Rola Ali, MD Profile picture
MD FRCPC #Pathologist🔬| Associate Professor👩🏻‍🎓Kuwait University|#UBC alum🏔🍁Canada|#BSTPath #BreastPath #PathArt | طبيبة في علم تشخيص الأورام
16 Jan 20
Part2️⃣
🍪
🍪🍪🍪🍪
🍪🍪Giant Cell🍪🍪
🍪🍪🍪Rich Tumors🍪🍪🍪
🍪🍪 of Bone 🍪🍪
🍪🍪🍪🍪
🍪

#BSTPath @ariella8 @VijayPatho @Path_Matt @AbhijitSurgPath
1/7
Remember this case❓

🔬 Yes! GCT of 🦴
(micro features in view of location + age + radiological/gross features)

Answer to Qs:
DDx based on epiphyseal location alone:
🦴GCT of bone
🦴Chondroblastoma
🦴Clear cell chondrosarcoma

#BSTPath @kriyer68
2/7

GCT of 🦴 continues....

☠️Secondary changes:
ABC, storiform fibrous histiocytoma-like, foam cells, focal osteoid

☠️H3F3A gene mutation (encoding histone 3.3): p.G34W

☠️IHC: G34W antibody staining the mononuclear cells

See:
Read 9 tweets
6 Jan 20
🍪🍪🍪🍪🍪🍪🍪🍪🍪🍪🍪
🍪🍪🍪🍪Giant Cells🍪🍪🍪🍪
🍪🍪🍪🍪🍪🍪🍪🍪🍪🍪🍪

Part1️⃣

1/6
What better way to kick-start the new year🎇than with a tweetorial/#RolaCoaster ?
Specifically made for the #pathtwitter family💝
Hope you enjoy the🎢!

#BSTPath @kells108 @natasharekhtman
2/6

Qs:
Can you tell these 2 giant-cell rich lesions apart❓🧐

Answer is coming in Part2️⃣ of this #Tweetorial

#BSTPath @kriyer68 @Histopatolomon @HENRYY_MD @ADamronMD @D4L14H @AlanPath @padmapathology1 @DrMarkOng @MBBS_Pathology
@Chucktowndoc @RunjanChetty @pembeoltulu
3/6

So…
▪️Why is this distinction difficult❓🤔
Because...
- Location is unknown
- Architecture not appreciated
- Age unknown

▪️Solution❓
- Radiology is 🔑
(closest thing to gross
specimen is the black/
white ‘negative’ image!)
Read 6 tweets
22 Jun 19
1/4
Opinion appreciated ❓
Qs related to HER2

I got this breast cancer to perform HER2 FISH, with the Dx of invasive lobular carcinoma

See next for IHC and FISH👇🏼

#breastpath #breastcancer @kis_lorand @MBBS_Pathology @DrGeeONE @nusrat_xahra @tralimiguel @OSUcat03 ImageImageImageImage
2/4
It is negative for e-cadherin so that’s good but it was graded as 2 (probably 3+3+1).

So first Qs:
Wouldn’t you call this pleomorphic ILC or would just give a grade on bx? ImageImage
3/4

HER2 IHC was called equivocal (therefore sent for FISH)
ER= 90%
PR= 10% weak to mod

See next ImageImageImageImage
Read 6 tweets
22 Apr 19
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