Discover and read the best of Twitter Threads about #pulmpath

Most recents (8)

1/3
Opinion appreciated!
▪️52/M, bx labeled “pleural/chest wall” done elsewhere

▪️CT report: consolidation LT upper lobe lung (paramediastinal). Another CT: suprahilar 8cm mass encasing LT upper bronchus.
(Not sure exact location pulm or pleura?)
3pic sets #Pulmpath @AltaherN88
2/3
▪️Prominent storiform pattern.
▪️Cells relatively uniform.
▪️No HPC vascular pattern.
▪️Not blue/fascicular enough for synovial sarc.
▪️Current bx does not include border of the lesion, but a previous core showed infiltration into lung parenchyma.

IHC👇🏼
3/3
IHC:
Positive (patchy):
▪️pan CK
▪️WT1
▪️BCL2
▪️SMA
▪️TLE1 (focal)

Negative:
▪️p63
▪️TTF1
▪️Calretinin
▪️CD34
▪️S100
▪️Desmin
▪️ALK

Pending:
▪️D2-40, CK8/18
Read 4 tweets
How about a #Tweetorial with no ending? A document that can be added to at any time? Can it work? Let’s find out!

1/
This #pathtweetorial will address the entity know as “talc granulomatosis” and review the literature, including old papers!

#pathology #pulmpath #granuloma
2/
I did a quick search to find the first time “talc granulomatosis” was used as a term for lung lesions caused by excipients in pills, and came across this 1970 paper. Were Hopkins and Taylor the first to coin the term? Correct me if I’m wrong @yro854

ncbi.nlm.nih.gov/pubmed/5410600/
3/
But first, let me give you a taste of what talc granulomatosis looks like, courtesy of Extra Super Duper Pathologist @DrjohninNE

The main finding is foreign body granulomas surrounding birefringent particulate matter (excipients) in the interstitium

Read 14 tweets
Here are 10 cryptic clues to this diagnosis:
1. Georgina, William and Arthur
2. Chest pain
3. 17p11.2
4. Larger, lower
5. Canada
6. Face
7. No cathepsin
8. It's ok to be a man
9. Nothing in the wall
10. Epidermolysis bullosa, ichthyosis, neurofibromatosis

#pulmpath #dermpath
@kriyer68 and @ariella8 you guys are on top of your game!

Clues explained:
1. Georgina, William and Arthur (first names of Birt, Hogg and Dube)
2. Chest pain (from pneumothorax)
3. 17p11.2 (FLCN gene)
4. Larger, lower (cysts larger than LAM with predisposition for lower lobes..
Clues explained..(contd)

5. Canadian authors
6. Face (where fibrofolliculomas occur)
7. No cathepsin (cathepsin is pos in LAM not BHD)
8. It's ok to be a man (LAM is super rare in men, not BHD)
9. Nothing in the wall (unlike LAM, where cysts contain abnormal smooth ms cells)
Read 4 tweets
1/
Necrosis = cell death (unlike apoptosis, it does not occur naturally and is not programmed)

This short #Tweetorial shows you some of the histologic flavors of necrosis. The stain in each of these pics is hematoxylin-eosin (H&E)

#pathology #pulmpath #pathtweetorial
2/
First a question to test your knowledge. Necrosis with large numbers of neutrophils is called:
3/
And now a few examples. Necrosis in colorectal carcinoma is often described as “dirty” because it contains nuclear debris. This makes it look purplish instead of pink.

#gipath #MedEd
Read 14 tweets
1/
This is the beginning of a #tweetorial or #pathtweetorial on a mystery topic. Fear not, it’ll become evident soon what we’re talking about. But first I’ll show you an image. These serpiginous fibroblast plugs are diagnostic if organizing pneumonia (formerly BOOP)
2/
In MOST cases of organizing pneumonia seen on lung biopsy, the etiology is not evident on histology. But sometimes, there is a clue. Examine this pic closely and then see if you can answer the quiz in the next tweet in this thread.
3/
What does the pic in the previous tweet show?
Read 24 tweets
1/
It’s time for a #tweetorial on hypersensitivity pneumonitis. It’s a greatly misunderstood entity. Potentially treatable, so can be very good news. OTOH, misdiagnosing UIP as chronic hypersensitivity pneumonitis can be very bad.

Follow this thread for a #pathtweetorial
2/
Let’s start with a poll regarding a common misconception. What is the predominant inflammatory cell in hypersensitivity pneumonitis?
3/
Hypersensitivity pneumonitis is an inflammatory reaction that occurs in individuals (classically never-smokers) who are exquisitely sensitive to an organic antigen.

Obvious exposures (moldy hay=farmer’s lung) can be fairly straightforward to recognize clinically.
Read 20 tweets
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
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 😊
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.
Read 27 tweets
Tweetorial on carcinoid tumor of the lung. I’ll add to it little by little every week 😊

#pathology #pulmpath

1/
Carcinoid tumor is the lower grade end of the spectrum of neuroendocrine tumors in the lung.

Caution: lung terminology is different from GI tract terminology
2/
In the lung, the terminology is
✴️ Typical carcinoid tumor
✴️ Atypical carcinoid tumor
✴️ Small cell carcinoma
✴️ Large cell neuroendocrine carcinoma

We don’t terms such as “well differentiated NET” because...this is #pulmpath and we are special 😜
3/
Carcinoid tumors are very similar on H&E to low grade NE tumors in the GI tract or pancreas. Nesting, odd patterns, bland cytology, granular chromatin (“salt and pepper”)

Read 16 tweets

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