#PathSky 22M, referred here for a βhigh-grade sarcomaβ of the leg. Everyone agree? Wide excision plus chemo plus RT?
22.01.2025 21:33 β π 17 π 5 π¬ 1 π 1@doctoryizhu.bsky.social
PGY-2 AP/NP resident @MayoClinicPath #Neuropath #Cytopathology
#PathSky 22M, referred here for a βhigh-grade sarcomaβ of the leg. Everyone agree? Wide excision plus chemo plus RT?
22.01.2025 21:33 β π 17 π 5 π¬ 1 π 1Great case. Thank you for sharing!
06.01.2025 02:09 β π 2 π 0 π¬ 1 π 0SMA negative.
#PathSky 15F, thumb mass. There are no relevant positive immunostains. However, FISH for DDIT3 amplification (not rearrangement) is positive. This is an excellent example of a GLI1-amplified sarcoma. This is a great paper from the MSKCC group. pubmed.ncbi.nlm.nih.gov/38934567/
20.12.2024 18:33 β π 18 π 7 π¬ 1 π 1MyoD1
GFAP.
#PathSky 30M, abdominal wall mass. Microcysts, bland round to spindled cells, thick-walled vessels. Positive for desmin, MyoD1, myogenin, and GFAP. Classic findings in EWSR1::PATZ1 sarcoma. Why isnβt this a fusion-positive RMS? Excellent questionβ¦https://pubmed.ncbi.nlm.nih.gov/38043789/
06.12.2024 17:24 β π 17 π 5 π¬ 0 π 0#PathSky Cystic leg mass, 31F. The outside pathologist thought this was probably a BFH/DF, but wasnβt sure how to explain the epithelium. This is a siderotic BFH with βadnexal inductionβ. You can get basically any imaginable adnexal proliferation. Siderophages are a good BFH clue.
05.12.2024 16:30 β π 19 π 3 π¬ 0 π 0Example of how BK nephropathy can be easily missed due to sampling. Dense inflammation only seen in deep medulla in this sample. Cortex unremarkable. Striking viral inclusions visualized. SV40 IHC positive. #renalpath #nephrology #pathsky
04.12.2024 17:32 β π 24 π 12 π¬ 0 π 0PRKAR1A
#PathSky 34M with a jet-black mass next to the seminal vesicle. Melanoma? A very occasional psammoma body was present, and expression of PRKAR1A was completely lost. Malignant melanotic nerve sheath tumor (previously βmelanotic schwannomaβ) in an unusual location.
04.12.2024 16:57 β π 27 π 6 π¬ 1 π 1Autolysis versus ATN in autopsy kidney. Same kidney. Better preserved areas show thin tubular epithelial cells till sitting on basement membrane = ATN. Dethatched lining tubular epithelial cells falling into lumen = autolysis/can't assess. #renalpath #pathsky #nephrology #autopsypath
04.12.2024 17:01 β π 16 π 5 π¬ 1 π 0GFAP
#PathSky Solid and cystic mass next to the liver in a 50F with no relevant hx or other masses. Once you think of it, extraspinal myxopapillary ependymoma in a rather odd location seems a good fit. Why not, right?
02.12.2024 19:34 β π 19 π 4 π¬ 2 π 0Excellent PKD gross photo taken by @clilleymd.bsky.social #nephology #pathsky #renalpath
03.12.2024 04:08 β π 31 π 2 π¬ 0 π 1Keratin
SMARCB1
#PathSky Hand mass, 32M. Bland spindle cell tumor with collagen trapping- just an FH, right? Also some less bland epithelioid areas. This is a predominantly spindled epithelioid sarcoma- βmodulationβ from epithelioid to spindled cells is an under appreciated morphological hallmark. See Comment.
22.11.2024 14:48 β π 27 π 9 π¬ 4 π 2S100
OCT2
#PathSky
Scalp mass, 33M. Just a nice example of soft tissue Rosai-Dorfman disease. I think this low power βpale->pink->blueβ look is a good low power clue. In addition to S100 protein, Karen Rechβs group here at Mayo have shown OCT2 to be valuable in this dx. pubmed.ncbi.nlm.nih.gov/33177341/
I havenβt seen a #pathsky starter pack yet! Iβve tried to keep up with all of the new pathologists joining, but I know I have missed many! Please tag yourselves/others below and I will follow them and add them π @kmirza.bsky.social @clilleymd.bsky.social @brettkurpiel.bsky.social go.bsky.app/6bWDSjT
13.11.2024 21:03 β π 48 π 24 π¬ 33 π 2Hello π , I am Chuan joining #PathSky ππ¬
16.11.2024 01:41 β π 7 π 1 π¬ 0 π 0