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📢 #Pathology #tweetorial alert!
⚕️ Dx: Plexiform #Schwannoma (aka neurilemmoma)

🔬 Multiple (2-50) nodules or foci of fascicular expansion.
🔬Biphasic: dense hypercellular areas (Antoni A) + loose hypocellular areas (Antoni B)

Scroll down ⬇️ #dermpath #BSTPath

2/
A plexiform multinodularity is typical of plexiform schwannoma on gross examination.

https://twitter.com/Kashifhazim/status/1281211415647395842?s=20

3/
Usually sporadic (90%)
NF2 associated (5%)

NF2 gene on 22q12 ➡️ merlin.
🆚
Plexiform neurofibroma is associated with germline mutation of NF1 (17q11.2 ➡️neurofibromin)
sciencedirect.com/science/articl…

Read 7 tweets

Tristan D Rutland

@TristanRutland7

Skin, Young adult

#Dermpath #BSTpath #pathtwitter

Based on the above images, what is your initial impression?

*Dermatofibrosarcoma protuberans

Immunohistochemistry:

CD34

Read 16 tweets

Tristan D Rutland

@TristanRutland7

@ZHOUSEH

Read 15 tweets

Tristan D Rutland

@TristanRutland7

@ZHOUSEH

Bladder, adult female

@ZHOUSEH @MattieFarzin @rennmont @DrJPLow @ariella8 @RunjanChetty @JMGardnerMD @01sth02 @DrBMcGinn @s_prendeville @DrGeeONE @Dr_Brian_Cox @pembeoltulu @TheKarenPinto @kis_lorand @MarcosLepeMD

#GUPath #Surgpath #pathtwitter

SMA

ER PR

Read 11 tweets

KevinKuan

@kkuanMD

@Gagandeepk5MD

30yoF with upper arm mass. What is the diagnosis? Histology pictures later. #pathology #PathTwitter #BSTPath #radiology @Gagandeepk5MD @DrVish @JMGardnerMD @ApekshaNas @sarahjwu @ALBoothMD @c_castrodad @yokoda_md @NRiddleMD @histiocytosisX @TheKarenPinto @01sth02 @vhnguyenmd

So the tumor is completely encased in the muscle, not contiguous with the compact bone.

Read 4 tweets

Brian McMillen

@Teclis82

@ADamronMD

1. #Breastpath Hey all, myofibroblastomas are really sweet. Let’s learn about them. @ADamronMD @TheKarenPinto @KRoSlideReview @Chucktowndoc @jennpincus @LizaMQuintana @drkennethtang @dr_MPrieto

2. Clinical: Uncommon tumors. Well circumscribed, may slowly enlarge over time. Size usu. up to 4cm. Historically (and on boards/RISE exams presently)more common in men, but now seem to occur equally in men and women.
See pubmed.ncbi.nlm.nih.gov/18976021/

3. A couple annotated low power pics.

Read 13 tweets

Karen Pinto DNB, FRCPath

@TheKarenPinto

Age: 14-year old female
History: Proptosis & pain
Specimen: Exenteration
#pathology #PediPath #BSTPath #orbit

(*Image courtesy: Dr. Sayed Hashim)

3 main questions:
Q1. Is it benign or malignant?

Q2. If malignant - differentials?

DDx of orbital tumors in children:
1. Rhabdomyosarcoma (RMS)
2. Neuroblastoma
3. Synovial sarcoma
4. Chloroma
& so on

Read 28 tweets

Rola Ali, MD

@DrRolaAli

@ariella8

Part2️⃣
🍪
🍪🍪🍪🍪
🍪🍪Giant Cell🍪🍪
🍪🍪🍪Rich Tumors🍪🍪🍪
🍪🍪 of Bone 🍪🍪
🍪🍪🍪🍪
🍪

#BSTPath @ariella8 @VijayPatho @Path_Matt @AbhijitSurgPath

@kriyer68

1/7
Remember this case❓

🔬 Yes! GCT of 🦴
(micro features in view of location + age + radiological/gross features)

Answer to Qs:
DDx based on epiphyseal location alone:
🦴GCT of bone
🦴Chondroblastoma
🦴Clear cell chondrosarcoma

#BSTPath @kriyer68

https://twitter.com/cadxpath/status/876674793021489153?s=21

2/7

GCT of 🦴 continues....

☠️Secondary changes:
ABC, storiform fibrous histiocytoma-like, foam cells, focal osteoid

☠️H3F3A gene mutation (encoding histone 3.3): p.G34W

☠️IHC: G34W antibody staining the mononuclear cells

See:

https://twitter.com/cadxpath/status/876674793021489153?s=21

Read 9 tweets

Rola Ali, MD

@DrRolaAli

@kells108

🍪🍪🍪🍪🍪🍪🍪🍪🍪🍪🍪
🍪🍪🍪🍪Giant Cells🍪🍪🍪🍪
🍪🍪🍪🍪🍪🍪🍪🍪🍪🍪🍪

Part1️⃣

1/6
What better way to kick-start the new year🎇than with a tweetorial/#RolaCoaster ?
Specifically made for the #pathtwitter family💝
Hope you enjoy the🎢!

#BSTPath @kells108 @natasharekhtman

@kriyer68

2/6

Qs:
Can you tell these 2 giant-cell rich lesions apart❓🧐

Answer is coming in Part2️⃣ of this #Tweetorial

#BSTPath @kriyer68 @Histopatolomon @HENRYY_MD @ADamronMD @D4L14H @AlanPath @padmapathology1 @DrMarkOng @MBBS_Pathology
@Chucktowndoc @RunjanChetty @pembeoltulu

3/6

So…
▪️Why is this distinction difficult❓🤔
Because...
- Location is unknown
- Architecture not appreciated
- Age unknown

▪️Solution❓
- Radiology is 🔑
(closest thing to gross
specimen is the black/
white ‘negative’ image!)

Read 6 tweets

Chandra Krishnan

@hematogones

Painless hemiscrotal mass in a child, complex hydrocele on ultrasound.

Testis mass + smear... Fight!

#pedipath #gupath #cytopath

Rhabdomyosarcoma is indeed the top-level diagnosis... but more importantly, what type??

Note: several H&E patterns here that correspond nicely to the patterns on cytology.

#pedipath #gupath #pathology

Note the multiple patterns here - and see how they relate to myogenin staining.
This is an uncommon example of mixed-histology rhabdomyosarcoma.

Classic Embryonal - variable myogenin
Dense Emb/Solid Alveolar - strong, diffuse myogenin
Sclerosing - Weak/absent myogenin

#pedipath

Read 5 tweets

Valerie Fitzhugh, MD

@DrFNA

@kriyer68

Last night I posted this lovely gross picture; I’m now adding a couple of histologic images. Kudos to @kriyer68 and @DrAldehyde for being the first to submit the correct answer- this is indeed a synovial sarcoma! Not a bad time for a #Tweetorial #BSTPath

Synovial sarcoma is actually uncommon in joint cavities & does not recapitulate synovium in any way. Its rare amongst soft tissue sarcomas, representing only 5-10% of the cases. The disease is most prevalent in teenagers & young adults; 50% of cases are seen in pediatric patients

These most commonly present as pain in the affected site with an associated mass. In many cases the duration of symptoms is 2-5 years. They are seen most commonly in the extremities and are often associated with tendons. #BSTPath

Read 12 tweets

Sanjay Mukhopadhyay

@smlungpathguy

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Are you new to Twitter? Are you a pathology resident or a pathologist? Are you wondering what to tweet about or where to start? This brief tutorial is for you. Pathology on Twitter is awesome 👍🏾❤️✅

#Tweetorial = Tutorial of tweets

#pathtweetorial = Pathology version

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First step, check out this awesome guide to social media for newcomers. SUPER useful.

pathinfo.wikia.com/wiki/Social_Me…

It had great tips, like this one: ALWAYS include a picture of yourself on your profile. He’s right: please do it NOW! It’s essential. Just use a selfie 😊

@RoseannIWu

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Follow a few pathologists. Use this handy guide created by @RoseannIWu to begin with, and then just follow people whose tweets you like. Following is a friendly gesture on Twitter, and conveys that you are interested that person’s tweets.

Read 27 tweets

Bin Xu

@BinXu16