#GUpath prostate bx: nice example of "microcystic" pattern prostatic adenocarcinoma (still 3+3) pathologyoutlines.com/topic/…

52 year old man duodenal biopsy

🖥️ Thyroid nodule. TI-RADS 5. 📏 6mm. Anechoic. 💉 Ultrasound guided fine needle aspiration performed by Interventional Pathologist. 1️⃣ Pass. 25g. 🔬 Bethesda IV. Follicular Neoplasm. #CytoPath #Cytology

1. It is indeed cryptococcosis (see H&E from adjacent field, GMS, and original pic #pembified) 👏🏾👏🏾👏🏾 2. Asteroid bodies are USELESS for diagnosis because they are non-specific 3. Cryptococcus can be missed on H&E because walls are very light gray; clue: "bubbly" look

Updates from the WHO Classification of Breast Tumors, 6th Edition (not published yet) Invasive lobular carcinoma - More detail on special architectural patterns Solid papillary ILC • Presence of pseudocapsule • Often with satellite foci of ILC at the periphery • Awareness to avoid misclassifying as a papillary lesion especially on small biopsy samples Dr. Tan #USCAP #pathology #PathX #PathTwitter

I'll bet you a distressingly large percentage of the people seeing this post would call this "lepidic". The whole growth pattern paradigm sounds really nice in theory but is quite a disaster in practice

#GUPath 🧩 Prostate biopsy What's the diagnosis? And is it clinically relevant? 🤔 #PathTwitter

5cm breast mass in male patient. #PathX #PathTwitter

#GUpath trainees: in this radical cystectomy for urothelial carcinoma, what's the likely location of this #LPpath section?

1/ Watch out for the sneaky prostata cancer 👇👇👇 #GUpath #pathology

#GUpath radical prostatectomy (for prostate ca, better seen elsewhere) here, nice example of CENTRAL ZONE (boxed) showing 🔬clear cell cribriform hyperplasia juxtaposed to 🔬HGPIN (outlined)

#PathTip #GUpath #LPpath: when screening prostate biopsies at low power &👁️ small glands traversing from one side of the core to the other ("glands crossing the street"): definitely🛑stop &📷 go down on high power!

No tricks here. What category would everyone use for this thyroid FNA, and why?

Horrible treatment (radiation) associated epithelial changes in duodenal mucosa. The p53 can be ignored, probably reflecting upregulation rather thana mutational event. The same can be seen in the stomach. Hutchings DA, et al PMID: 36843539; PMCID: PMC10460459.

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.

Our Gynecologic Pathology cases @UMiamiPathology are fascinating! Here’s a striking example of pilomatrix-like high-grade endometrial carcinoma (PiMHEC), a recently described entity mostly driven by CTNNB1 mutations. Look for solid basaloid growth with conspicuous central tumor cell necrosis, and pilomatrix-like keratinization with the hallmark ghost cells. This case also had a focal conventional FIGO grade 1 endometrioid component. IHC shows diffuse nuclear β-catenin with loss of PAX8 and ER in the pilomatrix-like component. These tumors are believed to behave aggressively.

1/ Necrosis = cell death (unlike apoptosis, it does not occur naturally and is not programmed) This short #Tweetorial shows you some of the histologic flavors of necrosis. The stain in each of these pics is hematoxylin-eosin (H&E) #pathology #pulmpath #pathtweetorial

Fact or artifact? 😰 Poor Fixation 🔬 Underfixation can make perfectly benign TDLUs look discohesive and atypical, mimicking atypical lobular hyperplasia (ALH). #PathX #PathTwitter #breasthpath

Not all that has ink is a true margin. 1. Make sure the ink is not in a cleft between fat lobules 2. Make sure you have a full cross-section of the tissue in the block. Tissue disruptions with ink are to be considered artifactual until proven otherwise 3. Check the diagram that shows where the section was taken from 4. If in doubt, walk over to the histology and lab and ask for the paraffin block. Looking at the entirety of the tissue within the block will give you information you cannot easily glean from the two-dimensional slide #breastpath