Anna Vasileva

Pathologist who loves a good diagnostic puzzle 🔬 | Educator at heart | Here to share cases, tips & the occasional plot twist under the microscope

[Anna Vasileva @pathoblog]

@Romanow_MD I'm so happy for you! 🫶🏻

[Anna Vasileva @pathoblog]

@Kenny92954457 Chickenoma 😍

[Anna Vasileva @pathoblog]

9/9
The takeaway:
🔵 HER2 3+ rules out anti-EGFR therapy
🔵 Opens access to two approved targeted regimens
🔵 Age is not a reason to treat blind
Test it, it really matters.

#gipath #pathtwitter #pathology

[Anna Vasileva @pathoblog]

🧵 1/9
Elderly male. Metastatic colorectal cancer with liver mets. RAS wild-type — looks straightforward.

Then the molecular profile comes back: HER2 IHC 3+.

This changes the entire treatment plan. Here's why 👇

[Anna Vasileva @pathoblog]

8/9
Key detail on testing 🔬

IHC 3+ responds well. IHC 2+ without amplification — almost no benefit.

Use HERACLES criteria, not breast cancer scoring. And when possible, test the metastatic tissue — not just the primary.

[Jerad Gardner, MD @JMGardnerMD]

Hard time remembering all those #hemepath immunostains/markers? This chart by Dr. Jeanette Ramos will help! Full chart free here: https://t.co/HnptGnGjcr.
#medstudents #pathTwitter #path2path #usmle #MedStudentTwitter #MedED #medtwitter #hematology #hemeonc #lymphoma #leukemia

[Anna Vasileva @pathoblog]

@MAHoureih @DrRanasaleh @xenaalabbas @ariella8 @atman_ci @DrGeeONE @DrMarkOng @glinglerimek @Janiranavarro @kis_lorand It really is easy to overlook — a very inconspicuous find, especially at the end of the week! 👏🏻

[Anna Vasileva @pathoblog]

@AnjumShaon88707 Wow, a very exotic localization!

[Anna Vasileva @pathoblog]

🧵 1/6
A nodule on the face. Sent as a skin biopsy. No clinical history provided. Spoiler: this is NOT a primary skin tumor. 👇

#pathtwitter #dermpath #uropath #pathology

[Anna Vasileva @pathoblog]

6/6
Bottom line: clinical history is not just background noise — it is part of the diagnosis. Never forget that 🔑

Have you ever seen a case like this? 👇

[Anna Vasileva @pathoblog]

5/6
📌 Take-home points:
— Clear cells in skin = always rule out metastasis
— RCC loves to metastasize late and to unusual sites
— PAX8 + CD10 + CAIX = your best IHC friends here