Top Tweets for #DQvsPAP
Today’s #FNAFriday #DQvsPAP: Body Fluids Edition!
Metastatic Breast Adenocarcinoma to pleural fluid
☄️DQ (top) Classic “cannonball” with pleomorphism
🔎Nucleoli can be seen on Pap (lower)
Today’s #FNAFriday #DQvsPAP!
Angiosarcoma can be VERY tricky!
🤔FNA samples may be bloody and scantly cellular
🩸DQ (top) Spindled cells with atypia
🔎If you look very carefully intracytoplasmic lumina can sometimes be found! I think maybe a little easier to see on Pap (lower)
Today’s #FNAFriday #DQvsPAP!
So-called “irritation cells” in BAL, bronchial cells with enlargement and multinucleation
Look for cilia/terminal bars!
🔎 DQ (L) Multiple nuclei may give impression of nuclear irregularities
🔎Pap (R) shows overall smooth nuclear contours
Today’s #FNAFriday #DQvsPAP!
👉🏼#CytoPath of Synovial sarcoma
Cellular sample w/ moderate pleomorphism, spindle cells, and cohesive (dare we say epithelioid? 🤷🏻♀️) areas.
On DQ (top) nucleoli can be seen, though these are generally described as “inconspicuous” for SS on FNA
Today's #FNAFriday #DQvsPAP!
#CytoPath of Merkel Cell Carcinoma!
🥏Small round blue cell tumor- on DQ (L) high N:C ratio, mitoses, and apoptosis evident
🧂🌶️Pap (R) shows fine "salt and pepper" chromatin with inconspicuous nucleoli
And of course IHC=dot-like CK20!
Today's #FNAFriday #DQvsPAP!
#CytoPath Breast Adenocarcinoma:
🫧DQ (L) clearly shows cytoplasmic bubbles/vacuoles which are more subtle (though still discernable) on the Pap (R)
〰️However-as always, nuclear contour abnormalities are best seen on the Pap!
#BreastPath
Today's #FNAFriday #DQvsPAP!
#CytoPath of Meningioma!
🌀DQ (Top) shows subtly whorled structures, but it's hard to see into them.
🔎Pap (Below) makes it much easier to see the whorled architecture as well as the characteristic nuclear pseudoinclusions!
#NeuroPath
Today's #FNAFriday #DQvsPAP!
#CytoPath of a Granuloma!
💃🏻Epithelioid histiocytes have "footprint" nuclei, leading to a "dance step diagram" appearance in both DQ and Pap!
🤔In US, when you see well-formed granulomas w/out necrosis, think about sarcoidosis!
Today’s #FNAFriday #DQvsPAP!
Must-know #Thyroid diagnosis: Anaplastic Carcinoma
👀 Highly atypical cells with lots of apoptosis without evidence of specific differentiation on DQ (L)
🔎 Chunky chromatin best appreciated on Pap (R)
Today’s #FNAFriday #DQvsPAP!
Must-know #Thyroid diagnosis: Medullary Thyroid Carcinoma
👀 Plasmacytoid to spindled cells on DQ (L), can be dishesive
🔎 Speckled chromatin best seen on Pap (R)
Today’s #FNAFriday #DQvsPAP!
A #Thyroid finding:
🔥Flame cells- associated with Graves dz but non-specific-also seen in hot nodules or just active follicles
👀 Magenta globular edges best seen on DQ (L)
🔎 Pap (R) may show “ragged” edges but much harder to appreciate flames 🔥
Today’s #FNAFriday #DQvsPAP!
A common #Thyroid finding:
Cyst lining cells
👀 Swirling stretched out cells with enlarged nuclei on DQ (top)
🔎 Pap (bottom) shows wispy cytoplasm, overlapping, and elongated nuclei with occasional grooves
Today’s #FNAFriday #DQvsPAP!
Must-know #Thyroid morphology:
Oncocytes, formerly known as Hurthle cells (a misnomer!)
🔎 DQ (top) Cells with abundant cytoplasm full of mitochondria, which are seen as red granules on Pap (bottom)
🔎Nucleoli and grooves can be seen on Pap
Our first #FNAFriday #DQvsPAP!
A classic #Thyroid diagnosis:
Papillary Thyroid Carcinoma
👀 Nuclear pseudoinclusions are best seen on Pap (R), but hints of them can be seen on DQ (L)
🔎 DQ also shows nuclear enlargement but powdery chromatin and grooves best seen on Pap
🎉New year, new #FNAFriday series!
👉🏼#DQvsPAP!
Let’s compare #CytoPath using two of our most-used stains:
🤜🏼DQ: Diff-Quik, a Romanowsky/Wright-Giemsa stain often used for immediate assessments on air-dried slides
🤛🏼PAP: Papanicolaou stain, for GYN and non-GYN fixed slides
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