South Bay Pathology

South Bay Pathology Society: Fostering education and collaboration between pathologists in the Bay Area since 1951. Tweets by C. Louie, MD and E. Forgo, MD

[South Bay Pathology @SouthBayPath]

Jan meeting highlight: 30F w fibroids
🔬Placental site nodule!
📍Placental site nodule: Ki-67 <8%, <4mm
📍Atypical placental site nodule: Ki-67 8-10%, mod-severe atypia
📍GATA-3 + in trophoblastic tissue
📍PMID: 25675185
Great case courtesy of Dr. Taylor & Dr. Zaloudek #GYNpath

[South Bay Pathology @SouthBayPath]

Jan meeting highlight: 68F w hx of breast ca, melanoma. 4cm small bowel mass. Pos S100, Sox10. Neg CKMix, DOG1, HMB45, Desmin, Melan A.
🔬Clear Cell Sarcoma-Like Tumor of GI Tract!
📍Rare!
📍Ileum (70%)
📍Poor px
📍EWSR1-ATF1 +
Great case courtesy of @JCloutierMD & Dr. Charville

[South Bay Pathology @SouthBayPath]

Dec meeting highlight: 52M w h/o melena & hematochezia, w internal hemorrhoid
🔬Invasive Mucosal Melanoma!
📍⬆️LN/distant mets, 5yr survival 14%
📍⬆️CN & structural changes; BRAF, KIT, MAPK mutations
📍⬇️point mutation burden
Great case courtesy of Drs. Lee & Menke #Dermpath

[South Bay Pathology @SouthBayPath]

Nov. meeting highlight: 65F h/o CKD on dialysis, w dysphagia & thickening of distal esophagus
🔬Lanthanum deposition!
📍Oral non-Ca2+ based phosphate binder
📍PAS+ PASD+
📍Vague sx, non-specific EGD
📍PMID: 28134986, 25602800
Great case courtesy of Drs. Janowski & Umetsu #GIpath

[South Bay Pathology @SouthBayPath]

Please join us for the SBPS Annual Spring Meeting this year in beautiful Monterey on May 9th, 2020.
This year's topic is GU pathology with Dr. Victor E. Reuter and Dr. Kiril Trpkov!
Register now at https://t.co/zwy0WW0XGe! #GUpath

[South Bay Pathology @SouthBayPath]

Nov meeting highlight: 25M w anemia➡️ulcerated gastric lesion. CD117(C-kit) DOG-1 CD34+, desmin S100-
🔬SDH-Deficient GIST!
📍C-kit/PDGFRa mutation-
📍Peds & young adults, F>M, gastric
📍⬆️survival vs typical GIST
📍Resistant to imatinib
Great case courtesy of Dr. Patel #GIpath

[South Bay Pathology @SouthBayPath]

Nov meeting highlight: 68M w enlarged & eroding scalp mass. CD31 CD34+. CKmix EMA SMA HHV8-
🔬Epithelioid hemangioma!
📍B9, variable morph: well-formed➡️spindled cells in sheets or vasoformative
📍FOS rearrangement common
Great case courtesy of @dwadamsMD & Dr. Charville #BSTpath

[South Bay Pathology @SouthBayPath]

Nov. meeting highlight: 67F w PMB➡️TAH/BSO
🔬Ovary - Adult granulosa cell tumor!
🔬Endometrium - Complex atypical hyperplasia!
📍Ovary - FOXL2 402 C>G+
📍⬆️estrogen production
📍Good Px
📍Px factors: stage, size, rupture, nuclear atypia
Great case courtesy of Dr. Hansen #GYNpath

[South Bay Pathology @SouthBayPath]

Nov. meeting highlight: 63M w bladder tumor
🔬Mixed small cell neuroendocrine carcinoma and High-grade papillary urothelial carcinoma!
📍Mixed tumors are not a separate category in WHO
📍Synaptophysin+, chromogranin+, NSE+ ➡️ may be neg!
Great case courtesy of Dr. Grujic #GUPath

[South Bay Pathology @SouthBayPath]

Oct meeting highlight: 50M w poorly-controlled Type II DM & ESRD, w severe thigh pain
🔬Myopathic process, favor post ischemic changes!
📍Rare complication of long-standing uncontrolled DM
📍Acute U/L LE muscle pain
📍PMID: 12502683, 31015244
Great case courtesy of Dr. Vogel

[South Bay Pathology @SouthBayPath]

Oct meeting highlight: 66F, h/o esophageal & duodenal ulcers, now w nausea
🔬Atypical esophageal epidermoid metaplasia!
📍⬆️risk for squamous neoplasia
📍TP53 mutations may be early biomarker for HG dysplasia or carcinoma!
Great case courtesy of @JCloutierMD & Dr. Martin #GIpath

[South Bay Pathology @SouthBayPath]

Oct. meeting highlight: 65F w posterior neck mass
🔬IgG4-related sclerosing lymphadenopathy!
📍⬆️LN can occur before, concurrent w, after dx of IgG4-RD
📍No constitutional sx
📍⬆️histology patterns
📍A/w few scattered EBV+ cells
Great case courtesy of Dr. Fernandez-Pol #HemePath

[South Bay Pathology @SouthBayPath]

Oct. meeting highlight: 62F w 8cm kidney mass
🔬TFEB MiT family translocation associated RCC!
📚Rare!
📍Median age 31y,⬆️range: 3-68y
📍Indolent but may be clinically aggressive
📍Biphasic➡️papillary, oncocytic, solid/nested
Great case courtesy of Drs. Fels-Elliott & Chan #GUpath

[South Bay Pathology @SouthBayPath]

Oct meeting highlight: 65 w salmon patch lesion on conjunctiva
🔬Myeloid Sarcoma!
📚Extramedullary tumor mass of myeloid blasts
📍(+): CD45RB, CD43, dim MPO
📍(-): Ckmix, CD34, CD14, CD117, TdT, MCT, CD19, CD22, CD79a, CD3, CD138
Great case courtesy of Dr. Fernandez-Pol #HemePath

[South Bay Pathology @SouthBayPath]

Oct. meeting highlight: 70 w ⬇️weight & ⬆️LN
🔬Whipple Disease!
📚Rare!
📍Tropheryma whipplei, in soil/sewage
📍Sx: D, malabsorption, ⬇️wt, fever, arthralgia, occ. CNS/cardiac involv.
📍Lipogranuloma in LN
📍PAS+ bacilli in histiocytes
Great case courtesy of Dr. Duncan #Hemepath

[South Bay Pathology @SouthBayPath]

Sept meeting highlight: 56M w ⬆️PSA
🔬Malakoplakia!
📚GU (bladder 70%, prostate rare)>GI tract>any site
📍Defective phagocytosis/bacteria elimination
📍Targetoid inclusions = Michaelis-Gutmann bodies
📍Mimics malignancy!
Great case courtesy of Drs. Ladwig, Zaloudek, Simko #GUpath

[South Bay Pathology @SouthBayPath]

Sept. meeting highlight: 45F w BL ⬆️inguinal LN
🔬Syphilis!
📚Quant RPR+. Rare in LN: prominent RFH. Often w hx of prior skin or mucosal lesion. Spirochetes within/around walls of venules, can be in GC.
📍Vulvar bx weeks later: Syphilis +
Great case courtesy of Dr. Temmins

[South Bay Pathology @SouthBayPath]

Sept. meeting highlight: 66F w 3cm incidental mass on XCR.
🔬Typical Carcinoid Tumor!
📚<2 mits, 🚫necrosis. Excellent prognosis. Atypical carcinoid: 2-10 mits, foci of necrosis=⬆️recur. rate & mortality. Risk fx: family history, MEN1+. Great case courtesy of Dr. Cherny #LungPath

[South Bay Pathology @SouthBayPath]

Sept. meeting highlight: 65F w fevers, oral & arm petechiae, ⬆️LFTs, flow w ⬆️plasma cells. Recent travel to Asia.
🔬Atypical plasmacytosis a/w Dengue Fever!
📚Can mimic plasma cell leukemia! PMID: 12873179, 21091833, 28408424. Great case courtesy of Drs. Dayhoff & Fong #Hemepath

[South Bay Pathology @SouthBayPath]

August meeting highlight: 14M w chest discomfort & SOB ➡️6cm lung mass w subcarinal adenopathy. Clinical concern for Coccidioides ➡️fluconazole w ⬆️discomfort
🔬NUT carcinoma!
📚BRD4-NUTM1+. Tx: Molebrisib (Bet inhibitor). Poor prognosis. Great case courtesy of Dr. Song #Lungpath