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Based on the above images, what is your first impression?
* Dermatofibrosarcoma protuberans
^Pleomorphic dermal sarcoma
* Dermatofibrosarcoma protuberans
^Pleomorphic dermal sarcoma
S100 and SOX10 
Based on the images only, what is your initial impression?
Based on the above images only, which of the following combination of immunohistochemical stains would you predict to be POSITIVE✅?
PASD
Question:
Based on the initial images, which of the following do you favour?
* Gastrointestinal stromal tumour
**Gangliocytic Paraganglioma
Based on the initial images, which of the following do you favour?
* Gastrointestinal stromal tumour
**Gangliocytic Paraganglioma
Question.
Based on the initial images, what is your first impression?
Based on the initial images, what is your first impression?
1/
📢 #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
📢 #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.
A plexiform multinodularity is typical of plexiform schwannoma on gross examination.
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…
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…
Based on the above images, what is your initial impression?
*Dermatofibrosarcoma protuberans
*Dermatofibrosarcoma protuberans
Immunohistochemistry:
CD34
CD34
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.
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/
See pubmed.ncbi.nlm.nih.gov/18976021/
3. A couple annotated low power pics.
Age: 14-year old female
History: Proptosis & pain
Specimen: Exenteration
#pathology #PediPath #BSTPath #orbit
(*Image courtesy: Dr. Sayed Hashim)
History: Proptosis & pain
Specimen: Exenteration
#pathology #PediPath #BSTPath #orbit
(*Image courtesy: Dr. Sayed Hashim)
3 main questions:
Q1. Is it benign or malignant?
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
DDx of orbital tumors in children:
1. Rhabdomyosarcoma (RMS)
2. Neuroblastoma
3. Synovial sarcoma
4. Chloroma
& so on
Part2️⃣
🍪
🍪🍪🍪🍪
🍪🍪Giant Cell🍪🍪
🍪🍪🍪Rich Tumors🍪🍪🍪
🍪🍪 of Bone 🍪🍪
🍪🍪🍪🍪
🍪
#BSTPath @ariella8 @VijayPatho @Path_Matt @AbhijitSurgPath
🍪
🍪🍪🍪🍪
🍪🍪Giant Cell🍪🍪
🍪🍪🍪Rich Tumors🍪🍪🍪
🍪🍪 of Bone 🍪🍪
🍪🍪🍪🍪
🍪
#BSTPath @ariella8 @VijayPatho @Path_Matt @AbhijitSurgPath
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
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
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:
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:
🍪🍪🍪🍪🍪🍪🍪🍪🍪🍪🍪
🍪🍪🍪🍪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
🍪🍪🍪🍪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
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
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!)
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!)
Painless hemiscrotal mass in a child, complex hydrocele on ultrasound.
Testis mass + smear... Fight!
#pedipath #gupath #cytopath
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: 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
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
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
1/
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
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
2/
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 😊
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 😊
3/
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.
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.
A to Z alphabet in #ENTpath #oralpath #endopath
A: angioinvasive fungal sinusitis, adenoid cystic carcinoma, ameloblastic fibroima and anaplastic thyroid carcinoma
@smlungpathguy @aakasharmand @VijayPatho @TheKarenPinto @histolover @Histopatolomon @luishcruzc @kriyer68
A: angioinvasive fungal sinusitis, adenoid cystic carcinoma, ameloblastic fibroima and anaplastic thyroid carcinoma
@smlungpathguy @aakasharmand @VijayPatho @TheKarenPinto @histolover @Histopatolomon @luishcruzc @kriyer68
B
Basal cell adenoma
Biphenotypic sinonasal sarcoma
branchial cleft cyst
Basal cell adenoma
Biphenotypic sinonasal sarcoma
branchial cleft cyst
C
Clear cell carcinoma
Clear cell odontogenic carcinoma
Chordoma
CEOT
Clear cell carcinoma
Clear cell odontogenic carcinoma
Chordoma
CEOT
