Sanjay Mukhopadhyay

Skeptic, Pathologist

[Sanjay Mukhopadhyay @smlungpathguy]

1.
Introducing a new thread: super basic lung pathology for PGY1s, with arrows. If you are a PGY1, leave a comment and I will tag you in a future post.

A hamartoma is a disorganized mix of overgrown normal tissues (in their normal location) that creates a mass. Good news: they are benign!

#pathology #pulmpath #tweetorial #pathtweetorial #sblppgy1

[Sanjay Mukhopadhyay @smlungpathguy]

@Renegbuya @DrGeeONE @JMGardnerMD @HENRYY_MD @s_prendeville @rovingatuscap @LaraHarikMD @priyaraomd @VarshaManuchaMD @drmehrarohit @TristanRutland7 @Williamson_SR @rajalbshah @padmapathology1 Me too bro! 🙏🏾🙏🏾

[Tim Bracey @drtimbracey]

@kriyer68 @smlungpathguy @pepeheffernan @ariella8 @MirunaPopescu13 @Histopatolomon @Saroja_DeviG @MeredithKHerman @Path4People @ColeBiehlDO @nilufer510 @TingZhaoPathdoc @ZemplenPataki @Nate_path @natasharekhtman @kis_lorand You know when you are a pathologist when a tissue diagnosis doesn’t start with the words “came back as….”

[Sanjay Mukhopadhyay @smlungpathguy]

#mottirl lives on!!! 💥💥💥💥

[Olaleke Folaranmi @DrGeeONE]

Had a great chat with an amazing #GUpath boss, Dr. Susan Prendeville.

Thrilled for the chance to use #MOTTIRL hashtag!
(Met On Twitter and Then In Real Life)

I do hope to see more someday. Let’s keep the family alive.
#PathTwitter #PathX
@smlungpathguy @JMGardnerMD @HENRYY_MD @01sth02 @Vik_deshpandeMD @pepeheffernan @chriszioga @WeinrebIlan @darcykerrMD @DrMarkOng @KMirza @CraigHorbinski @ac_pathgal @DrVish @vi_monappa @Sara_Jiang @edusqo @SGottesmanMD @MarcelaSaebL @RunjanChetty @FRodriguezNP

[Sanjay Mukhopadhyay @smlungpathguy]

@rovingatuscap @KMirza @LaraHarikMD @Mvgs1706 @LJTafeMD @01sth02 @drmehrarohit @h_alahmadie @NakhleDr @FKhaniPath Lovely!

[Sanjay Mukhopadhyay @smlungpathguy]

What an amazing summary of #PathTweetAward !! Thank you @ariella8 ! 🙏🏾🥰🥰

[Celina Stayerman MD @ariella8]

🌎🔬 The Network That Never Sleeps! 💙

Across continents and time zones, the global pathology community is united by an extraordinary spirit of generosity, curiosity, mentorship, and shared learning.

At any given moment, somewhere in the world, a pathologist is sharing a fascinating case, teaching a colleague, exchanging insights, or unraveling a diagnostic challenge.

Knowledge travels across time zones, keeping our community connected, inspired, and learning around the clock.

Together, we form a living network of knowledge, where every case shared, every question asked, and every lesson learned enriches us all.

🏆 Welcome to the October 2026 #PathTweetAward Compilation!

Join me in celebrating the wonderful educational contributions of pathologists from around the world. Each contribution strengthens this remarkable community and reminds us that the greatest value of knowledge lies in sharing it!

💙 A special thank-you to our dedicated screening judges:

@adi_agnihotri @ariella8 @archibhat3 @PoojaSMD @cebulka26 @LakshmiKoulmane @pembeoltulu @VijayPatho @VHNguyenMD @ahsanuitis @jsamsoondar

Special recognition to the pioneers of this initiative, @smlungpathguy and @AmyHDeekenMD, and to Muhammad Ahsan Gill (@ahsanuitis) for helping bring it to life through the creation of @PathTweetAward.

Compiled by Celina Stayerman, MD (@ariella8)

#PathTweetAward #PathTweetAwardOct2026 #PathX #PathTwitter #PathTwitterFamily

[Sanjay Mukhopadhyay @smlungpathguy]

@RizviUroos 🙏🏾🙏🏾😊

[Sanjay Mukhopadhyay @smlungpathguy]

@Autopsy_MD Agree 😥🙏🏾

[Sanjay Mukhopadhyay @smlungpathguy]

#pulmpath #asthma #pathology

[Sanjay Mukhopadhyay @smlungpathguy]

4.
When I ask PGY1s why they think a cell is malignant they often say "prominent nucleoli". A much better criterion is irregularity of nuclear contour. Benign nuclei tend to be symmetric, malignant nuclei are often not. This gives rise to the "4 quadrant rule"
#sblppgy1

[Sanjay Mukhopadhyay @smlungpathguy]

@SansanoValero @raghupillappa @yro854 @MelissaUpton7 2.
As a PGY1, you will start to learn what mitotic figures look like. You should suspect something is a mitosis if the normal nuclear structure (with nice membrane) is lost and replaced by something fuzzy. Here are some examples:
#sblppgy1

[Dr.Uroos Fatima @RizviUroos]

What is your type ??!!
Mine is bit of 1(not an expert, but no choice than to rely on morphology ) ; more of 7( being a literary person, need to check the language & spellings & description anywhere) and 10( to get the mental peace back ) 😄
#pathology #pathologists #pathtwitter

[Sanjay Mukhopadhyay @smlungpathguy]

@vtwin7041 let's say they are negative (as they usually are)...then what?

[Sanjay Mukhopadhyay @smlungpathguy]

One day I was reviewing an explanted lung from a patient with IPF (20 slides). Histology was perfect for UIP. On the 20th slide I asked for 20 recuts. On the 20th recut a granuloma appeared. Do I change the diagnosis to “chronic hypersensitivity pneumonitis”?

[Sanjay Mukhopadhyay @smlungpathguy]

@AmberAg31780588 @ccf_idfellows hello! I'm sorry, no, not for public viewing. Please check out my YouTube where I discuss similar concepts (it's free and open access). Or this video (101K views):
https://t.co/1OYFXWHOjp

[Sanjay Mukhopadhyay @smlungpathguy]

@jppathpd #PathTweetAward

[Sanjay Mukhopadhyay @smlungpathguy]

@TJLynnMD #PathTweetAward

[Tim Bracey @drtimbracey]

@FCademartiri The day a radiologist or pathologist realises that clinical correlation is our job too is the day we become a truly useful clinical diagnostician.

Why not cut out vague useless phrases like this one, which is basically just a form of microaggression.

[Tim Bracey @drtimbracey]

@FCademartiri I couldnt agree more and the same for pathologists! When is clinical correlation NOT recommended? It is always required and recommended, however sometimes SPECIFIC information/further testing is required, and in that case we should recommend that, the phrase on its own is useless

[Sanjay Mukhopadhyay @smlungpathguy]

Thank you to the amazing infectious disease faculty and fellows for having me. I love to work with this super nice AND super smart group of docs. I learn something every time we meet!! 🙏🏾🙏🏾

[CCF ID Fellows @ccf_idfellows]

Thank you so much to Dr. Mukhopadhyay from the Division of Anatomic Pathology for an amazing overview of fungal pulmonary pathology today at ID Grand Rounds! We are so lucky to work with you!

[Sanjay Mukhopadhyay @smlungpathguy]

Focal
⚫️⚫️⚫️⚫️⚫️⚫️⚫️⚫️⚫️⚫️⚫️⚫️⚫️⚫️🔴🔴⚫️⚫️⚫️⚫️⚫️⚫️⚫️⚫️

Diffuse
🔴🔴🔴🔴🔴🔴🔴🔴🔴🔴🔴🔴🔴🔴🔴🔴🔴🔴🔴🔴🔴🔴🔴🔴

Patchy
⚫️⚫️⚫️⚫️⚫️⚫️⚫️🔴🔴⚫️⚫️⚫️⚫️⚫️🔴🔴⚫️⚫️⚫️⚫️⚫️⚫️🔴🔴

#pathology