Top Tweets for #PathPitfall
#Pathpitfall alert
HER2 IHC: Cytoplasmic staining? Now what?
✅ Focus only on membrane staining (cytoplasmic is nonspecific & ignored for scoring).
✅ More common with some assays than others (4B5 > HercepTest)
✅ If diffuse cytoplasmic staining obscures membrane evaluation:
→ Run FISH
→ Repeat IHC on a different block to identify membrane staining
→ Or switch to another validated HER2 assay if available.
Dr. Huina Zhang #USCAP2026 #pathology @Pathology_URMC #PathX #pathtwitter
#GIPath #PathPitfalls
Thank you @RaulSGonzalezMD for sharing this possible #PathPitfall to be aware of. ↘️
High-grade colonic tubular adenoma with focus of invasive adenocarcinoma? Not quite. This TA is just involving a submucosal lymphoglandular complex. This rare finding should not be mistaken for malignancy. Great recent case series here: https://t.co/1RYqBTF6Uu #pathology #gipath
@drtimbracey @smlungpathguy @dr_rob69 @DrCycloPath @MPThomas_Path @DraEosina @IHeartPathology @diagnexia @Vik_deshpandeMD @TristanRutland7 I love trying to trick my trainees with this #PathPitfall!
Here is an intraductal papilloma involved by collagenous spherulosis (! not ADH/DCIS)
#PathBoards #PathPitfall
What a great day!
I managed to trick a resident into calling thymus metastatic PTC (you know this is one of my favorite pitfalls!)
AND I got to pet Kobe, the therapy dog! ❤️❤️❤️
#PathPitfall
Listening to the great (and surprisingly entertaining) @RaulSGonzalezMD teaching our @USFpathology residents today, he discussed GCT in the GI tract which prompted me to think of this classic #PathPitfall in the head and neck!
#PathPitfall, The Look Deeper Edition:
At low power, pseudoepitheliomatous hyperplasia overlying granular cell tumor may be more eye-catching than the GCT itself -can be so proliferative that it looks like SCC. Look deeper! S-100 IHC impressively highlights tumor cells.
#ENTPath
#PathPitfall Breast Biopsy-Displaced Epithelium
🔬Biopsy procedure➡️may lead to lesion disruption
🔬More common in papillary lesion
⚠️Misdiagnosis of invasive carcinoma or LVI
❗️Myoepithelial markers,if +, is helpful, but can be -
❗️Favor displacement if fragment in biopsy tract
Maybe for the spookiest day of the year it would be reasonable to revisit the whole #PathPitfall series? 👻👻👻
#PathPitfall Series ALERT!
I thought it might be useful to do a series highlighting potential pitfalls in various contexts in pathology.
You'll see some old friends, new entities, and hopefully won't fall into any pits IRL!
Bonus: What's the pitfall in the cover image?
🎃👻
Next up for our #Halloween “Cells in Costume” series:
Medullary thyroid carcinoma pretending to be a paraganglioma with “zellballen” architecture!
#EndoPath #PathPitfall
👻Happy #Halloween! 🎃
A time to dress up and pretend to be something different, just like these #Pathology entities!
Here’s some parathyroid pretending to be thyroid! (Pseudofollicular change)
What’s your favorite pathological mimic? #PathPitfall
Today’s #FNAFriday #CytoHisto correlation
🧶Lots of spindled cells mixed with glandlike epithelioid elements in biphasic synovial sarcoma
(DQ & H&E)
🧬SS18-SSX fusion
👉🏼#PathPitfall: Epithelioid components mimic adenocarcinoma
Today’s #FNAFriday #CytoHisto correlation
🐓Chicken-wire vasculature, myxoid matrix, signet ring lipoblasts in myxoid liposarcoma
(DQ & H&E)
🧬t(12;16)(q13;p11.2) FUS-DDIT3 in most
👉🏼#PathPitfall: bubbly background and signet rings can raise c/f adenocarcinoma!
Love a #PathPitfall?! Come out Monday evening for some tricky Head and Neck cases with #ENTPath superstars @HandNPath @PathDocBoston @WeinrebIlan and…me!
#USCAP2023 @TheUSCAP
Pitfall Alert!!!
Seen at the site of bowel perforation..
What do you think #pathtwitter #GIpath ?
Signet ring cells?? Pseudo signet ring cells??
Answer in the next tweet...
@Mvgs1706 @BIDMCpath @ALBoothMD @Vik_deshpandeMD @Teclis82 @DrMarkOng @navale_pooja @UJoneja @natzpat @YuhoMD Wow, Monika, this is a real #Pathpitfall,muciphages usually in lamina propria and these ones also look so signet ring like and even the nuclei don't look so innocent .
Thank GOD for the existence of #IHC and those that know when to order 😁🙏🙏
#PathTweetAward
Today’s #FNAFriday #CytoHisto correlation
🫧Physaliferous (bubbly) cells in myxoid stroma: a classic case of chordoma
(Top:DQ Below:H&E)
🟤(+) Brachyury
👉🏼#PathPitfall: when presenting as head/neck mass, stroma can lead to impression of pleomorphic adenoma
Today’s #FNAFriday #CytoHisto correlation
Giant cells in a background of bland mononuclear cells in a case of giant cell tumor
(Top:DQ Below:H&E)
👉🏼#PathPitfall: giant cell differential is broad!
Today’s #FNAFriday #CytoHisto correlation
🤔Deceptively bland metastatic melanoma-even bubbles in the background like you’d see in normal adrenal cortex!
(L: H&E R:DQ)
🟤(+) MART/45, SOX10
👉🏼#PathPitfall: adrenal cortex is positive for Melan-A!
Spindle cell rhabdomyosarcoma is often overlooked because of very limited desmin and myogenin expression, as in this MYOD1 L122R variant. MYOD1 IHC is the most sensitive marker in this morphological setting. #BSTpath
Today’s #FNAFriday #CytoHisto correlation:
Pheochromocytoma:
(L: DQ, R: H&E)
👉🏼Polymorphic nuclei
👉🏼Abundant cytoplasm
👉🏼Loosely cohesive clusters
➕GATA3
A potential #PathPitfall when metastatic breast CA is in DDx of adrenal mass.
📌Pheos are cytokeratin NEGATIVE!
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