Clarissa E. Jordan, MD Profile picture
Mar 2, 2022 11 tweets 6 min read Read on X
🩸#HemePath AML subtype #PathTweetorial 🧵

Which cytogenetic/molecular finding is most consistent with this morphology? (Poll⬇️)

#PathTwitter #MolecularPath #MedEd @MayoClinicPath
(P.S. Always learning - I welcome any feedback!) ImageImage
Which cytogenetic/molecular finding is most consistent with this morphology? AML with…
Answer: ✨inversion of chromosome 16 is associated with acute myeloid leukemia with abnormal eosinophils✨

These abnormal eosinophils have mixed eosinophilic and basophilic granules Image
How is the cytogenetic abnormality determined diagnostically? 🤔

A brief introduction to #cytogenetics… 🧬

Cytogenetics is the microscopic investigation of the DNA structure/content at the chromosomal level using banding of metaphase preparations 🦓
Banding = darker and lighter areas on a chromosome, which are reproducible across specimens 🦓

Most common type of banding is G-banding:
📌Dark bands: AT-rich, heterochromatic, fewer active genes
📌Light bands: CG-rich, euchromatic, more active genes

From Wikipedia ⬇️ Image
Our talented technologists identify banded chromosomes by assessing (in order):

1️⃣ Chromosome size
2️⃣ Centromere position
3️⃣ Banding pattern

From @ASH_hematology and Wikipedia ⬇️ Image
Cytogenetics studies are essential in making a diagnosis of AML with inv 16

🔎 This can be subtle on conventional karyotype, so further testing with FISH/molecular is warranted if the karyotype is normal but the morphology suggests inv 16

From PEIR @UABPathology ⬇️ Image
The inversion of chromosome 16 (or the translocation t(16;16) leads to the fusion of CBF-beta and MYH11 🧬

CBF normally binds to enhancers/promoters of genes involved in hematopoiesis, increasing transcription of these target genes ➡️ hematopoietic differentiation/maturation
With the fusion gene, this process is blocked 🛑 ➡️ less transcription of target genes ➡️ less hematopoietic differentiation/maturation ➡️ disease

✨ Important to note that AML with inversion 16 is considered to be in the favorable risk category ✨
End 🧵

That’s all for this tweetorial! Thanks for following along 🤗

Again, always learning - I welcome any feedback or suggestions!

#PathTweetorial_CEJ #HemePath_CEJ
Link to the top of this tweetorial ⬇️

All my tweetorials are now archived on my website 🗂 (link in bio)

This one in particular is at pathcejmd.com/educational-ca…

🤗

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More from @pathcejmd

Jul 13, 2022
If you follow me, you know I love tweeting about #HemePath and lately #AML subtypes🩸

So far, I’ve covered the subtypes of AML with recurrent genetic abnormalities (per WHO 2016) - see below if you’re interested! ⬇️

Looking forward to more HemePath #tweetorials in the future! Image
AML with t(8;21)(q22;q22.1) RUNX1::RUNX1T1
Read 11 tweets
Jan 15, 2022
Hey #path2path #PathMatch22 applicants! Thinking about your rank list and wondering what📍Rochester, Minnesota is like?

In a word, beautiful 😍

A 🧵 for those who won’t get a chance to visit us this #virtual interview season! @MayoClinicPath @MayoClinic
Just to get it out of the way…

YES, it gets cold here 🥶❄️ Yes, it snows 🌨

But as someone who grew up in the desert ➡️ and then lived in TX 🤠 ➡️ if I can handle it, you definitely can too! (Just need to get yourself some good gear🧥🥾 - I’ve got suggestions!)
If you don’t want to go outside in the winter, Mayo Clinic & Rochester have tunnels & sky bridges connecting the med center w downtown, including from the parking ramps to the hospital 🏥
But personally, I’m excited for outdoor activities like snowshoeing & cross-country skiing!
Read 11 tweets
Sep 28, 2021
Catching up on 🧬 “Understanding #NGS and Interpreting Reports for Oncologic Pathology” with Dr. @sabahkadri and Dr. Cecilia Yeung at #CAP21 @AMPath 👩🏻‍💻

Super useful talk with excellent case studies! Here are just a few takeaways 🧵⬇️ #MolecularPath_CEJ #Informatics_CEJ
🤔 Considerations in developing an NGS assay

📌 @Pathologists has NGS assay development tools regarding test design, validation, quality, and bioinformatics: cap.org/member-resourc…
📌 How much do you want to know? ➡️ what test is needed? (WGS vs WES vs targeted sequencing)

1/
🧬 NGS in a nutshell with Dr. Yeung

1️⃣ Library preparation (hybrid capture vs amplicon-based)

2️⃣ Sequence the fragments of DNA (cyclic reversible termination vs detection of chemical byproducts ⚡️ as single nucleotide is added)

2/
Read 15 tweets
Sep 28, 2021
🧬#MolecularPath “Selecting the Right Tool for the Job: Practical Considerations for the Application of Molecular Diagnostics Methods in SurgPath” with @LJTafeMD and Dr. Larissa Furtado

A few takeaways (just scratching the surface of this excellent talk!) ⬇️🧵#MolecularPath_CEJ Image
First up: Pre-analytical Considerations

Purposes of molecular oncology testing:

🔵 Diagnosis
🔵 Therapy response/management
🔵 Monitoring

1/
Considerations for molecular oncology testing:

🔵 Availability of specimens
🔵 Testing options: targets 🎯, analytical sensitivity, TAT ⏱, cost
🔵 Clinical scenario
🔵 NCCN guidelines

2/
Read 18 tweets

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