Deepu Alex

Interests in Drug Development, Molecular Genetic Pathology, Cytopathology and Oncologic Surgical Pathology

[Vanda Torous MD @VandaTorousMD]

Collision of good versus bad in this pelvic wash: sheet of benign mesothelial cells versus metastatic high-grade serous carcinoma

#CytoPath #PathTwitter

[Syed Z. Ali @sza_jhcyto]

The so-called “circle artifact” has been traditionally defined with GYN malignancies on a ThinPrep PAP test as a result of tumor diathesis and less often with extensive blood or inflammation. This voided urine had extensive acute inflammation with candidiasis.

[Syed Z. Ali @sza_jhcyto]

A "Chromosomal Super Overload" - FNA of an "Anaplastic Thyroid Carcinoma".

[Syed Z. Ali @sza_jhcyto]

"Comet Tails or Cercariform" cells: High-grade Urothelial Carcinoma in a voided urinary specimen. (ThinPrep)

[Syed Z. Ali @sza_jhcyto]

"Like big balloons" - Adenoid Cystic Carcinoma. (Parotid, FNA)

[Syed Z. Ali @sza_jhcyto]

Adenocarcinoma, presenting a sharp contrast with the juxtaposed benign squamous cells in a lower esophagus brushing. Prominent solitary macronucleoli, lack of adhered PMNs and a clean slide background with absence of inflammatory debris rules out reactive condition. (ThinPrep)

[Syed Z. Ali @sza_jhcyto]

A heavy "intoxication" - Pancreatic Ductal Adenocarcinoma. (EUS-FNA)

[Syed Z. Ali @sza_jhcyto]

A "crunchy" FNA - Papillary Thyroid Carcinoma.

[Toby Schmitt, MD @TobyASchmitt]

Couldn't be more excited to announce the launch of https://t.co/iJqFUSnnfj, the virtual slide site I wish had existed during my pathology residency. You can:
- Order special stains to work up cases
- See annotated histologic features
- Prepare for exams with board-style questions

[Syed Z. Ali @sza_jhcyto]

Glands, Acini or Rosettes? Occasionally, the vague "tigroid" smear background helps. This pancreatic FNA with IHC help was diagnosed as "Acinar Cell Carcinoma". (EUS-FNA)

[Syed Z. Ali @sza_jhcyto]

Gorgeous cytomorphology of a biphasic cellular "fibroepithelial neoplasm" on a breast FNA that was confirmed to be a "Phyllodes Tumor" on excision.

[Syed Z. Ali @sza_jhcyto]

The out-of-proportion, "megalo-macro- gigantic" nucleoli of a poorly-differentiated "Hepatocellular Carcinoma". (Liver, FNA)

[Syed Z. Ali @sza_jhcyto]

"NEVER forget the path of the traversing FNA needle". Liver mass in a 50/M with history of "Pancreatic Neuroendocrine Tumor (PanNET)". The flat sheets of mesothelial cells present a beautiful and eye-catching contrast with the background metastatic PanNET.

[Natasha Rekhtman MD PhD @natasharekhtman]

First #PathFellowship Open House at @MSKPathology. Please join us!

[Syed Z. Ali @sza_jhcyto]

MULTINUCLEATION in mesothelial cells is most often a reactive cytologic feature, in this case associated with lymphocytosis. (Pleural fluid, Cytospin)

[Syed Z. Ali @sza_jhcyto]

NOT benign osteoblasts on FNA from a sclerotic spine lesion. Despite the innocuous appearance, these cells represent bone metastasis from the patient's known "Lobular Breast CA". (FNA)

[Syed Z. Ali @sza_jhcyto]

A crunchy thyroid with "onion skinning", " tubular capillaries" and " chunky calcifications" - Papillary Carcinoma. (FNA)

[Ritu Nayar, MD @NayarRitu]

Extended HPV Genotyping and Dual Stain for triage of primary HPV screen-positive cases: Practical guidance for the cytopathology laboratory. Work done by the ACS Cervical Cancer Roundtable’s Laboratory Infrastructure Workgroup. @CancerCytopath @cytopathology @cervicalRT

[Syed Z. Ali @sza_jhcyto]

"Micropapillary Adenocarcinoma" of the lung involving pleural effusion. Impressive tumor cytoarchitecture with psammoma bodies. (cytospin and cell block)

[Syed Z. Ali @sza_jhcyto]

"Nuclei bent in pain" - Epithelioid histiocytes (of course a misnomer!) from a non-necrotizing granuloma on a lung FNA.