rajEndiran

Visiting Prof. Of Pathology, Sri Ramachandra Institute Of Higher Education & Research

[Janira Navarro @Janiranavarro]

**Pediatric acinar cell carcinomas**

- 10% of pediatric ACC can be associated with Cushing syndrome
- They are associated with increases in AFP serum levels
- Aggressive neoplasms
- Morphologically they look like neuroendocrine tumors

Dr. La Rosa #USCAP2026 #pathology #PathX #PathTwitter

[Sumanta Das @SumantaDas_7]

Adult male. Retroperitoneal mass.
#PathX #PathTwitter #BSTPath

[Samson W. Fine, MD @rovingatuscap]

'Feelin' Groovy' - florid urothelial metaplasia in a prostate needle biopsy, mimicking basal cell hyperplasia and HGPIN at low magnification; at high magnification cytoplasmic vacuoles (upper R) & nuclear grooves (lower R) in the metaplastic cells aid in identification #gupath

[Meredith Herman, DO @MeredithKHerman]

Epithelioid features can be seen in a variety of lesions- let's review:

What is your interpretation?
A. Epithelioid sarcoma
B. Epithelioid histiocytoma
C. Epithelioid angiosarcoma
D. Epithelioid hemangioendothelioma

#PathPearls #PathQuiz

[Elizabeth Montgomery, MD @LizMontgomeryMD]

Esophagitis dissecans (sloughing esophagitis). The detached portion of the epithelium loses its glycogen!

[Modern Pathology @ModernPathology]

Mastocytosis (seen here) is often sought by naive colleagues and seldom seen. Mod Pathol offers a great review:
Panarelli NC, Hornick JL, Yantiss RK. What Is the Value of Counting Mast Cells in Gastrointestinal Mucosal Biopsies? Mod Pathol. 2023 Feb;36(2):100005. PMID: 36853780.

[Aravind Palraj @Rheumat_Aravind]

🧬 ANA Patterns at a Glance

🔵 Homogeneous → Lupus
🟣 Speckled → Mixed autoimmune disease
🟢 Centromere → Limited scleroderma
🟠 Nucleolar → Systemic sclerosis
🔴 Cytoplasmic → Myositis

⚠️ ANA pattern alone does NOT diagnose disease.

#MedTwitter #Rheumatology #ANA #Autoimmunity #MedicalEducation #FOAMed

[Charlie Herndon @DrCycloPath]

✅Myxoinflammatory fibroblastic sarcoma arises in distal upper > lower ext of adults (mc 40-60yo), scattered pleomorphism with huge nucleoli, dense inflammation
📽️&🔬🙏@JMGardnerMD
https://t.co/IkQGPR0IPZ
https://t.co/orpMKmQNRE
#BSTPath #DermPath #PathTwitter #Pathology

[❗NTE®️N🅰️L Ⓜ️edℹ©️ℹne @pgMedicine]

Polycythemia Vera: Major and Minor Criteria

Low EPO in Polycythemia Vera is a clue that the bone marrow is making RBCs autonomously.

Kidney is saying “stop making RBCs,” but the JAK2-mutated marrow keeps producing them.

That’s why PV = high Hb/Hct + JAK2 mutation + low EPO.

[Arch Pathol Lab Med @ArchivesPath]

Can AI help assess macrovesicular steatosis on donor liver biopsies? Find out here 👉 https://t.co/xpNXGraS5b

#CAP #Archives #LiverPath

[Joseph Susa, DO @CutisViaLux]

A nice case of Ochronosis. Banana-shaped, ochre-yellow (golden-brown) pigment in thickened dermal collagen bundles. Can be endogenous from alkaptonuria but more frequently exogenous origin secondary to hydroquinone treatment. #DermX #Dermpath #Dermtwitter #pathology #MedEd

Histology 📷: me
Clinical📷: Dermnet NZ. Waikato District Health Board.

[Elizabeth Montgomery, MD @LizMontgomeryMD]

An example of crystal storing histiocytosis; the patient needs to be evaluated for a plasma cell disorder or other lambda-restricted B cell neoplasm.
Arnold CA, et al. Am J Surg Pathol. 2018 Oct;42(10):1317-1324. PMID: 29878935.

[Janira Navarro @Janiranavarro]

Challenges of staging appendiceal mucinous neoplasms
Mucin outside the appendix in a LAMN case, is it pT4 or not?

-Acellular mucin without inflammatory reaction, mesothelial hyperplasia, or neovascularization is presumed to be a result of carryover during handling or gross examination, and should not be designated as pT4a (Pic A)
- Organizing acellular mucin with neovascularization on the serosal surface is categorized as pT4a (Pic B)

Umetsu et al https://t.co/cdM0816Ac3

[Gopambuj Singh Rathod @IamGopambuj]

Membranous nephropathy is no longer just “primary vs secondary” disease — it is now an ANTIGEN-SPECIFIC podocytopathy.

🔬 Newer antigens are redefining diagnosis & prognosis:
▪️ NELL1 → malignancy/drug-associated MN
▪️ EXT1/EXT2 & NCAM1 → lupus/autoimmune MN
▪️ SEMA3B → pediatric MN
▪️ FAT1 → post-HSCT MN
▪️ CNTN1 → neuropathy-associated MN
▪️ PCDH7 → indolent MN phenotype

⚡ Emerging concept: Dual-antigen MN
(NELL1+PLA2R, NCAM1+EXT1/2 etc.) suggesting complex autoimmune evolution.

🧪 Mass spectrometry-based antigen mapping is becoming the future gold standard for PLA2R-negative MN.
#GSR #BuddingNephros #MembranousNephropathy #RenalPathology #NephTwitter #MedTwitter

[❗NTE®️N🅰️L Ⓜ️edℹ©️ℹne @pgMedicine]

Amyloidosis

[Pathology mcqs @Pathology_mcqs]

🔬 Molecular Pathology of Adipocytic Tumors — High-Yield Map
Morphology 🧫 + genetics 🧬 + behavior ⚠️ in one glance.
Lipoma (HMGA2) → ALT/WDL (MDM2/CDK4) → DDL (JUN).
🎯 Rapid revision for FRCPath | NEET SS
#Pathology #MolecularPathology #Liposarcoma #Lipoma #FRCPath #NEETSS

[Pathology mcqs @Pathology_mcqs]

A one-stop revision sheet covering all major cytology systems with crucial numeric cut-offs 🔢, adequacy thresholds ✅, key cellular requirements 🧫, and diagnostic exceptions⚠️

Perfect for last-minute revision ⏱️and quick glance recall 👀
#Pathology #Cytology #HighYield #NEETSS

[Dr. AK 🇮🇳 @docakx]

Flower cells seen in blood smear.

Which disease is this?

[William Aird @WilliamAird4]

1/2

HEMATOLOGY feels impossibly broad… until you realize most problems start in just 4 compartments:

🩸 red cells
⚪ white cells
🟣 platelets
💧 plasma

[Charlie Herndon @DrCycloPath]

#TooCloseToDiagnose??? #PathQuiz 🔬☀️ #DermPath

A) Bowen disease
B) Actinic keratosis
C) Lichen planus-like keratosis
D) Seborrheic keratosis