Don Le

Former 2019 Chair of @texpathol DCS | Former Pathology Resident @bswhealth | Former Cytopathology Fellow @bcmhouston | Surgical Pathology Fellow @methodisthosp

[Anthony J Gill @CaDxPath]

Here's a rare but well defined entity:

"Papillary thyroid carcinoma with desmoid type fibromatosis"

Two components of the tumour:
1) BRAFV600E positive papillary thyroid carcinoma

2) Desmoid type fibromatosis (nuclear expression of beta-catenin)

So unusual-deserves a retweet!

[ROHIT MEHRA @drmehrarohit]

Malakoplakia presenting as a renal mass- histiocytes (von Hansemann cells) with Michaelis-Gutmann bodies. Shown HE & Calcium stain- one of the best I have seen! #kidney #gupath #pathology #MedTwitter #pathresidents @UMichPath @UMichUrology

[Jean Hou, MD @JeanHouMD]

I got a request to post the images from the case I presented at this year's USCAP "Kidney and Beyond" session. So here it is again in all of its insane glory... Intraglomerular metastasis of a poorly-differentiated salivary gland primary.

[J. Bish @ENTpathology]

Dx: HPV-related adenosquamous carcinoma
Teaching points:
1) Soft palate is oropharynx, always consider HPV-related carcinomas in OP
2) Ages of HPV+ OP carcinomas is rising (this pt was 82)
3) HPV+ adenosquamous CA looks weird, salivary-like (esp MEC), doesn't follow the "rules"

[Taywin Atikankul @AtikankulTaywin]

Coexistence of DCIS and LCIS (with invasive lobular carcinoma)

True “collision” or “progression” from ductal to lobular phenotype (as a member of low grade breast neoplasia family) ❓🤪

#breastpath #pathology #surgpath

[Raul S. Gonzalez, MD @RaulSGonzalezMD]

I saw yesterday's GEJ case when I was in training. It was signed out as polypoid Barrett's with high-grade dysplasia. I got a teaching recut. A few years later, I came across it, took a look, and said wait a sec ... that's a pyloric gland adenoma! #pathology #gipath

[Raul S. Gonzalez, MD @RaulSGonzalezMD]

I hope everyone enjoyed yesterday's case of an epidermoid cyst arising in an intrapancreatic accessory spleen. #pathology #gipath

[Raul S. Gonzalez, MD @RaulSGonzalezMD]

Yesterday's case ... so I never believed in "inflammatory myoglandular polyp," until I saw (and diagnosed) this case. Hope I was right! #pathology #gipath

[Greta Evaristo, MD @gtevaristomd]

Since we all need a tiny bit less of stress & a tiny bit more of educational material, I thought I would share with you this beauty.. *Middle-age F, breast Bx*
#BreastPath #SurgPath

[Aysha Mubeen @AMubeen_Path]

Solid pseudopapillary neoplasm of pancreas it is 👏
➡️young female,tail mass
➡️cyto:papillary fronds,bland tumor cells,hyaline globules,nuclear grooves
➡️DDX:PNET(SPN can be NE markers+ mostly CD56, Synpato less chromo)
➡️nuclear beta-catenin+(CTNNB1 mutation)
#GIpath
#pathboards

[Jerad Gardner, MD @JMGardnerMD]

Pleomorphic lipoma. Fat, ropey collagen, myxoid, hyperchromatic pleomorphic cells with floret/wreath multinucleation. Atypical but benign. Loss of 13q (RB1) or 16q. #pathology #BSTpath pics: @kusaurap

[Don Le @dusk2don]

Histoplasmosis: 2-4 micron yeasts with narrow-based budding commonly within macrophages. Buzz words: bird or bat droppings, Ohio, Mississippi. Touch prep of retroperitoneal lymph node.

[Jerad Gardner, MD @JMGardnerMD]

Great tips for telling osteoblasts from plasma cells in bone by @KyleBradleyMD #pathology #hemepath #BSTpath

[Monika Vyas @Mvgs1706]

Gangliocytic paraganglioma (GPG) - perhaps one of the most enigmatic pathology entities!
Classic location - D2/periamp (rarely spinal cord)
EGD - nodule/bump
Histo- 3 components -
1. Endocrine - carcinoid/paraganglioma-like
2. Schwannian/spindle cell
3. Ganglion cells
#GIpath

[Jennifer Boland, MD @JenniferBoland7]

Melanoma simulating pulmonary adenocarcinoma with areas of interstitial and lepidic-like growth, in and amongst the pneumocytes. The stuff of nightmares. Keratin and Melan A pictured, S100 and SOX10 also positive.

[J. Bish @ENTpathology]

Been ages since I did this, hope I remember how.
Recent case, 82-year-old woman, large soft palate mass, pictured here. #headandneckpathology #ENTPathology #ENTpath #oralpath

[Brian McMillen MD @Teclis82]

Case I very nearly eff’ed up: 42 year old man, 3.5cm mass apparently arising from the gastric serosa. Will post some IHCs in a bit.
#GIpath #BSTpath @IHC_guy @JMGardnerMD @TxicMegacolon @LizMontgomeryMD @CArnold_GI