ThePathologist

Surgical Pathologist. Anatomía Patológica.

[Stanford Pathology @StanfordPath]

It’s a pilomatricoma/pilomatrixoma! Benign skin tumor with nests of basaloid cells and central cornified material with “ghost cells.” 👻

#PathBasics #Pathoween #PathTwitter #MedStudentTwitter

[Brendan Dickson, MD @B_C_Dickson]

CLEAR CELL SARCOMA. IHC: HMB45. NGS: EWSR1-ATF1. NB: fascicles of spindle-epithelioid cells separated by thin fibrous septa; amphophilic cytoplasm; ovoid nuclei with prominent small nucleoli; scattered pigmentation.

[Jeffrey Cloutier, MD, PhD @JCloutierMD]

Nice example of grade 3 chondrosarcoma. #BSTpath #sarcoma

[Dr Travis Brown 🎧 @DrTravisBrown]

Histology/micro flash card

Cervical cancer

Risk factors: HPV infection, smoking, age, number of sexual partners
Incidence population

~60% HPV-16
10-15% HPV-18

60% of pts with CIN-1/low-grade regress to normal after 1 year

Prognosis is dependent upon severity

#PathTwitter

[Simon Roy MD @SimonRoyMD]

Sex Cord Tumor With Annular Tubules (Ovary)
Can be associated with Peutz-Jeghers syndrome!
Tubules, hyaline material in lumen, palisaded nuclei.
Inhibin, calretin, WT1, keratins+, EMA-
#pathboardspotter

[Dr Travis Brown 🎧 @DrTravisBrown]

Histology liver flash card

Hepatoma

Rare
Assoc ♀on OCP

Usually solitary (70-80%)
Can be asymptomatic
Presentation abdominal mass/pain

Can spontaneously rupture
Av 5-15cm mass

Histo
Tightly packed hepatocytes
Sinusoids compressed
No portal triads/central vein

#PathTwitter

[Tristan Rutland MBBS FRCPA IFCAP @TristanRutland7]

Ovary, multiloculated cyst
Adult.

#GYNpath #Pathtwitter #Pathresidents

[Brendan Dickson, MD @B_C_Dickson]

CONVENTIONAL CHORDOMA. IHC: brachyury. NB: lobulated neoplasm composed of sheets of epithelioid cells; abundant and bubbly cytoplasm; round nuclei with mild atypia; and focal myxoid stroma.

[Abhijit Das, MD @AbhijitSurgPath]

Part 2

[Abhijit Das, MD @AbhijitSurgPath]

Fibroblastic and myofibroblastic tumors - MALIGNANT

Salient morphological features and basic facts for residents

#MakeSurgiPathEasy
#BasicFactsForResidents
#FibroblasticTumorsMalignant

[Barry McGinn @DrBMcGinn]

#PathTwitter let me present to you this very photogenic paraganglioma. Note the nested architecture and the nice S100 positive sustentacular cell network surrounding the tumour cell nests #pathology

[Elizabeth Montgomery, MD @LizMontgomeryMD]

...sneaky sneaky. Kaposi sarcoma in gastric mucosa.

[Elizabeth Montgomery, MD @LizMontgomeryMD]

A lovely well-marginated subcutaneous pleomorphic lipoma; it is a delightful diagnosis to make - so splendid under the microscope and the patient has a benign neoplasm! Fleurette cells, wiry collagen, and mast cells, oh my!

[Syed Z. Ali @sza_jhcyto]

A Parotid "Acinic Cell Carcinoma (ACC)" obscured by abundant reactive lymphocytes ("TALP" - Tumor associated lymphoid proliferation). Still in my experience, TALP is much more common and pronounced in FNAs of Mucoepidermoid CA than ACC.

[Dr Travis Brown 🎧 @DrTravisBrown]

Histology testis flash card

Leydig cell tumour

Most common sex-cord stromal tumour
1-2% testicular tumours
Any age (av 20-60yrs)

Testicular mass
Oft asymp
15% pts gynaecomastia

Majority benign
5% malig -> features >5cm, cyto atypia, >3mt/10hpf, vas inv, necrosis

#PathTwitter

[Raul S. Gonzalez, MD @RaulSGonzalezMD]

Another cool case a friend sent me: the only example of gastric carcinoma with enteroblastic differentiation that I've seen (so far). https://t.co/b8oYVy5hDl #pathology #gipath #pathtwitter

[Dr Travis Brown 🎧 @DrTravisBrown]

Histology flash card

Langerhans cell histoocytosis (LCH)

Primarily occurs in children (but occurs in all ages)

Patients produce too many Langerhans cells/histiocytes -> tumours

Symptoms vary from pt to pt
Common affect areas: skin/nails, mouth, bones, LN

#PathTwitter

[Jeffrey Cloutier, MD, PhD @JCloutierMD]

Sacral bone tumor with extension into soft tissue. #BSTpath

[Hiep C. Nguyen @DrNguyenhiep]

Important forms of bile duct injury in scoring systems. #liverpath

[Barry McGinn @DrBMcGinn]

Could I convince anyone this is a penetrating vessel (a “lollipop”) in hyaline vascular Castleman’s disease? #pathology