Jamie Sington

UK Consultant Histopathologist

[Jamie Sington @SingJamieD]

@forthejon @et565 On morphology I would have gone for HG dysplastic naevus. PRAME and molecular seem to point in the same direction here and what you have said is v reasonable. Management is the same - wider excision.

[Jamie Sington @SingJamieD]

@ChristineJKoMD @RACARR51 Agree - its a tremendous paper. Would recommend to anyone wanting an update in cutaneous SCC.

[Jamie Sington @SingJamieD]

@STEVENKOLKERMD Just to play devils advocate Steven, why would you be uncomfortable or comfortable? If you have given the accurate measurement, this is as much as can be asked of you. Its up to the surgeon based on many factors to determine if it is adequate (unless you are the surgeon 😅).

[Jamie Sington @SingJamieD]

@DrMarkOng Gastric signet ring cell carcinoma?

[Jamie Sington @SingJamieD]

@HENRYY_MD @RACARR51 @mccalmo @david_terrano @tonitatirado @MarcelaSaebL @et565 @DrGeeONE @kis_lorand @gonzadetoro @ChristineJKoMD @SGottesmanMD @VHNguyenMD @TristanRutland7 Follicular (infundibular) SCC

[Jamie Sington @SingJamieD]

@drtimbracey @RaulSGonzalezMD @Pathoutlines @diagnexia @DrCycloPath @Vik_deshpandeMD @drkeithsiau @LizMontgomeryMD @RhondaYantiss @TristanRutland7 @DrMarkOng Fabulous demo of the pathology Tim, thx.

[Jamie Sington @SingJamieD]

@STEVENKOLKERMD I see this nearly every day!

[Jamie Sington @SingJamieD]

@david_terrano Thank you. Free to download too!

[Jamie Sington @SingJamieD]

@DraEosina @drtimbracey @diagnexia @RaulSGonzalezMD @Pathoutlines @Pathmath1 @DrMarkOng @jansen_marnix @GIJamesMD @DrCycloPath @TristanRutland7 @Vik_deshpandeMD Do we know what the risk of malignancy is if we left these in situ after Bx?

[Jamie Sington @SingJamieD]

@mismatchdef A strong contender...

[Jamie Sington @SingJamieD]

@drtimbracey @LumirKunovsky @UEGJournal @my_ueg @WileyHealth @Y_ECCO_IBD @imedverse @DCharabaty @JosephHabibi_MD @joostphdrenth @HaoYin20 @Bealoquebea @juliomayol @stevenbollipo @ibdseb @MariettaIacucci @DVinsard @RogerFeakins But they have to get to the epithelium somehow, presume transiting through the lamina propria - relevance depends on the context. If looks like UC / CD on scope, the findings of LP neutrs could be supportive of disease activity - might be bad luck you are missing cryptitis etc.

[Jamie Sington @SingJamieD]

@ArjunRamaiya1 Your image is beautiful; it is clearly sparing some suprabasal rete, and I wonder what you might call it if 'fully' confluent with similar atypia, no upward ascent or adnexal colonisation, but with PRAME positivity. Kossard believed lentig naevi of elderly = MIS if I'm correct?

[Jamie Sington @SingJamieD]

@ArjunRamaiya1 I do hope they ask for further clarification 😆

[Jamie Sington @SingJamieD]

@ArjunRamaiya1 @RishiAgraw21699 I think it can be quite difficult to know when budding + stromal reaction = (incipient) vs dermal invasion. Even more tricky when tumour has a pushing front in a superficial bx!

[Jamie Sington @SingJamieD]

@drtimbracey @DrMarkOng @RunjanChetty @RahulADeb I recall TATs reducing in GI resections when we introduced them. Yes, great to look at but a really well described macro is fine for small blocks in complex cases. We seemed to manage before!!

[Jamie Sington @SingJamieD]

@DrMarkOng @drtimbracey @RunjanChetty @RahulADeb I think this means someone doesn't have enough work to do!

[Jamie Sington @SingJamieD]

@RACARR51 Are they periungual?

[Jamie Sington @SingJamieD]

@ArjunRamaiya1 Fantastic example Arjun. Totally agree - incisional and punch are nonsense here

[Jamie Sington @SingJamieD]

@dgbrackett Seen a few times and not sure what to call, so usually go for post-inflammatory polyp or similar.

[Jamie Sington @SingJamieD]

@ArjunRamaiya1 Panfolliculoma.