Top Tweets for #PathTip
#PathTip:
when bugs (usually reside within cystic space) not obvious on H&E, do a "thick section" (6 micron) Gram stain to better👀🔬find 'em
@Notas_Patologia #PathTip:
if you 👁️ pink osteoid-looking elements with admixed malignant cells & wondering if could be osteosarc, SATB2 #IHCpath useful
(note: sensitive, but not specific! ▶️ strong negative predictive value)
#pathtip
🔪 Sampling of a wart (eg. verruca vulgaris) can be difficult esp if superficial and base cannot be visualized
⚠️ Squamous cell carcinoma (SCC) can have warty surface appearance
⬇️ A case of wart that ➡️ in fact, SCC
#pathx #dermpath #fammed #path4people #pathagonia
🩸 Venous Invasion in Colorectal Cancer
😰 Can be challenging
☝️Hints: Look for "Orphan Artery" sign and "Protruding-Tongue"👅 sign (⬇️)
🎨 Use Elastin > Endothelial stains b/c latter can be lost
#pathx #pathtip #path4people #pathagonia #gipath #pathtwitter #pathology #cancer
#pathtip
A histologic soft clue to amyloid near the vessels:
It can have crack-like features within it
#gipath #pathx #pathagonia #path4people #pathtwitter #amyloid #medx
#pathtip
📖 Intramucosal Lymphatics-Different in Colon than Esophagus, Stomach, and Small Bowel
🔵 Tumor in former=less likely to spread
🔵 Colorectal Intramucosal Adenocarcinoma = pTis
🔴 Esophageal, Stomach, Small bowel Intramucosal Adenocarcinoma = pT1a
#pathx #path4people
#pathtip
Stomach, at low power, identify areas of fibrosis or where lamina propria is edematous, then look closer.
Can you see the signet ring 💍 cells?
#pathx #gipath #pathtwitter #pathology #medx #hemeonc #pathagonia #path4people #gastriccancer
#pathtip
🔬 Foveolar Metaplasia in Duodenum
🤔 Think Peptic Duodenitis
🤔 Think rule out H Pylori
🤔 Also, think gastric heterotopia ⬇️ , which can often have overlying foveolar metaplasia
#pathx #gipath #pathagonia #path4people #gastroenterology #medx
#pathtip
📖Nodular Regenerative Hyperplasia
🩺Pt w signs of portal HTN (splenomegaly, esophageal varices, ascites)
🩻Imaging looks like cirrhosis
🔬But Trichrome shows no cirrhosis
🎨Reticulin network compressed b/n nodules
📖Many causes but➡️portal hepatic🩸flow abnormality
#pathtip
🔬 Hyperplastic Polyp (stomach)
🔬 How will they look like in pt with AMAG/EMAG?
🔬 Traditionally: hyperplastic, dilated foveolae w edematous, inflamed lamina propria
🔬 AMAG/EMAG: The "hyperplastic" foveolar epithelium can have extensive intestinal metaplasia ⬇️
#pathtip
🔬 Hyperplastic polyps (stomach) are commonly dx
🔴 Dysplasia can occur (<2-20% of cases)
⚠️ Rarely, adenocarcinoma can be found
🔵 Ass with atrophic gastritis (AMAG or EMAG) + reactive gastropathy
#gipath #pathx #gastroenterology #medx #path4people #pathagonia
#pathtip
📕 Hyperplastic polyp (stomach)
🗺️May occur anywhere in stomach inc GEJ
🔵Thought to arise➡️regenerative response to mucosal injury
⚠️Ass w background mucosal abnormalities (eg. AMAG, reactive gastropathy)
🔬May have histologic overlap w Menetrier+hamartomatous polyps)
#pathtip Esophageal Dysplasia in Barrett
1️⃣ Surface Maturation (eg. glands and surface have similar nuclear size)
2️⃣ Gland Architecture (eg. crowding, cribriform, cystic dilation, necrotic luminal debris)
3️⃣ Cytology (eg. Hyperchromatic, polarity)
4️⃣ 👀 for inflammation+erosions
#pathtip
📖 Reduplication of Muscularis Mucosae, Esophagus
🔴 With chronic injury, muscularis mucosae can be duplicated
⚠️ Depth of invasion can thus be confused.
❗️If tumor passes thru "first" muscularis mucosa, it's still pT1a, but may be misstaged pT1b (into submucosa)
#pathtip
🔬 If on Core Needle Biopsy:👀Stromal mucin pools W/O neoplastic cells
⚠️ Recommend excision
🤔 Why?
❗️Breast Ddx: Mucinous carcinoma v. Mucocele like Lesion.
--- Former may have very⬇️neoplastic cell
clusters, so could have been a sampling issue
#pathtip
🔬 Papilloma with ADH/DCIS
🔵Extent of ADH/DCIS inside papilloma does not appear to be related to breast cancer risk
🔴What's more important for recurrence risk is presence of ADH/DCIS OUTSIDE the papilloma,
👀Carefully around surrounding breast tissue of papilloma
#pathtip
📖Apocrine Adenosis (Breast)
📚It's sclerosing adenosis w/ apocrine metaplasia
🔵Benign
❗️But may look worrisome b/c angulated glands and concern for cytologic atypia (If don't recognize apocrine change)
📖Recognize you can get apocrine metaplasia w sclerosing adenosis
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