@alfredomaldo

@alfredomaldo

@alfredomaldo

Dermpath_doc_trish

@PIorfino

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:

Next is higher power at 100x

And now 200x

Read 6 tweets

Diego Morales, MD

@DiegoMoralesN

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) 🧬🔬🎭

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.

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

Read 26 tweets

Arjun Ramaiya

@ArjunRamaiya1

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

@DiegoMoralesN

And tagging my icons to say “thank you” for your valued contributions and teaching 🙏
@DiegoMoralesN @melanopath @mccalmo @et565 @JacobSmalberger @alegru18 @CarlosMonteag20 @atman_ci @PIorfino @HENRYY_MD @kis_lorand @AlomariDermpath @CArnold_Coach @DKalodimou @ChristineJKoMD

A short commentary of some interesting facts.

Read 3 tweets

Dermpath_doc_trish

@PIorfino

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

Let’s look closer at peach 🍑

Now closer at strawberry 🍓

Read 8 tweets

Dermpath_doc_trish

@PIorfino

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

Only 53…leg. Didn’t suspect it. Only hx of prior nevi removed.
I suppose it’s obvious where the diagnosis is headed…

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 .

Read 7 tweets

Tanishq Mathew Abraham

@iScienceLuvr

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 ↓

https://twitter.com/iScienceLuvr/status/1636479850214232064

As I showed earlier, I had the chance last week to play around with GPT-4's multimodal capabilities:

https://twitter.com/iScienceLuvr/status/1636479850214232064

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.

Read 16 tweets

Samson W. Fine, MD

@rovingatuscap

@MSKPathology

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/

@TheUSCAP

2. Select sessions to attend:
MAKE A PLAN! @TheUSCAP

Review the conference website: 2023am.uscap.org

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

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

Antonio Guerrero

@guerreroespejo

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?
1/8

#Pathologists #haematology

🔬: Histiocytic process with granular basophilic cytoplasm and Michaelis-Gutmann bodies (arrows), positive for calcium with von Kossa special stain (arrowhead); findings pathognomonic for malakoplakia.

PULMONARY MALAKOPLAQUIA
2/8

doi.org/10.1093/cid/ci…
#pathTwitter

🧫of the pulmonary nodule:➖
🧫biopsy of the abdominal wall lesion: Rhodococcus equi resistant to TMP-SMX, but susceptible to rifampicin, vancomycin, azithromycin, ciprofloxacin, & imipenem.
RHODOCOCCUS EQUI SUBCUTANEOUS ABSCESS
3/8

doi.org/10.1093/cid/ci…
#microbiology

Read 8 tweets

Antonio Guerrero

@guerreroespejo

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)
Eosinophilia
1/7

Due to normal ejection fraction, the differential diagnosis of dyspnea included non-cardiogenic pulmonary edema, pneumonitis secondary to chemotoxicity, and infection.
2/7

doi.org/10.1016/j.idcr…
#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

3/7
#lungdisease #parasitology #Pathologists

Read 7 tweets

Dermpath_doc_trish

@PIorfino

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@

Things you can notice at low power:
🔺acral skin with nail☑️,
🔺no epidermal collarette around area of lesion (which appears dermal)☑️,
🔺something looks bluish☑️

So let’s start figuring this out, yes 🙌? Is this a:

Read 9 tweets

Tristan Rutland MBBS FRCPA IFCAP

@TristanRutland7

Adult

#BSTpath #Dermpath #Pathresidents #Pathtwitter

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

* Dermatofibrosarcoma protuberans
^Pleomorphic dermal sarcoma

S100 and SOX10

Read 23 tweets

Arjun Ramaiya

@ArjunRamaiya1

Classic and common dual pathology. 70 Male curetted “Seborrhoeic keratosis” …..which its not 🤣🤣🤣
#dermpath #dermtwitter #pathtwitter #dermatology #dermatologist #pathologist #dermatopathologia #dermatopathology

Morphology: basal cell carcinoma with an unusually diffuse and dense infiltrate of monotonous small inactive lymphocytes.

Immunohistochemistry:

Read 4 tweets

Frank Han MD 🇺🇦Pediatric/ACHD/GUCH Cardiologist

@han_francis

#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: link.springer.com/article/10.100….

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

Antonio Guerrero

@guerreroespejo

A 17-MO♀️, Morocco: fever, pallor, epistaxis, gingival petechiae, lower limbsedema, & hepatosplenomegaly.

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

🔬myelogram: ?
1/9

#parasitology #haematology #Pediatrics

Myelogram revealed the presence of leishmania bodies and figures of hemophagocytosis.

VISCERAL LEISHMANIASIS ASSOCIATED WITH MACROPHAGE ACTIVATION SYNDROME
2/9

doi.org/10.1016/j.idcr…
#Pathologists #microbiology #IDtwitter

The patient was put on liposomal amphotericin B and corticosteroid therapy with good clinical and biological evolution.
3/9

#MedTwitter #Doctor

Read 9 tweets

DavidSusterMD

@MdSuster

@smlungpathguy

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

Pathology mcqs

@Pathology_mcqs

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

Options

Answer is multiple myeloma.
The image shows "INTRA-NUCLEAR INCLUSIONS" called "DUTCHER BODIES".
They are deposits of immunoglobulins. Intracytoplasmic immunoglobulin inclusions are called RUSSEL BODIES.
Seen in multiple myeloma, plasmacytoma, lymphoplasmacytic lymphoma (LPL).

Read 9 tweets

Raul S. Gonzalez, MD

@RaulSGonzalezMD

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

Pathology mcqs

@Pathology_mcqs

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

Options:

Diagnosis is juvenile papilomatosis.
Observe "swiss-cheese appearance" in gross and microscopy.
Other conditions with Swiss cheese appearance

Read 7 tweets

Pathologist Prof. Arne Burkhardt MD (Fan Account)

@pathnoerror

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

PATHOLOGEEK

@pathologeek_

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.
#DCF_path
#PathTwitter

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

3/9
🍄 Invasion of the tissues and vessels

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

#DCF_path #pathology #pathologist
#PathTwitter

Read 9 tweets

Pathologist Prof. Arne Burkhardt MD (Fan Account)

@pathnoerror

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.

It doesnt just stay here. We see it clear now.

Now we understand how to find it. Lets look at what it does. The Expression of the SP.

Read 14 tweets

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