One of the difficult aspects of #hemepath training is time management in a high-paced/demanding environment & the ability to multitask effectively while learning a difficult discipline. Every yr I offer our fellows helpful tips I’ve learned so far 🧵👇🏻More tips welcome,pls add 1/
Get rid of paper…
Don’t do anything twice
Take ownership of your cases… they are just as much yours as they are your faculty’s
Bookmark your frequently visited websites… saves you a lot of time over the year… here are some of mine! Shoutout to @hematogones for his awesome BM diff calculator
Use social media… it will accelerate your learning, networking opportunities and will expand your professional circle
Your time is your most valuable commodity! I realize you don’t make a lot of money as a trainee but invest in yourself… use your time wisely… it’s ok to accumulate some debt!
Aim for perfection…. Your definition of perfection will evolve with time… don’t shortchange yourself!! This is your opportunity to learn!!
And finally…. Appreciate the opportunity you have as a trainee… this is your only time to make mistakes that are mostly inconsequential….the goal is to learn from your mistakes!! Give yourself the time and freedom to learn and enjoy yourself…. Happy learning all!!!
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Now that we know the answer is MDS-biTP53 let's see how we got to the answer...
I'll start from the beginning.. what exactly is this image that I showed you?
It's a whole genome view of using @bionano 's #OGM of a BM aspirate.. giving U a bird's-eye view of the chromosomes 1/
How do we interpret this? Easy!
normal cells have 2 copies of somatic chromosomes (1-22) one X & one Y if male, and 2 X if female.. (with some normal exceptions: i.e. men tend to lose their Y as they age... we think it's normal🤷♀️ or at least a very common somatic mosaicism) 2/
The chromosomes are on the X axis, their copy number is on Y axis! again, somatic chromosomes (1-22) should line up on 2 (red arrow) w/ roughly equal signal (above (blue) and below (red) the line).. here U can see parts of 4p (short arm), 4q(long arm) & 5q have 1 copy (loss) 3/
Best way to recognize pathological/neoplastic immunophenotypic changes is having a good grip on immunophynotypic variations in reactive/regenerative conditions… summarizing #FlowICCS22 plenary session 3 here👇🏻 🧵1/ #hemepath
Normal granulocytic maturation patterns…. Plots follow maturation from promyelocyte (*) to neutrophils #flowiccs22#hemepath 2/
Here are phenotypic changes post GCSF therapy compared to Normal…. Don’t over-interpret this pattern as abnormal myeloid maturation #flowiccs22#hemepath 3/ promyelocyte (*) to neutrophil
@AaronGoodman33 Typical cytomorphology is characterized by “blasts” with hand mirror (red arrow, cytoplasm to the side) or pearl necklace (green arrow, small cytoplasmic vacuoles around nucleus) appearance #bpdcn#hemepath#RareDisease#WHOHEME 1/
@AaronGoodman33 Skin and lymph node are most common extramedullary sites of involvement. Skin infiltrate is usually dermal with an appreciable “grenz zone” (uninvolved band b/w dermis and epidermis).. Lymph node typically has diffuse or paracortical involvement #hemepath#WHOHEME#BPDCN
Just another ordinary day at #hemepathMDA … 🤯
60-70 y/o woman
To all brave #hemepath aficionados how would you classify this case?
Poll and individual high quality images below. Pls comment if you’re feeling particularly brave today, let’s talk new #WHO 😎
The story of 1 day in the life of a #hematopathologist… I’m too exhausted to make a fancy educational thread but here are some amazing 🔬 pics for your viewing pleasure. I diagnosed all cases in one day 🤯 only at @MDAndersonNews Happy almost weekend people 🥂 #hemepath 🧵 1/n
Myeloproliferative neoplasm w/ concurrent BCR::ABL1 and JAK2 V617F ..the megekaryocyte morphology is clue to something beyond CML #mpnsm#PathOutPic 2/
BPDCN with perfect so-called “hand mirror” (red) and “pearl necklace” (black) morphology #BPDCN#PathOutPic 3/
WT1 mutations are present in ~7% of de novo AML, are typically Lof mutation involving exons 7-9 of the gene. They frequently (~15%) co-occur w/ NPM1mut & have detrimental impact in this setting, shown by @AkEisfeld and colleagues in bit.ly/3eWQtXw@LeukemiaJnl
We studies a cohort of de novo NPM1-mut AML. 7% had concurrent WT1 mutations at baseline. 22% (15/67) relapsed; 4 (27%) with newly acquired Lof WT1-mut. Illustrated by @furudateken