while we've had concurrent digital avail for past several years for routine🔬cases, only recently have we been able to have digital scans for the whole mount prostatectomies we do
nice #GUpath#grosspath correlation of prostate cancer
#makingprostatepathfunagain
When do you work up a triple-negative cancer in a breast core needle biopsy to rule out metastasis?
- When histologic features raise concern for non-breast origin, especially if there is no in situ carcinoma (sometimes this is a difficult distinction to make).
- All triple-negative cancers unless there is in situ carcinoma.
What stains do you do?
GATA3 is performed by >90% of breast experts, followed by SOX10, CK, TRPS1, and TTF-1 (pic 2).
Dr. Schnitt #USCAP2026 #pathology #PathX #PathTwitter
✅ Tubulocystic Renal Cell Carcinoma 🎯🧬
• Exclusive tubulocystic growth of small to intermediate-sized tubules and cysts lined by a single layer of hobnail cells
• Eosinophilic cells display enlarged, irregular nuclei, prominent nucleoli, and abundant eosinophilic cytoplasm
• Characterized genetically by a consistent gain of chromosome 17 and losses of chromosomes 9 and Y
• Usually follows an indolent clinical course with an excellent prognosis, though rare metastases are documented
📢 ISUP Consensus Publications on Genitourinary Cancer Precursor Lesions Released! Congratulations to the ISUP Consensus Panel and contributing authors.
Direct links to WG articles in comments below. Archived publications linked here: https://t.co/dGOxyh1hpd
Oficialmente en mi segundo Mundial. Un orgullo inmenso representar a mi país ante el mundo. Gracias a Dios, a mi familia y a cada ecuatoriano por la confianza. ¡Vamos con todo, Ecuador! 🇪🇨🙏🏻⚽️
*Dogma-defying soft tissue tumors*
Not all EWSR1-WT1 fusion tumors are desmoplastic small round cell tumors (DSRCT)
There are unusual EWSR1-WT1 fusion-positive tumors with glomoid/myoid morphology, lacking desmoplasia, showing desmin/SMA positivity on IHC, and a favorable clinical prognosis.
Dr. Warmke #USCAP2026 #pathology #PathX #PathTwitter
New entities in soft tissue pathology
***FET-CREB fusion sarcomas***
Variable histology with epithelioid/round cells showing an odd combination of multiple aberrant markers (CK, EMA, MUC4, ALK, CD30, synapto , etc.) is valuable for screening FET-CREB sarcomas
Half of cases are intra-abdominal
Wide age range
Highly aggressive
Will be included in the upcoming BST WHO book
FET-CREB is an umbrella term for fusions between FET genes (mainly EWSR1, sometimes FUS) and CREB family transcription factors (CREB1, ATF1, or CREM)
Pitfall: Angiomatoid fibrohistiocytoma (AFH) and FET-CREB sarcomas have a similar genotype, but morphology differs and, most importantly, AFH mortality is >1% versus >50% in FET-CREB sarcomas
Dr. Agaimy #USCAP2026 #pathology #PathX #PathTwitter
Lung: Benign metastasizing leiomyoma
On CT, can present as nodules, solitary mass, cavitary or cystic lesions, and miliary pattern.
IHC positive: desmin, caldesmon, SMA, ER, PR, WT1; low Ki-67 index.
Largest published series: ~80% had a history of uterine leiomyoma; the other 20% had no history or unknown history of uterine leiomyoma.
Dr. Yi #USCAP2026 #pathology #PathX #PathTwitter
#HilaryBuckleyAward Low grade endometrial stromal sarcoma with smooth muscle differentiation showing starburst pattern. 105 mm mass in uterus. Spindle cell nodules with radiating collagenous bands. <1mm from serosa. Positive for CD10, SMA. Negative Cyclin D1, Melan A #BAGP2026
Histopathologic Flavors of Metastatic Prostate Carcinoma - "Amphicrine"/prostatic adenocarcinoma with neuroendocrine expression
🔷Tumor cells simultaneously express both prostate and neuroendocrine markers (expression can be patchy)
🔷 High-grade carcinoma without definite small cell features (like Gleason pattern 5)
De novo amphicrine sample report (pic 2)
Treatment emergent PC sample report (pic 3)
Dr Chan #USCAP2026 #pathology #PathX #PathTwitter
***Histopathologic flavors of metastatic prostate carcinoma***
- Conventional prostate cancer (looks like prostate cancer and NKX3.1 positive, pics 2 and 3)
- Neuroendocrine prostate cancer
- "Amphicrine" / prostatic adenocarcinoma with neuroendocrine expression
- Undifferentiated
- Other morphologic variants
Dr. Chan #USCAP2026 #pathology #PathX #PathTwitter
🚨 2026 Melanoma Management Algorithm – Fully Updated!
The definitive practical guide for cutaneous melanoma is here.
Key 2026 update:
✅ Perioperative immunotherapy is now preferred for resectable macroscopic Stage III (clinically positive nodes, satellites/in-transit, nodal recurrence)
→ Neoadjuvant PD-1 ± CTLA-4 (or relatlimab) → Surgery → Response-adapted adjuvant therapy (NADINA + SWOG S1801)
Plus:
• Precise surgical margins & SLNB criteria
• BRAF-driven decision tree for Stage IV
• Brain mets, mucosal & uveal melanoma pathways
• Current preferred philosophy & landmark trials
Aligned with NCCN v2.2026 & ESMO 2025. Designed for real-world oncology practice.
Save this. Share with your team. Use it daily.
What’s your biggest takeaway from the new perioperative approach? Drop it below 👇
Follow for more high-yield cancer algorithms → @DrRupamOncology
#Melanoma #Oncology #Immunotherapy #NCCNGuidelines #CancerCare #MedEd