G. Eli Morey MD MPH

Digital dermatopathologist / CEO Spek. Moffitt #dermpath fellow ‘20. #CAP RF Chair ‘19. #Publichealth. Love my family, 🇺🇸🎼🏄🏽‍♂️📷🇷🇺. T/RT≠medical advice.

[G. Eli Morey MD MPH @elimoreymd]

@STEVENKOLKERMD 6. When in doubt, and the lesion is borderline, think about submitting for Castle Biosciences DiffDx test to differentiate Melanoma from benign. For pts 18 and older, there is a "spitz switch" used in the algorithm that specifically looks for genes associated with Spitz tumors.

[G. Eli Morey MD MPH @elimoreymd]

@STEVENKOLKERMD A few "rules of thumb" to dx Spitz tumor:
1. "starts with a nest, ends with a nest" get the clinical image and correlate - is it symmetric and well circumscribed?

[G. Eli Morey MD MPH @elimoreymd]

@STEVENKOLKERMD 5. Finally, Spitz more often on non-sundamaged skin than melanoma. Also, Spitz on face or leg.

[G. Eli Morey MD MPH @elimoreymd]

@STEVENKOLKERMD 4. Spitz can have cherry red macronucleoli but they shouldnt extend to the base of the lesion - mostly remain up top, like mitotic activity. Spitz tumors may have atypical mits, but should not have any clusters of mits.

[G. Eli Morey MD MPH @elimoreymd]

@STEVENKOLKERMD 3. Look for maturation (cells get smaller as you go deeper) and a flat or at least even base of the tumor. Can have some spitzoid patterns, like inspissating between collage fibers.

[G. Eli Morey MD MPH @elimoreymd]

@STEVENKOLKERMD 2. consistent pigmentation, no weird pockets of pigment, esp deep (pigment should be superficial for the most part)

[G. Eli Morey MD MPH @elimoreymd]

Can you spot the coconut palm tree?

[G. Eli Morey MD MPH @elimoreymd]

Aloha! Missing the garden isle….. Found this on a recent pap! #cytotec #gynpath #cyto #hawaii #PathTwitter

[G. Eli Morey MD MPH @elimoreymd]

@HENRYY_MD @Melanchocyte @StanMiller17 @JDuranMD @SDeMicheleMD @melanopath @NMacagnoMD @et565 @pembeoltulu @Histopatolomon @MarcelaSaebL @RitchaSaxena Does anyone routinely stain a DPN with such distinctive, classic cytology and histology? Just curious.

[G. Eli Morey MD MPH @elimoreymd]

Blue nevus with balloon 🎈cell change! No increased risk of malignancy. Interesting how two adjacent areas show differing levels of melanin content. Blue nevi are most common in peds/young adults. Often head and neck, hands or feet. #dermpath #pathtwitter #dermtwitter #pediatrics

[David Larson @dmlarsonpath1]

Thought this was a nice example. I haven’t seen this very often.
#wartydyskeratoma
#beautyinthebenign

[Henry YANG @HENRYY_MD]

WOW! What a nice dive of this tick!!! Beautiful catch, Image courtesy Dr Hong Jiang. Ale’s former fellow, Aren’t you proud of her? @alegru18
Show these comparison with @SGottesmanMD Gorilla 😜

@DCSkipperDO @et565 @DrAldehyde @redsnapperpath @PIorfino @VHNguyenMD

[G. Eli Morey MD MPH @elimoreymd]

or Factor 13a?

[G. Eli Morey MD MPH @elimoreymd]

Skin biopsy from distal thigh, 60-70 year old male. What is your best diagnosis? How do you know? #pathtwitter #dermpath #dermtwitter #MedEd #dermatology

[G. Eli Morey MD MPH @elimoreymd]

Would you expect this to be CD68 positive or MelanA positive?

[G. Eli Morey MD MPH @elimoreymd]

Punch biopsy of intralesional kenalog, a glucocorticoid. This was injected to treat a keloid in the earlobe. Seen it in the books but never in person! #dermatology #dermpath #PathTwitter #MedTwitter #MedEd #Skin

[G. Eli Morey MD MPH @elimoreymd]

#dermpath #entpath #oralpath #lungpath

[G. Eli Morey MD MPH @elimoreymd]

Preauricular cheek, dermal nodule. 70s Female. No known cancer history. PAX8-negative. ER/PR-negative. CK7+, CK20-neg. Thoughts?

[G. Eli Morey MD MPH @elimoreymd]

Ki67

[G. Eli Morey MD MPH @elimoreymd]

GATA-3