensity in order to use as prognostic marker and surrogate if high risk HPV. #capchat @bfaquin @Pathologists @LewisPath

[Jim Lewis Jr. @LewisPath]

@AmyHDeekenMD @Pathologists @nicnac0 @bfaquin @EntPath We hope that the formal CAP Evidence Based Guidelines publication would provide pathologists with the back up to insist that p16/HPV specific testing not be performed for non-oropharyngeal and non-squamous carcinomas. #capchat @AmyHDeekenMD @LewisPath @bfaquin @Pathologists

[Jim Lewis Jr. @LewisPath]

@Pathologists @bfaquin Good for you all. Is it DNA ISH or RNA ISH? Both "work" for high risk HPV detection by performance different. RNA ISH is more sensitive and specific for transcriptionally active high risk HPV. @Pathologists #capchat @bfaquin @JScapaPathMD @LewisPath

[Jim Lewis Jr. @LewisPath]

@Pathologists @bfaquin p16 should be positive in >70% of tumor cells, in both nucleii AND cytoplasm, and with at least moderate intensity in order to use as prognostic marker and surrogate if high risk HPV. #capchat @bfaquin @Pathologists @LewisPath