Discover and read the best of Twitter Threads about #Pathologists

Most recents (22)

Human #intestinal #spirochetosis:
✔️#sexual #transmitted infections
✔️of the large intestine by anaerobic spirochetes of the genus Brachyspira spp.

🖊️A De Gea, @alfredomaldo ,@clarapath, @MarianaDazAlmi1, @alirri, Raquel Escudero, et al.
👇… Colonoscopic biopsy. In rou...
@alfredomaldo @clarapath @MarianaDazAlmi1 @alirri Gastrointestinal symptoms such as abdominal pain, proctitis, or chronic diarrhea are the most common manifestations.

Most cases with accompanying symptoms show improvement with metronidazole antibiotic therapy.

Routine staining methods (haematoxylin & eosin & Warthin-Starry) can identify spirochetes on the surface of enterocytes.
Histologically, characteristic findings include a decrease in microvilli &a predominantly eosinophilic inflammatory infiltrate.

#Pathologists #pathology Colonoscopic biopsy compare...
Read 12 tweets
With #USCAP2023 approaching, I have been conversing with @MSKPathology fellows about how to make the most of the meeting

Thought I would share some ideas here (thread🧵):

1. Large professional mtgs can be overwhelming & IMO, require a strategy in order to maximize gains
👇🏻 1/ Image
2. Select sessions to attend:

Review the conference website:

Select "Schedule" under the "Program" drop-down menu for a day by day, hour by hour view #USCAP2023 👇🏻 2/ Image
3. Focus, Focus, Focus

Too many concurrent sessions at #USCAP2023 to randomly select

Residents: make ACTIVE choices - is there a subspecialty I'm considering fellowship in? is there a technology (#molecpath, #digitalpathology, #AI) that I want to learn more about? 👇🏻 3/
Read 18 tweets
As we see videos in social media of the first $PACB PacBio Revio to enter the @broadinstitute , with the promise of the long-read $1000/genome in place, what does it look like today to set up a Next-Generation Sequencing factory/institute?
There have been many of these institutes come and go, and probably the @broadinstitute (Cambridge, US) and the @sangerinstitute (Cambridge, UK) are the two referents in historical terms and in their magnitude of achievements in #genomics. So if we take them as an example, what do
we learn from them?
1) They were successful at being early adopters of large-scale Sanger Sequencing.
2) They were very well funded from the get-go, and contributed in large part to the success of sequencing the reference #human #genome in 2000-2001.
Read 46 tweets
A 71-YO therapy for multiple mieloma, voriconazole for Aspergillus fumigatus sinusitis, prophylaxis with TMP-SMX: febrile neutropenia, nodular lesion on abdominal wall
CT: pulmonary nodule unchanged in last a month
🔬biopsy of pulmonary nodule?

#Pathologists #haematology Histopathology of the fine-...Image
🔬: Histiocytic process with granular basophilic cytoplasm and Michaelis-Gutmann bodies (arrows), positive for calcium with von Kossa special stain (arrowhead); findings pathognomonic for malakoplakia.

🧫of the pulmonary nodule:➖
🧫biopsy of the abdominal wall lesion: Rhodococcus equi resistant to TMP-SMX, but susceptible to rifampicin, vancomycin, azithromycin, ciprofloxacin, & imipenem.
Read 8 tweets
A 17-YO: a 3-week of dizziness, headache, & weakness of the R leg

MR: ring-enhancing lesions in the frontal lobe & basal ganglia on the L side (A; T1-W) as well as surrounding edema & midline shift (B; T2-W)

DOI: 10.1056/NEJMicm2202196
#neurology #radiology #IDTwitter
IgG ab for Echinococcus multilocularis & E. granulosus: ➖

Surgical excision🔬: necrotic tissue, granulomatous inflammation, echinococcal laminated membrane (C, arrow) & an intact cyst (D, arrow)

RT-PCR: ➕for E. multilocularis

#parasitology #Pathologists #pathology
CT imaging of the chest and abdomen did not show any other sites of disease.


DOI: 10.1056/NEJMicm2202196
#microbiology #MedTwitter #Doctor
Read 6 tweets
A 14-yo ♂️ lived on a farm: a 1-month history of episodic headaches, vomiting, & papilledema
MR: a multiloculated cyst of the brain (A) with a hypointense rim and small projections in T2 phase (B, arrow)

DOI: 10.1056/NEJMicm2208104
#neurology #radiology #pediatric Image
Findings suggestive of CYSTIC ECHINOCOCCOSIS.

CT of the body: no other sites of disease.
A craniotomy was performed, during which saline irrigation was used to separate the cyst wall from the brain to avoid rupture.

DOI: 10.1056/NEJMicm2208104
#IDtwitter #parasitology Image
🔬: an echinococcal laminated membrane lined by a germinal layer with daughter cysts (Panel D, arrows) and protoscolices (inset, arrows) with hooklets (arrowhead).


#microbiology #Pathologists #pathology Image
Read 5 tweets
A 32-YO♀️ from Guatemala, Ph+ B-ALL post #chemotherapy: #dyspnea
CT: ground-glass opacities (2A yellow box), interstitial pulmonary edema with septal thickening (2B yellow circles), & pericardial effusion (2C yellow arrows), lymph nodes (2D yellow arrows)
Due to normal ejection fraction, the differential diagnosis of dyspnea included non-cardiogenic pulmonary edema, pneumonitis secondary to chemotoxicity, and infection.
#haematology #radiology #IDtwitter
She progressed to acute hypoxic respiratory failure.

🔬bronchoalveolar lavage: numerous larvae (3A,3B) with short buccal grove (arrow head) and prominent genital primordium (arrow) consistent with STRONGYLOIDES HYPERINFECTION

#lungdisease #parasitology #Pathologists
Read 7 tweets
A 17-MO♀️, Morocco: fever, pallor, epistaxis, gingival petechiae, lower limbsedema, & hepatosplenomegaly.

Pancytopenia, hypoalbunemia.
Triglyceridemia, ferritinemia, LDH & fibrinogen:⬆️
Direct Coombs test:➕

🔬myelogram: ?

#parasitology #haematology #Pediatrics
Myelogram revealed the presence of leishmania bodies and figures of hemophagocytosis.

#Pathologists #microbiology #IDtwitter
The patient was put on liposomal amphotericin B and corticosteroid therapy with good clinical and biological evolution.

#MedTwitter #Doctor
Read 9 tweets
A 63-year old man, kidney transplantation: fever and a painful ulcer on the lateral side of the tongue.

🔬: showed invasion of X?
#OralPath #maxillofacial #nephrology
🔬 showed invasion of Cryptococcus neoformans.

A tongue swab:➕for HSV-1.

The cryptococcal antigen test on serum: ➕


#mycology #Pathologists #microbiology
A CT-scan of the lungs showed extensive ground glass lesions & a lesion of 4.7 cm in the left upper lobe.

Bronchoalveolar lavage:➕for Cryptococcus neoformans & Pneumocystis jirovecii.


#IDtwitter #MedTwitter
Read 8 tweets
What we examined. What the cohort was. How they died. An autopsy review from late last year. Our first initial urgent findings. #pathologist #histpathology #PathTwitter #CPC22 #MedTwitter
Tissue with lymphocytic infiltration.
(Blue dots: lymphocytes). The tissue is inflamed.
Example 1
Tissue with lymphocytic infiltration.
(Blue dots: lymphocytes). The tissue is inflamed. The muscle fibres are destroyed.
Read 23 tweets
When your heart is the most important organ. #Pathologists #Cardiology #cardiologist #MedTwitter #Histopathology #pathology ImageImageImageImage
The heart shows inflamation and lymphocytes attacking the organ seeking the combat the SP #Cardiotwitter #MedTwitter #Pathologists #Cardiology #Histopathology ImageImageImageImage
Read 3 tweets
10 Steps to Pathology 2022 -Immunohistochemistry. This is the only way you will see it. Follow for more. Share to tell the gold standard must be upheld. You cannot miss the science. Image
It doesnt just stay here. We see it clear now. Image
Now we understand how to find it. Lets look at what it does. The Expression of the SP. ImageImageImage
Read 14 tweets
Let’s talk about microscope ergonomics! 🔬

Musculoskeletal pathologies among pathologists are very real, and often, quite literally, a giant pain in the neck.


A growing collection of studies suggest that #pathologists face far higher risk for musculoskeletal problems.

The most common problem areas tend to be the neck and upper back.

BUT, many of these issues can be prevented!

Img source: (Agrawal, et al., 2014)

These are *repetitive stress injuries* caused by repetitive or sustained submaximal exertion of the body’s soft tissue structures including muscles, tendons, ligaments, and nerves 🤕

Read 15 tweets
Can we improve how we treat cancer with stereotactic radiation? Yes, we can.

Here’s a @ClinOncology editorial with Drs. @MichaelTMilano & Alina Mihai on including clinical treatment volumes (CTVs) for microscopic disease.…
#radonc #medphys 1/
Radiation therapy (RT) can non-invasively treat microscopic disease. In curative settings, RT complements or competes w/ surgery to improve cancer care and patient outcomes.

I’ll discuss how matters using curative lung cancer and metastatic disease as examples. 2/
Stereotactic RT lets us give very high doses safely. Advances in medical physics & computer programming, matched w/ clinical trials, show we can improve tumor control & decrease central “in-field” failures. Its evolution initially required ignoring microscopic disease. 3/
Read 27 tweets…

#BMW lets get down the #REALITY of what @metpoliceuk are claiming to have taken place surrounding one of your @BMWavesBlog.

As you can hear for yourselves @MPSHaringey, @CPSUK @MaxHillQC @IOPC_Help a senior @bccoroners #AndrewWalker
3 @ukhomeoffice #pathologists , @StaffordScott_ who claims to have seen the #evidence , @PoliceInspForum, @PoliceChiefs @MHewittNPCC still up to this very day have not given the answers that doesn't add up to anyone who knows their professional field to come to the conclusion
#AmbroseGGBall had driven his car at breakneck speed up to 100 mph, crashing his car, to then continue a further 500 yards without leaving a single mark on that stretch of road that the #police claimed to have taken place.

Read 5 tweets
I am putting together a talk on PD-L1 and I have developed some cartoons to help describe the different scoring systems and provide a visual easy to understand picture of how #Pathologists interpret PD-L1
There are three major scoring systems that are used for PD-L1
TPS (Tumor proportion score)
CPS (Combined Positive Score)
IC (Immune cell score)
We can use cartoons to conceptualize what these mean.
We can then build a cartoon version of a tumor to help understand how these PD-L1 scores may differ between tumors and the challenge in interpreting them
Lets start with the TPS score
Read 12 tweets
#Pathologists ♥️ eosinophils.

We love scanning for them in a skin rash, admiring them when they infiltrate a tumor, & even counting them in esophageal biopsy. 🔬

But what do you know about eosinophils in the blood? 🤔


#pathbracket #hemepath #pathtweetorial @EmoryPathology
If the answer is "not much 🤷🏼‍♀️", then you're in luck, because the subject of my 2nd #pathtweetorial is:


🩸 Approach to Peripheral Blood Eosinophilia 🩸

Here's a brief outline of what I'll be discussing:


Let's get started with a case!

30 y/o M, presents with 3 months of fatigue, weakness, weight loss & abdominal pain.

Peripheral blood 🩸 & bone marrow 🦴 show the following 👇

Read 15 tweets
”I got tested for #COVID19 10 days ago and I don’t have a result! What’s taking so long????” This is a question I have heard many, many, times over the last 9 months. It is not everyone’s reality, but it does happen sometimes (Long thread alert) 1/14
Let’s talk about #COVID19 testing from the pathologist’s perspective (physicians like me who review and sign off on the validation studies in our labs so you can get tested amongst many other jobs; I need to do a what a pathologist does thread, but I digress) 2/14
In order for you to get PCR testing, it requires a swab and viral transport media (or VTM; it helps preserve the virus so the mRNA can be extracted later for testing, if it is present in the patient). Both of these items have been in short supply throughout the pandemic 3/14
Read 14 tweets
#Doctors and #Medicine need an #AI update.
Bold and convincing book.

#ArtificialIntelligence has the ability to bring the fourth industrial revolution. Healthcare is deemed to be an industry which can get transformed the most.

@EricTopol is a #cardiologist, historian of the present and a #MedicalFuturist.
He believes that the way we practice medicine now ( #ShallowMedicine ) relies too heavily on human inputs and is thus plagued by human biases and imperfections.

Read 23 tweets
In this time of national emergency, I as a pathologist can not keep quiet on issues like mass testing. After all, laboratory testing is what we do best, not other doctors who have other specialisations and interests.
The push for mass testing has brought a proliferation of substandard test kits which many including non-medical people are getting hold of and performing themselves. Worse, DOH in violation of the Clinical Laboratory Act allowed other doctors to administer tests that they have no
expertise and experience in. This will create false results with possible catastrophic consequences for health and the economy.
Read 8 tweets
RE: general principles underlying #SARSCoV2 testing for #Covid_19:
1) true: the tests may be based on technology/techniques that are decades-old and “any grad student could do.” That doesn’t mean one can develop/scale-up a clinical-grade test quickly/easily 1/18
The difference between a research and a clinical test is how the performance characteristics must be understood clinically. If you’re going to screen 1000s of patients, and use the results to clear negative patients, you have to understand how often you’ll get it wrong 2/18
In this case, we should be very concerned with the sensitivity of the test (false negative rate). If it’s even as low as 90% that’s potentially thousands of people who have the virus sent back into their communities. 3/18
Read 19 tweets
🤩I am constantly marveled by the endless ways in which we #Pathology and #LabMedicine, can use Twitter to engage, share, support & learn from each other. Here is the link to my presentation that celebrates the unlimited opportunities to harness Twitter👉🏽 Image
Like the #SolarEclipse that occurred in August 2017, to me, Twitter has been a community wide experience of marveling a visual process that can create a burst of awe at an organic velocity. It's really exciting to be engaged in this global experience. Image
#AcademicTwitter is using Twitter at the University and Research setting to teach. It has wide range benefits and I recommend reading the following article written by @soragnilab and @Aiims1742 published in @nature that describes this phenomenon.… ImageImage
Read 12 tweets

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