Charles Herndon

Challenge yourself to some extra cyto!
4 questions in each module. Can you do it??
⬇️⬇️⬇️
🍤Pancreas
pathologynotebook.com/cytopancreas-4
🫁 Lung
pathologynotebook.com/cytolung-4
🚽 Urinary
pathologynotebook.com/cytourinary-4
⬆️⬆️⬆️
#CytoPath #PathTwitter #Pathology #PathSky

✅#1 & #3: *ABUNDANT* colloid is considered benign and satisfactory for evaluation, even if the “6 groups of 10” criterion of adequacy is not met.
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✅#2: Excessive gel and precipitated stains may obstruct cellular features, rendering an aspirate non-diagnostic.
A complete lack of follicular cells in the absence of colloid (e.g., blood or cyst fluid only) is another reason for the non-diagnostic category
#CytoPath #PathTwitter #Pathology #PathSky

Challenge yourself to some extra cyto!
4 questions in each module. Can you do it??
⬇️⬇️⬇️
🍤Pancreas
pathologynotebook.com/cytopancreas-4
🫁 Lung
pathologynotebook.com/cytolung-4
🚽 Urinary
pathologynotebook.com/cytourinary-4
⬆️⬆️⬆️
#CytoPath #PathTwitter #Pathology #PathSky

#3 of 3: Interpretation?
A) Non-Diagnostic
B) Benign
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FNA #2 of 3: Interpretation?
A) Non-Diagnostic
B) Benign
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#Thyroid FNA shows abundant colloid but no follicular cells.

Interpretation:
A) Non-Diagnostic
B) Benign

#CytoPath #PathTwitter #Pathology #PathSky

Today's BRAND NEW cytopathology challenges!
🧐🧐
pathologynotebook.com/cytopancreas-6
pathologynotebook.com/cytolung-6
pathologynotebook.com/cytourinary-6

Enjoy!🥳🥳

#CytoPath #PathTwitter #Pathology #PathSky

Answer for #1 and Bonus: Tubal metaplasia
Cells: columnar, ciliated (terminal bar), pseudostratied
Nuclei: oval, may be pleomorphic or hyperchromatic, chromatin even, nucleoli not seen
Cytoplasm: discrete vacuoles
!! Individual ciliated cells not enough !!
#CytoPath #PathSky #PathTwitter #Pathology

Answer for #2: Atypical endocervical cells
Cells: sheets, strips, pseudostratified
Nuclei: enlarged, elongated, hyperchromatic heterogeneous & coarse chromatin
Hyperchromasia more monotonous than metaplasia
Cytoplasm: may be abundant, but N:C is increased; distinct cell borders
#CytoPath #PathSky

When you are finished reviewing the answers, take today's BRAND NEW cytopathology challenges!

pathologynotebook.com/cytopancreas-6
pathologynotebook.com/cytolung-6
pathologynotebook.com/cytourinary-6

#CytoPath #PathTwitter #Pathology #PathSky

Bonus: How would you interpret these glandular cells?
A) Metaplastic
B) Neoplastic
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Question 2 of 2:

How would you interpret these glandular cells?

A) Metaplastic
B) Neoplastic
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#PapSmear

How would you interpret these glandular cells?

A) Metaplastic
B) Neoplastic

#CytoPath #PathSky #PathTwitter #Pathology#PapSmear

CYTO CHALLENGES!!

Four questions in each module, can you do it?

#CytoPath #PathTwitter #Pathology #PathSky

pathologynotebook.com/cytopancreas-1
pathologynotebook.com/cytolung-1
pathologynotebook.com/cytourinary-1

For reference: Non-keratinizing SCC
Syncytial aggregates, background tumor diathesis
High N:C, nucleoli prominent
Liquid based preps have less tumor cellularity, cells are rounded up (may appear glandular), and the tumor diatheses is a "clinging" diathesis

✅Keratinizing squamous cell carcinoma
Mostly single cells, aggregates less common
Variation in cell size & shape, tadpole cells
N:C can be low or high, nuclei vary markedly
Macronucleoli & tumor diathesis less common
HPV-related like non-keratinizing SCC
Worse overall survival, less radio-sensitive

❌Negative for malignancy, examples:
Atrophy: Fine, even chromatin texture and smooth nuclear borders are important clues to the benign nature of such groups.
Repair: Stretched out "pulled taffy" appearance with nuclei displaying evenly distributed chromatin, smooth borders, and
#CytoPath #PathSky

❌HSIL
cells occur singly, in sheets, or syncytial aggregates
hyperchromatic groups seen in syncytial aggregates
N:C is always high, prominent indentations/grooves, hyperchromatic
nucleoli generally absent
cytoplasm can be immature, mature (keratinizing), or metaplastic
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After reviewing the answer, take these cyto pathology challenges!

Four questions in each module, can you do it?

#CytoPath #PathTwitter #Pathology #PathSky

pathologynotebook.com/cytopancreas-1
pathologynotebook.com/cytolung-1
pathologynotebook.com/cytourinary-1

Bonus: Which of the following is true of endocervical keratinizing SCC compared to non-keratinizing SCC?
A) HPV-related
B) worse overall survival
C) more radiosensitive
#CytoPath #Pathology #PathSky

Postmenopausal bleeding in a 65-year-old woman.
Her pap smear is shown. What is your interpretation?
A) Negative for malignancy
B) High grade
C) Squamous cell carcinoma
#CytoPath #Pathology #PathSky

Challenge yourself to some extra cyto!
4 questions in each module. Can you do it??
⬇️⬇️⬇️
pathologynotebook.com/cytopancreas-3
pathologynotebook.com/cytolung-3
pathologynotebook.com/cytourinary-3
⬆️⬆️⬆️
#CytoPath #PathTwitter #Pathology

🙏🙏https://karger.com/acy/article/68/3/179/879415/Pitfalls-in-Thyroid-
Fine-Needle-Aspiration

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✅AUS with architectural atypia
Architectural atypia consisting solely of follicular patterning and micro follicles is more prevalent in ✅RAS-like genetic anomalies
#Thyroid #CytoPath #Pathology #PathTwitter #PathSky

AUS cases featuring nuclear atypia more frequently show BRAF-like mutations
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❌AUS with nuclear atypia
may include nuclear enlargement, crowding, chromatin pallor, and nuclear grooves
nuclear pseudoinclusions may be rare and seen in isolation, but are not a criterion for AUS
#Thyroid #CytoPath #Pathology #PathTwitter #PathSky

Read the explanation below.

Then challenge yourself to some extra cyto!
4 questions in each module. Can you do it??
⬇️⬇️⬇️
pathologynotebook.com/cytopancreas-3
pathologynotebook.com/cytolung-3
pathologynotebook.com/cytourinary-3
⬆️⬆️⬆️

#CytoPath #PathTwitter #PathSky #Pathology

Bonus: Follicular patterning is more frequently associated with___ mutations
A) BRAF
B) RAS

AUS featuring __ atypia
A) architectural
B) nuclear
#Thyroid #CytoPath #Pathology #PathTwitter #PathSky