Top Tweets for #GrayZonePath
#grayzonepath #GUpath prostate bx:
when there's extensive mucinous fibroplasia, definitive grading can be challenging! (rule is to "subtract off the mucinous fibroplasia & grade the underlying architecture)
DDx here seems 3+3 vs 3+4 [some (not me😅) could argue 4+3 as well]
![slusagar's tweet photo. #grayzonepath #GUpath prostate bx:
when there's extensive mucinous fibroplasia, definitive grading can be challenging! (rule is to "subtract off the mucinous fibroplasia & grade the underlying architecture)
DDx here seems 3+3 vs 3+4 [some (not me😅) could argue 4+3 as well] https://t.co/bFgV752Pca](https://pbs.twimg.com/media/GhMaTgNaAAEMH4F.jpg)
![slusagar's tweet photo. #grayzonepath #GUpath prostate bx:
when there's extensive mucinous fibroplasia, definitive grading can be challenging! (rule is to "subtract off the mucinous fibroplasia & grade the underlying architecture)
DDx here seems 3+3 vs 3+4 [some (not me😅) could argue 4+3 as well] https://t.co/bFgV752Pca](https://pbs.twimg.com/media/GhMaTOIaUAA9sAI.jpg)
#grayzonepath #GUpath prostate bx🔬example:
4+4 vs 4+5? adding poll for fun but perhaps no right answer...⏬
some consider foci on the right (black box) as "solid rosette-like" pattern 5, in contrast to pattern 4 with true lumens (left yellow box)
#GUpath challenges in prostate bx grading:
🔬when prostate cancer engulfs a nerve (rectangle), many times this can mimic pattern 4...
3+3?
3+focal 4?
perhaps no right answer #grayzonepath
@fouad_boulos Agreed!
Too often these #grayzonepath cases are a challenge, with sometimes problematic divergent clinical pathways (surgeons often run with just the topline Dx/grade)
At least I don’t have to😅those ADH vs UDH bx contralat side to cancer anymore (which often➡️double mastectomy)
#GUpath #grayzonepath:
prostate bx with cancer, conceivably elements of pattern 4 with +/- cribriform formation, but lower power 🔬shots show cancer focus effectively centered around an incoming nerve...
#GUpath #grayzonepath prostate bx:
3+4 (better 4 elsewhere) but in these level sections shown, IDC elements or just "colonization" of adjacent glands?
#GUpath #grayzonepath prostate bx
(no "right" answer, but good depiction & case for discussion)
📸🔬 here
⏬
poll to follow
Radical prostatectomy. Gleason 3+5=8 PCa? Or Grade Group 1 and Grade Group 5 PCa nodules inconveniently adjacent to each other? No clear transition well formed glands➡️poorly formed glands➡️single cells/files as described in PMID 30737469. #gupath #ProstateCancer #pathology
Large gland #prostate cancer in needle biopsy. Would you call this …
Pseudohyperplastic Acinar adenocarcinoma or Ductal adenocarcinoma?
👉 Note pseudohyperplatic will be Gleason pattern 3 and ductal Gleason pattern 4.
#GrayZonePath #GUPath
Caption this #prostate cancer with its Gleason grade. 🤔
#GUPath #GrayZonePath
Spoiler - 3 grade confounders in IDC-P, ?poorly-formed glands and perineural invasion.
#grayzonepath #GUpath prostate bx:
(no "right" answer, but good depiction & case for discussion)
📸🔬 here
⏬
poll to follow
Prostatic Adenocarcinoma (AMACR+, p63-, HMWK-)
&
Intraductal Spread of Urothelial Carcinoma (Urothelial Ca: AMACR+, p63+, HMWK weak+; Basal cells: p63+, HMWK strong+) #GrayZonePath #GUPath
My end of the year #GrayZonePath case for #GUPath and #HemePath tweeplers.
Pelvic lymph node in radical cystectomy with lymphadenectomy from a male patient in his 80s with bladder mass.
Answer in comment 😉
Not all “Pax8-positive clear cell carcinomas” in the #kidney are renal cell carcinomas. 70s female with a 10 cm renal mass. See answer in comment. #GrayZonePath 43 #GUPath
#Prostate carcinoma w/ marked radiotherapy effects may appear as scattered foamy (histiocytoid) cells. These almost dead residual tumor cells can be subtle & hard to find in RP. W/o pankeratin (helpful), it’s like searching for ghosts🔍👻 #HappyHalloween #GrayZonePath 41 #GUPath
#Prostate needle core biopsy.
Diagnosis???
🔬Intraductal carcinoma (IDC-P)
🔬Atypical intraductal prolif (AIP)
🔬Cribriform invasive carcinoma
Answer in comment.
#GrayZonePath 40 #GUPath
Nice luminal linear low-grade nuclei and “cup-like” CAIX positivity. Extensively cystic Clear Cell Papillary RCC ... or Renal Neoplasm of LMP? #GrayZonePath 39 #GUPath
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