Discover and read the best of Twitter Threads about #pathology

Most recents (24)

1) Welcome to our new #accredited #tweetorial on the Pathophysiology of #DKD in #T2D: Traditional Teaching and New Insights. Our expert author is Hans-Joachim Anders, MD, @hjanders_hans from @LMU_Uniklinikum of @LMU_Muenchen
2) This #accredited #tweetorial series on the foundations of #kidneydisease #DKD through the lens of #T2D is supported by an independent educational grant from the Boehringer Ingelheim/Lilly Alliance and is intended for healthcare providers.
3) This activity is accredited for #physicians #physicianassociates #nurses #NPs #pharmacists 🇺🇸🇪🇺🇬🇧🇨🇦. Past programs still eligible for credit are at ckd-ce.com. Faculty disclosures are at ckd-ce.com/disclosures/. FOLLOW US for regular programs by expert faculty!
Read 48 tweets
Who are pathologists? There's a lot of misinformation about us, and although this isn't an exhaustive list, these are some of the more common stereotypes that need dispelled. #pathology
1. Pathologists are bad communicators.

Medical schools specifically select for students who are excellent at communication. This is an essential skill for any medical doctor.
Pathologists need to be clear and concise in our reports, in our communication with clinicians, and especially giving expert testimony in court. We also speak with patients and families (surprise!)
Read 17 tweets
1/5 In looking at the #frontline #digitisation #RFI for EPR suppliers I note that there isn’t any mention of requirements to populate #sharedcarerecords or support #interoperability standards such as #ukcore. After 20+ years, why doesn’t the NHS centre get this? A short 🧵
2/5 Interoperability is at least as important as the functional list of requirements. Regions (not Trusts and even not ICSs) are standardising on capability, not systems - e.g Maternity, #epma, specialist systems like ophthalmology. EPRs must be able to work with other systems
3/5 Also, how should an #EPR work within a #pathology and a #radiology network not co-terminus with an ICS? These are more organic and high data liquidity through interoperability is key. That’s another interoperability dimension we should be including.
Read 6 tweets
Study from #England looking at the impact of #SARSCoV2 on #brain #pathology in 785 UK Biobank participants (aged 51–81) imaged twice found:

-brain changes in the following regions:
--greater reduction in grey matter thickness and tissue-contrast in the orbitofrontal cortex & parahippocampal gyrus
--greater changes in markers of tissue damage in regions functionally-connected to the primary olfactory cortex
--greater reduction in global brain size.
- infected participants also showed on average larger #cognitive decline between the 2 timepoints
-these imaging and cognitive longitudinal effects were still seen after excluding the 15 cases who had been hospitalized.
Read 6 tweets
Immune and inflammatory gene signatures may predict HCC sensitivity to immunotherapy, and we thus train AI models to recognize tumors with activation of these signatures directly from HCC histology. We used approx. 350 HCC slides together with RNA seq data (TCGA series)
👇
We investigated different deep learning models, the first being a patch based approach
Read 6 tweets
1/14 🆕 🚨Accelerated article on #breastcancer just out in @nature! #bcsm

We asked:
1️⃣ What drives response to #chemotherapy in #breast #cancer
2️⃣ Can we use #machinelearning to predict response to chemotherapy❓

Link: nature.com/articles/s4158…

A 🧵👇👇👇 @OncoAlert
2/14 We are unable to #predict #response to treatment in clinic…

✅Good response ➡️treatment very effective ➡️better survival
❌Poorer response ➡️treatment less effective ➡️worse survival

Being able to forecast response would be a landmark advance!
3/14 We ran a study in women with #breastcancer @CUH_NHS+@CRUK_CI:
1️⃣who had a #cancer biopsy (which we analysed)
2️⃣received 18 weeks of chemo+/-targeted therapy
3️⃣had surgery (and we measured how much cancer remained)

We associated PRE-therapy profiles↔️POST-therapy response👇
Read 14 tweets
Heads up to followers on twitter, will be virtually attending the #ESASRBANZBMS conference this week (21-24th Nov) so expect a bunch of tweets with a particularly heavy science bend. Disclaimer: this is by no means an extensive coverage & usually includes personal reflections. /1
So before continuing, I will try to...
- keep everything here in this thread
- share what I snippets I can
- add a number to keep tweets in some order
- respond where possible (but am also engaging in the conference spaces)
- link to papers when I can /2
Now a bunch of # in case relevant to these folks: #MedTwitter #Science #anzbms #biology #pharmatwitter #ortho #rheum #immunology
#arthritis #pathology #physicaltherapy
#pt #MSKRad #OccupationalTherapy
#physiotherapy

Anyone is most welcome to add relevant tags :D /3
Read 35 tweets
What is the Experiment, again?

"And #Covid is a project, however one tweezes it apart, of an unelected #billionaire #class that continues to amass enormous almost unthinkable amounts of money and property, beginning a #project of reshaping the #planet."

john-steppling.com/2021/07/what-i… Image
"& their influence is now expressed in global corps &, more, in NGOs & institutions such as the #WHO & #WorldBank, the UN, & the #WEF. That they are ignorant of their own hubris is perhaps the most terrifying part of this entire scenario. This is the age of the rigid & weak ego." Image
"The eradication of the unconscious, of archaic dreams & collective imagination, the disenchantment of the world, & of the self, has taken place rapidly over the last 30 yrs ... & this disenchanted human is one who finds it hard to grasp the ideas of #class & economic #coercion." Image
Read 9 tweets
#WeekendLecture
#CerebralMicrobleeds #CMB

Radiological construct: small (2–10 mm diameter) round or ovoid #hypointense foci with associated #blooming with enhanced visibility on #MRI sequences sensitive to #susceptibility effects

thelancet.com/journals/laneu… ImageImage
#WeekendLecture
#CMB
🔬#Pathology: recent or old microhaemorrhages
🩸Microvessel injuries, ie: dilatation/fragmentation of the wall, amyloid-ß (in CAA) and fibrin extravasation
🩸Extravasation of red blood cells
🩸#hemosiderin-laden macrophages
karger.com/Article/FullTe… ImageImage
#WeekendLecture

In daily practice #CMB represents a radiological marker of #small vessel disease

In general:
🩸Strictly #lobar CMBs👉CAA
🩸Strictly #deep👉hypertension-related SVD ie #arteriolosclerosis
🩸Mixed 👉combination👆, but must think #hereditary #SVD, ie #CADASIL Image
Read 8 tweets
1/ Hello again, everyone. I have finally put together my third Tweetorial, and I will be focusing it on one single entity, the enigmatic and often frustrating Low-Grade Appendiceal Mucinous Neoplasm (LAMN). #pathology #GIpath Image
2/ For starters, what is a LAMN? The name gets you most of the way there. It technically is an appendiceal adenocarcinoma, because it is an epithelial malignancy composed of glandular epithelium.
3/ The key distinction is that LAMN invades by pushing rather than trickling/destructive invasion, so it’s not a low-grade “adenocarcinoma” like those we often see in the colorectum.
Read 64 tweets
Ornamental tattoo: macroscopy & microscopy.
🔬Dark particles of tattoo ink stay in the dermis.
#pathology #tattoo
Thread ⬇️ ImageImageImageImage
Tattoo ink should be deposited in the dermis, which is a "permanent" layer of the skin: that ensures its durability. Tattoo artists recommend a deepness of 2-3.5 mm, depending on the type of skin.
❌A superficial tattoo may lose color intensity due to epidermal regeneration.
❌If the ink is deposited in the hypodermis, it causes "tattoo blowout": pigment diffuses in the hypodermis and lead to a permanent, blurry halo of colour around the tattoo. It appears immediately after tattoo injection, and it may be mistaken as a hematoma.
📸 (own experience) Image
Read 13 tweets
Daily Bookmarks to GAVNet 01/17/2021 greeneracresvaluenetwork.wordpress.com/2021/01/17/dai…
Data pathology: diagnosing problems with data

johndcook.com/blog/2021/01/1…

#pathology #data
2020 UST March Madness - Money: Inside and Out

moneyinsideout.exantedata.com/p/2020-ust-mar…

#money #march #bonds
Read 10 tweets
Since #COVID hit, we're hearing a lot about critical illness #myopathy (CIM). Follow this tweetorial that will cover the basic aspect of CIM. Photos below are from a patient with COVID-related CIM.
CIM is a syndrome rather than a distinct entity. It refers to patients who develop a myopathy while being critically ill. The classic characteristic histologic finding is that of "myosinolysis" or loss of myosin.
As the muscle fiber type is determined by the myosin heavy chains, loss of myosin results in "unclassifiable" fibers. Biopsy photos show ATPase reaction at pH9.4 (left), type 2 in dark brown (type 1 light brown), and pH 4.3 (right) with type 1 in dark brown (type 2 pink).
Read 9 tweets
1
Ok this is interesting #livertwitter #MedTwitter
26 yr old woman with jaundice+severe itching (a.k.a cholestatic hepatitis). Routine causes - viruses, prescription drugs, autoimmune liver disease blood tests - neg. No #ayurveda or #herbal drug use. Mysterious🤔
Liver biopsy👇
2
#pathology expert says its #drug induced liver injury. But patient denies any drug use. She has #PCOD - polycystic ovarian disease (mayocl.in/34S2LMh) and hence, #overweight.
Deep dive into history again - says she's taking #vitamins for weight loss! Asked to show👇
3
Can you identify the culprit component that caused this woman's severe liver injury? #Pathologist is right! #PathTwitter
Culprit - Chromium picolinate in #health #supplement 4 #diabetes #weigthloss. #Chromium is micronutrient enuf in daily food intake bit.ly/3nYNeBB
Read 5 tweets
All you need to know about grossing the #larynx
Here's a #PathVideoTweetorial

#pathology #grosspath #headandneckpath

Video 1: Let's first get oriented by seeing some images
Since the main tumor completely involved the epiglottis, the surgeon had to excise a part of the tongue (which is seen in the specimen)

Now that you’ve seen the images, let’s take a look at the real deal

Video 2: Larynx specimen intact
After I took the cut margins, I had to bisect the specimen
(This is how I gross the specimen, others may have their own techniques)

Video 3: Bisecting the specimen
Read 10 tweets
Today was a great day. Perhaps one of my best as a pathologist. Let me tell you why. /Thread. #pathology
About two years ago, I signed out a placenta on a sad IUFD case. I made a relatively rare diagnosis, but not a big diagnostic challenge. Most of the residents on this platform could have made it. The specific Dx isn’t important. What’s important is that it is known to recur.
This year...two years later...the obstetrician called me and asked me to review another placenta on the same patient. One of my partners had signed it out. It wasn’t entirely normal, but it looked much better than the placenta from the IUFD 2 years earlier.
Read 8 tweets
#BHB inhibits #inflammasome activation to attenuate #Alzheimer’s disease #pathology | Journal of #Neuroinflammation |

“Here, we find BHB levels are lower in red blood cells and brain parenchyma of AD patients when compared with non-AD controls... jneuroinflammation.biomedcentral.com/articles/10.11…
...Furthermore, exogenous BHB administration reduced plaque formation, microgliosis, apoptosis-associated speck-like protein containing a caspase recruitment domain (Asc) speck formation, and caspase-1 activation in the 5XFAD mouse model of AD.”
“Taken together, our findings demonstrate that BHB reduces AD pathology by inhibiting NLRP3 inflammasome activation. Additionally, our data suggest dietary or pharmacological approaches to increase BHB levels as promising therapeutic strategies”
Read 3 tweets
Case2 of #breastradpath with @LizaMQuintana

40 yo with focal asymmetry in rt breast on screening mg (blue arrows). See descriptions below all images.

#radres #radfellows #breastimaging #breastpath #pathology #breastmulti @BIDMC_BreastImg @BIDMCpath @DrTedJames Screening mammogram from to...
Patient returned for diagnostic #contrastmammo which confirmed focal asymmetry (blue arrows) & showed non-mass enhancement (NME) on recombined images (yellow arrows). US showed correlate. USG core done and post-MG confirmed target (yellow arrows). Contrast enhanced mammogram...Targeted ultrasound of the ...US guided core biopsy was d...
Calling all breast docs, what is your differential diagnosis? BI-RADS? Next steps??
Read 9 tweets
Hi #pathology tweeples! I just realized that the callus I have on my pinky is from using it to steady my hand as I dot 😂(with my green pen of course 😉). I must dot A LOT! 💪🔬

I have some #path (mostly) dotting related questions out of curiosity.

@BIDMCpath Image
The #pathology tweeples have very strong opinions about dotting pen color! My tweet is inspired by this from @Chucktowndoc
Does anyone else have a dotting pen-induced callus? (Just me? I hope I'm not alone. 🤞😊)
Read 11 tweets
Membranous type Basal Cell Adenoma (BCA).
🧨 Morphologically identical to cutaneous cylindroma, hence aka dermal analogue tumor.
🧨 This is a unique morphologic subtype that one should be aware of.
Why? Read below. #ENTpath
#pathology #pathboards #S&L 1/3
🧨 Because this particular subtype can be multifocal.
🧨 This can be associated with Brooke Spiegler syndrome, a rare AD disease caused by mutation of CYLD gene on chr 16.
🧨 This has a higher rate of local recurrence (25%) than other subtypes. 2/3
🧨 And this has high propensity for transformation into a basal cell adenocarcinoma.
🔬 Islands of basaloid cells surrounded by eosinophilic hyaline material, jigsaw puzzle like pattern & peripheral palisading.
3/3 #S&L
Read 4 tweets
What does a PATHOLOGIST do?

A quick primer for:
Med Students
Physicians
Residents
Patients
Fellows
Nurses
People
HCWs

Please read:

#medtwitter #MedStudentTwitter
#pathtwitter #pathology #pathRIOT

1/5
At the Hospital, Pathologists diagnose:

- Every Culture
- Every Blood smear
- Every CBC
- Every Bone marrow
- Every Chemistry
- Every Biopsy
- Every Surgical resection
- Every FNA
- Every Blood transfusion
- Every Flow cytometry
- Every Molecular test

2/5
- Every Cancer patient
- Every Cancer type
- Every Benign tumour
- Every Non-neoplastic tissue
- Every Cytogenetics test
- Every Pap smear
- Every Frozen section
- Every Toxicology
- Every Autopsy
- EVERY COVID19 test
- & MORE!

Outside:
- All of Forensics

3/5
Read 5 tweets
1/
In 1920, Dr. Otto Warburg wrote the best grant request ever: "Request. I need 10,000 Mark."
2/
The request was granted and in 1924 he decided to thinly cut and mount slices of rat tumor in Ringer solution. He then measured lactic acid (lactate) production.
3/
Why? Well in 1863, Pasteur showed that a hypoxic environment induced the fermentation of sugars. Warburg essentially wanted to determine how tumors respire. It would follow that in a hypoxic environment, tumors would produce lactate.
Read 18 tweets
1/3
The devil is in the 'detailed' #drug history #clinical
22 yr male, underweight
Teetotaler
Fatigue, appetite loss
Liver test AST 400 ALT 600
Viruses negative
Liver #biopsy 👇Severe #fatty #liver #disease, Mallory Denk++
#livertwitter #pathology #MedTwitter #MedStudentTwitter Image
2/3
The culprit 👇#Ayurveda #medicine
#Ayurvedic jam with butter, honey, milk as base given for premarital #weight gain! 3 months after stopping, liver tests normal
Consider #drug induced fatty liver in #patients. Not everyone is #metabolic #syndrome
#pseudoscience #Nash #nafld Image
3/3
Common drugs causing fatty liver
Steroids, Valproate
Inj Tetracycline
#HIV #AIDS meds NRTIs
Rare - methotrexate, chemodrugs irinotecan, 5FU, tamoxifen
Also important is Amiodarone
Herbals with #Margosa oil too
Remember #alternative meds rich in fats are important causes too.
Read 3 tweets

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