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Let's unveil more views of sectioned tubular objects.

-Case H&E 33864
Female 29 years
Wart left hand.
Deep palmo-plantar wart

(Via Virtual Pathology Slide Library)
#Foreingbodies #PathTwitter Image
Left slice: Image
Read 13 tweets
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
FINALLY clinician’s have figured that the PSEUDOSCIENTIFIC term “squamoproliferative lesion” means nothing more than a proliferating squamous lesion 🤣
#dermpath #dermtwitter #pathtwitter #dermatologia #dermatology #dermatologist #histopathology #dermatopathology Image
Squamoproliferative lesion was invented by some hotshot pathologist pretending its a diagnostic entity, but it actually means nothing more than an unspecified and unqualified proliferating squamous “lesion”.

#dermpath #dermtwitter #pathtwitter #dermatology #dermatopathology
Viral warts, seborrhoeic keratosis, actinic keratosis, keratoacanthomas, in situ and invasive squamous carcinomas are ALL either benign, atypical or malignant “squamoproliferative lesions”
#dermpath #dermtwitter #pathtwitter #dermatologia #dermatology #histopathology
Read 4 tweets
Finally a quiet moment😓.
This is an interesting case that came through this week:

76 F Rt Forehead.
SCC vs NUB #skin #dermpath #dermatology #dermatopathology #pathology #pathtwitter
low power 1st: ImageImageImageImage
Next is higher power at 100x ImageImageImage
And now 200x ImageImageImage
Read 6 tweets
Hey #PathTwitter & #MedTwitter, check out Pedro Pascal transformed into Pedro Pathcal as different stains & methods in histo/cyto/pathology!

Who said #Pathology & #LabMed can't be fun? Embrace your inner histo/cyto/pathologist and celebrate #LabWeek2023! (4/23 - 4/29) 🧬🔬🎭 Image
Hematoxylin, fancy name for a natural dye derived from tropical trees logwood and Brazilwood. It binds to acids (ie.DNA & RNA), turning them a lovely shade of blue or purple. It's a daily go-to in pathology labs! Check out PMID: 30001639 for a great read on its history and usage. Image
Eosin? More like "Oh, so pink!" This synthetic dye binds to all things positive in cells and ECM, highlighting muscles and connective tissues in shades of pink and red. It's a routine go-to in pathology labs along with hematoxylin! #PathMemes #LabLife Image
Read 26 tweets
50+ Female, painful “end” nodule middle finger after trauma ?Neuroma

A rare Pacinian Corpuscle Neuroma 🤩

#dermpath #dermtwitter #pathtwitter #pathresident #dermatologia #dermatology #dermatologist #pathologist #histopathology #surgpath #dermatopathologia #dermatopathology ImageImageImageImage
A short commentary of some interesting facts. Image
Read 3 tweets
Feeling lucky 🎰?
🍑vs 🍓.
These 2 lesions are similar but not the same. Let’s take a closer 👀 look…
#skin #dermpath #dermatology #dermatopathology #pathology #dermresident #dermboards #dermboardsstudying #pathologist #surgicalpathology #surgpath #pathtwitter #pathresident ImageImageImageImage
Let’s look closer at peach 🍑 ImageImageImageImage
Now closer at strawberry 🍓 ImageImageImage
Read 8 tweets
A pathologist’s first words:

“red is dead, blue is bad.”

This picture of a slide encapsulates both in one image.

#skin #dermpath #dermatology #dermatopathology #pathology #pathologist #surgicalpathology #surgpath #pathtwitter #pathresident #trishtorial Image
Only 53…leg. Didn’t suspect it. Only hx of prior nevi removed.
I suppose it’s obvious where the diagnosis is headed… ImageImageImageImage
I only did 3 stains, probably could have used just 1, but with the lack of history I guess it felt right to super-prove it . ImageImageImageImage
Read 7 tweets
How does GPT-4 do in the medical domain?

I got to play around with its multimodal capabilities on some medical images!

Plus a recent Microsoft paper examined its text understanding and got SOTA results on USMLE medical exams!

A quick thread ↓
As I showed earlier, I had the chance last week to play around with GPT-4's multimodal capabilities:
I also tried some medical images too! Here I started with some histopathology. I passed in an H&E image of prostate cancer and asked GPT-4 to describe it. It knew it was an H&E image of glandular tissue but was unable to identify it as low grade prostate cancer. Image
Read 16 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
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 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
This little lesion was a cute surprise. It came in from the finger (radial nail fold) of a 46 yo male, clinically described as either a wart or callus.

Let’s take a little look 👀see🫣shall we?#dermpath #trishtorial #pathtwitter@ ImageImageImageImage
Things you can notice at low power:
🔺acral skin with nail☑️,
🔺no epidermal collarette around area of lesion (which appears dermal)☑️,
🔺something looks bluish☑️ ImageImageImageImage
So let’s start figuring this out, yes 🙌? Is this a:
Read 9 tweets
Based on the above images, what is your first impression?

* Dermatofibrosarcoma protuberans
^Pleomorphic dermal sarcoma
S100 and SOX10 ImageImage
Read 23 tweets
Classic and common dual pathology. 70 Male curetted “Seborrhoeic keratosis” …..which its not 🤣🤣🤣
#dermpath #dermtwitter #pathtwitter #dermatology #dermatologist #pathologist #dermatopathologia #dermatopathology Image
Morphology: basal cell carcinoma with an unusually diffuse and dense infiltrate of monotonous small inactive lymphocytes. ImageImageImageImage
Immunohistochemistry: ImageImageImageImage
Read 4 tweets
#COVID19 #vaccineswork #Pathtwitter one of the pathology groups affiliated with The German Center for Infection Research (DZIF) put out an autopsy study on some adults who were found to be deceased after COVID immunization. Lets analyze:….
35 deceased were analyzed and 10 were found to have obvious other causes of death, but 5 of this group were particularly concerning to the authors because those had findings of myocarditis and also died without obvious warning symptoms. This isn't the full story though.
I do like their procedure used to arrive at the histopathologic diagnosis of myocarditis (our professions gold standard criteria); that part is secure. Part of their core conclusion is the decedents died of an arrhythmia from myocarditis - this is a hard diagnosis to establish...
Read 18 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
1) Nice illustrative example on a common issue in lung biopsy interpretation. Lung cancers are notorious for presenting with a mixture of patterns as well as invasive and non-invasive components that can make for pitfalls on sampling.

#pathtwitter #pulmpath @smlungpathguy
2) Here is an axial HRCT scan from a lesion - it shows two components - periphery of "ground glass" and a central denser area with a little bit of enhancement.
3) Now imagine two separate biopsies from this tumor; one where the needle is placed in the periphery, and one that snags that central component- likely to turn up pretty different findings.
Read 7 tweets
A 65 year old male presented with low urine output and bone pain. On further investigation serum creatinine was high and the patient had low hemoglobin. Bone marrow biopsy showed finding in the image. What is your diagnosis? #pathtwitter #pathtweetorial #pathresidents #pathboards
Answer is multiple myeloma.
They are deposits of immunoglobulins. Intracytoplasmic immunoglobulin inclusions are called RUSSEL BODIES.
Seen in multiple myeloma, plasmacytoma, lymphoplasmacytic lymphoma (LPL).
Read 9 tweets
01/ Buckle up, everyone, it’s time for a Tweetorial. Been working on this one for a while. This time, I’ll focus on the most common mesenchymal malignancy of the digestive tract: gastrointestinal stromal tumor (GIST). #pathology #gipath #PathTwitter
02/ GIST arises from the interstitial cells of Cajal. It can originate anywhere in the GI tract, though most cases occur in the stomach or small bowel. Rectum cases are uncommon, and GIST is very rare in the esophagus, colon, or appendix.
03/ Old terms for GIST include GANT (gastrointestinal autonomic nerve tumor) and leiomyoblastoma. These terms are no longer used, though you may run across them in older literature.
Read 80 tweets
A 17-year old male presented with a breast lump . Gross and Microscopic images from the excised lump ( shown in the images). Identify the true statement? (Options in the comments) #pathology #PathTwitter #PathTwitterFamily #pathtweetorial #tweetorial #MedTwitter #pathboards ImageImageImage
Diagnosis is juvenile papilomatosis.
Observe "swiss-cheese appearance" in gross and microscopy.
Other conditions with Swiss cheese appearance Image
Read 7 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
Pathology Report for Fungal Infections #tweetorial

1/9 Histopathological diagnosis of an invasive fungal infection should be PRIMARILY DESCRIPTIVE and must include:
Follow the thread to discover.
📌 The order can vary but try to include them all.
#PathTwitter Image
2/9 🍄 The fungal elements you find and their amount:

- Hyphae: Are they Pigmented or non-pigmented, septation and branching (acute angle, right angle or both)

- Yeasts: Their size, form and budding

- Pseudohyphae

#DCF_path #pathology #pathologist
#PathTwitter Image
🍄 Invasion of the tissues and vessels

🍄 The host’s reaction to the infection (inflammation, necrosis, or hemorrhage)

#DCF_path #pathology #pathologist
#PathTwitter ImageImage
Read 9 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

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