francisco fernandes

Path and cat enthusiast. PGY2 of pathology at FMUSP / Brazil. Every day is a new learning day. Don't gatekeep knowledge, share it!

[francisco fernandes @fcojuniormd]

good to know i'm not alone

[Histopathology @Histo_Journal]

https://t.co/JKoUVcZ4Vb
Serrated polyps of the large bowel? A well-illustrated comprehensive report of interobserver variation in the assessment of their histology. You are not alone if you cannot always decide between "sessile serrated lesion" and "hyperplastic polyp". #gipath

[Dr Rishabh Jain @DrRishabhOnco]

🧠 You can shrink the tumour—but not the tumour bed.
New RAPIDO analysis in BJS 2025 shows why small margins after TNT can turn dangerous 👇

💡 Trial: RAPIDO (n = 920, LARC)
🎯 TNT = 5×5 Gy + 6 CAPOX / 9 FOLFOX → TME
vs CRT = 25–28×1.8–2 Gy + capecitabine → TME

📊 8-year results:
• LRR 10.8% (TNT) vs 5.8% (CRT) → HR 1.91
• Spike seen only after sphincter-preserving surgery (SPS)
 → 12.1% (TNT) vs 4.8% (CRT) (HR 2.6)
• 🚨 If distal margin ≤ 10 mm → 25.4% (TNT) vs 1.8% (CRT) 💥 (HR 15.5)

🔍 Why?
TNT causes tumour shrinkage but leaves scattered viable cells in the original tumour bed.
✂️ Cutting “too close” (<1 cm) may slice through microscopic disease → higher local recurrence.

🇸🇪🇳🇱 Geography tells the story:
Sweden = more APR → no difference
Netherlands = more SPS & tight margins → higher TNT LRR

🩻 Takeaway:
TNT reduces distant mets ✅ but may raise local relapse if DRM ≤ 1 cm ⚠️
➡️ Surgeons must factor in baseline tumour bed, not just post-TNT shrinkage.

📖 Prata I et al. Br J Surg 2025
🔗 https://t.co/MqeM0xqH8i

#OncoTwitter #ColorectalCancer #RectalCancer #RadOnc #Surgery
@OncoAlert @esmo_open @BJSurgery
@myESMO

[Chen Yang, MD @cygupath_md]

Sometimes, our clinical colleagues find it challenging to understand why it might take longer to review a prostate biopsy that is entirely negative (or any negative case in general, like lymph nodes).

The way I see it would be like playing Where's Waldo, but there actually is no Waldo. But the catch is there might be, and it would be very bad if you missed him.

#surgpath #pathX #pathtwitter #pathology #gupath

[Charlie Herndon @DrCycloPath]

FNA of a parotid mass. What is your interpretation??🧐
A) Non-neoplastic
B) Benign neoplasm
C) Atypia of undetermined significance
D) Suspicious for malignancy
#CytoPath #Pathology #PathTwitter #ENTPath #Cytopathology
🔬https://t.co/rpzDql3ACF

[Tim Bracey @drtimbracey]

1cm polyp at anastamotic site of previous colectomy. What’s the diagnosis and the potential associated syndrome? #pathtwitter #GIPathology

[francisco fernandes @fcojuniormd]

@JMGardnerMD that’s one I knew the answer 🤭🤭

[francisco fernandes @fcojuniormd]

so….. something just happened…….. just met my hero @JMGardnerMD and got an autograph 😭😭😭😭🥳🥳

[francisco fernandes @fcojuniormd]

so so so eager to meet @JMGardnerMD at Belém 🥺🥺🥺

[Kurt Schaberg @KurtSchaberg]

I posted my notes on Respiratory cytology, including the new IAC-IARC-WHO system, to my teaching website, "Kurt's Notes" (https://t.co/OKmaPvGQpJ).

🫁 🫁 🫁 🫁 🫁 🫁 🫁 🫁 🫁 🫁 🫁 🫁 🫁 🫁 🫁 🫁 🫁 🫁 🫁 🫁 🫁 🫁 🫁

Full notes available here: https://t.co/2VbnXnLocV

[Kurt Schaberg @KurtSchaberg]

I finished my notes on Pancreatobiliary cytology, incorporating the new WHO system, for my teaching website "Kurt's Notes" (https://t.co/OKmaPvGQpJ).

🔬🔬🔬🔬🔬🔬🔬🔬🔬🔬🔬🔬🔬🔬🔬🔬🔬🔬🔬🔬🔬🔬🔬🔬🔬🔬🔬🔬🔬🔬🔬🔬

Full notes available here: https://t.co/3qpWgerly3

[francisco fernandes @fcojuniormd]

@KurtSchaberg @Leandrooeu

[Keith Siau @drkeithsiau]

How to remember liver segments using your hand 👊 (via Radiopaedia)

[francisco fernandes @fcojuniormd]

@pa_to_logia eu nas macros da ccp

[francisco fernandes @fcojuniormd]

@Leandrooeu Voltou ao proletariado querido?

[francisco fernandes @fcojuniormd]

@MayoPathology @MayoClinicPath @GaryKeeneyMD @kriyer68 @pembeoltulu @GeronimoJrLapac @RawiaMo57385655 @HeadandNeckPath @Chucktowndoc @BRThunderCat

[Pranav Renavikar @RenavikarP]

Recommended IHC for carcinoma of unknown primary
https://t.co/1814WPTVLv

[Jisun Cha MD FAAD @sunpungi]

Monkeypox #monkeypox #pathology #dermatology #dermpath

[francisco fernandes @fcojuniormd]

just a lung finding, not related to cause of death #pathtwitter #pathology #lungpath #autopsy

[Evi Abada, MD, MS @EviAbadaMD]

During the early days of residency, I hardly knew the difference between a neutrophil and a plasma cell. Now? At least I now know the difference between a proliferative and secretory endometrium. My point? Life is in stages. Embrace its beauty and give yourself grace! #MedTwitter