Matthew Zaba

Pathologist, Australia

[Matthew Zaba @mattzaba1]

Larynx landmarks which might be useful (I find easier to correlate with compared to digital photos). #gross #larynx

Pathological stage classification is based on location: supraglottis, glottis and subglottis. https://t.co/d0ZPvL370s

[Matthew Zaba @mattzaba1]

When all you get is one lonely acid-fast bacilli 🦠 Patient confirmed TB.

[Matthew Zaba @mattzaba1]

MCPyV IHC demonstrating strong nuclear positivity (and messy background cytoplasmic staining 🙄)

[Matthew Zaba @mattzaba1]

🟦Merkel cell carcinoma 🟦

Small round blue (…or should we say purple?) cell tumor on H&E. #PathTwitter

[Matthew Zaba @mattzaba1]

✅SATB2 exhibits strong nuclear positivity in ~75–80% of Merkel cell carcinomas (MCC), with sensitivity comparable to CK20

✅other neuroendocrine carcinomas (e.g., pulmonary small cell carcinoma), which typically show absent or only weak/focal SATB2 staining

[Matthew Zaba @mattzaba1]

@smlungpathguy It’s primarily a language model

[Matthew Zaba @mattzaba1]

🔷Visceral pleural invasion🔷

[Matthew Zaba @mattzaba1]

@kis_lorand Percentage pattern 4/5: 100% 😆

[Matthew Zaba @mattzaba1]

🟪Uterine myxoid leiomyosarcoma🟪

Macroscopic:
➡️Appearance is often gelatinous or glistening

Histopathology:
➡️Myxoid stroma
➡️Vague fascicular growth

Diagnostic criteria 🔬(1 or more of the following):
➡️Tumour necrosis
➡️Moderate to severe cytological atypia
➡️>1 mitosis per 10 HPF (0.55mm diameter field)
➡️Infiltrative margins

Immunohistochemistry:
➡️Desmin
➡️SMA

Take home point:
☑️Thorough sampling might be necessary to detect areas indicative of malignancy
Image

[Sanam Loghavi, MD صنم لغوی 🔬🧬 @sanamloghavi]

#hemepath #lymsm pitfall 🚨
CLL proliferation centers typically show uprgularion of cyclin D1. Don’t confuse this w/ mantle cell lymphoma.
There is no CCND1-r.
Read more about CLL w/ proliferation centers in the BM in our paper in @Human_Pathology
https://t.co/znIYZtOg9g

[Tristan Rutland MBBS FRCPA IFCAP @TristanRutland7]

Thoracic lesion, adult.

#BSTpath #Pulmpath #pathresidents #pathtwitter

[Vincent Rajkumar @VincentRK]

The serum free light chain FLC assay. Tutorial. #MedTwitter #MyelomaVR

Frequently ordered and frequently abnormal. This thread will reduce unnecessary headaches and referrals.

1/ Don’t order it unless you are suspecting myeloma, amyloid or related disorder

[Matthew Zaba @mattzaba1]

@RZitwer Thanks Richard!

[Matthew Zaba @mattzaba1]

@JMGardnerMD I believe it’s this 😅😆 https://t.co/CsQPLDJsX3

[Matthew Zaba @mattzaba1]

Anyone else mesmerized by these gout crystal scrapings? 😵‍💫😵‍💫😵‍💫 #gout

[Matthew Zaba @mattzaba1]

🟠Leiomyoma of the broad ligament🟠

☑️ circumscribed, firm mass
☑️ may develop prominent hydropic and degenerative cystic change
☑️ similar patterns and changes to its uterine counterpart, including criteria for malignancy

[Tristan Rutland MBBS FRCPA IFCAP @TristanRutland7]

🩻Brain tumour, adult ~30s

⚕️Previous history of lower limb tumour

❓Questions in thread

(Or just to answer below)

https://t.co/bA2zLIeAmw

#neuropath #bstpath #pathresidents #medtwitter #pathtwitter

[Matthew Zaba @mattzaba1]

So a new WHO book popped up online
⬇️➡️Genetic tumour syndromes 😅

[Matthew Zaba @mattzaba1]

https://t.co/piBvA50lqy

https://t.co/F48d0Nia9i

https://t.co/fCd6NahIaE

[Matthew Zaba @mattzaba1]

🔵SYNOVIAL SARCOMA🔵

✅ Low power blue tumour
✅ Monomorphic spindle cells +- epithelial component (monophasic or biphasic)

🧪IHC 🧪
✅ SS18-SSX fusion specific antibody 🤌🤌 (picture below)
✅ SSX-CT

🧬Molecular🧬
✅ SS18-SSX1
✅ SS18-SSX2
✅ rarely SS18-SSX4

🥼PROGNOSIS🥼
✅ Aggressive
➡️ 10 year survival ~75% children/adolescents and ~50 adults

[Matthew Zaba @mattzaba1]

Subtype

[Matthew Zaba @mattzaba1]

Twitter poll (x2) 📶📶

Recurrent Mantle cell lymphoma with a Ki67 70% ⬇️⬇️

[Matthew Zaba @mattzaba1]

Different area in the biopsy (2/2)