Chuan Chen, MD PhD

FNA of solid pancreatic head mass.
What do these cells represent?🧐🧐
A) Acinar cell carcinoma
B) Neuroendocrine tumor
C) Pancreatoblastoma
D) Solid pseudopapillary neoplasm
#PathSky #Pathology #GIPath #CytoPath

Had a great time presenting our lymphoid #NGS work at #USCAP and connecting with so many hematopathologists, including the CAPA group! Grateful for all the support and encouragement! #hemepath #Boston

#slidearchiveseries history of DLBCL s/p chemotherapy with residual retroperitoneal lymphadenopathy, s/p radiation therapy for bulky cauda equina leptomeningeal disease, now for management of prostate abscess #gupath #malakoplakia

So pretty 😃

Sharing our sincere appreciation and gratitude for our #Pathology residents & fellows! Thank you for your unwavering dedication and invaluable contributions to our special learning community 😊🙌

We can't wait to see everyone this weekend at #USCAP2025! Getting excited for Boston!

TTF1

#PathSky 84M with lung nodule, signed out as “adenocarcinoma, favor pulmonary origin”. There is supposed to be a bit of TTF1 expression, but it is subtle to say the least.

#PathSky Slowly growing superficial leg mass, 38M. Well-circumscribed, phleboliths, thrombosed vessels, cellular spindle cell areas, cavernous vascular channels. Dx?

#PathSky 79M with a superficial neck mass. Wildly pleomorphic, quite cellular- undifferentiated pleomorphic sarcoma, right? There are basically no mitoses though, the cells have abundant granular-glassy cytoplasm, there is a lot of inflammation, and many bizarre cells have nuclear inclusions.

#PathSky Older adult with a large, prolapsing esophageal mass. An excellent example of a “giant fibrovascular polyp” of the esophagus. Except that essentially 100% of these turn out to be well-differentiated ( or less often dedifferentiated) liposarcomas.

pubmed.ncbi.nlm.nih.gov/28984298/

Thanks for your support, Yi 😃

YouTube video by Chuan Chen, MD PhD Case 1. Hyaline vascular Castleman disease stromal rich variant with iTdT+ proliferation

Kicking off 2025 with my second YouTube series: Hematopathology Case Collection. The first case explores hyaline vascular Castleman Disease, stromal-rich variant with indolent T-lymphoblastic proliferation. Check it out here: youtu.be/T_1ByEJeWXM?...

CD31

ERG

CAMTA1

#PathSky This one definitely needs more than 4 images, so go to the Comments too. 65F, iliac crest lesion. The original pathologists quite reasonably considered an epithelioid hemangioendothelioma, although it was CAMTA1-negative.

Just learned about bluesky! For a first post, here is an image of ductal type prostate cancer. Diagnostic criteria can be controversial but common features are columnar cells and papillary structures. Typically considered grade 4. #GUpath

Smear preparation of a meningioma with chordoid features

Permanent section of a chordoid meningioma showing focal whorl formation

Smear preparation of a chordoma

Permanent section of a chordoid highlighting the cords of tumor cells in a myxoid background

Some tumor look-a-likes on this Friday:

Chordoid meningioma and chordoma can share similar features of cords of cells in a myxoid background. Chordoma shows diffuse nuclear Brachyury expression whereas chordoid meningioma is positive for SSTR2 helping to differentiate the two 🧠 #pathsky #neuropath

Kidney pathology in an autopsy case for decompensated cirrhosis. Patchy bile cast nephropathy (brown casts; green on Hall's bile stain) and a Randall plaque (papillary tip nephrocalcinosis). #renalpath #nephrology #pathsky #nephsky

Central Zone glands #prostate #gupath #PathSky
🌉complex architecture
🌉stratified eosinophilic cytoplasm
🌉prominent basal cell layer
🌉intra-luminal bridges ("Roman arches")
🌉mimic high grade PIN
🌉Rule of👍🏻: in NB from mid gland-base, have higher threshold for diagnosing HGPIN & r/o normal anatomy!

S100

OCT2

#PathSky
Scalp mass, 33M. Just a nice example of soft tissue Rosai-Dorfman disease. I think this low power “pale->pink->blue” look is a good low power clue. In addition to S100 protein, Karen Rech’s group here at Mayo have shown OCT2 to be valuable in this dx. pubmed.ncbi.nlm.nih.gov/33177341/

Keratin

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- “modulation” from epithelioid to spindled cells is an under appreciated morphological hallmark. See Comment.

KIT

CD31

#PathSky

I try not to talk about it, but sometimes I look at bone cases. Lytic sacral lesion, 69M. Among the many IHC it was sent with, CD31 and KIT were diffusely positive, but other endothelial and GIST markers were negative. Dx? Anything else you’d like?

Acute promyelocytic leukemia, Giemsa stain

#pathsky #medsky #pathology #oncology #hemepath

Vegetable matter as seen in a fatal case of aspiration pneumonia 🔬

#thingsthatkill #autopsy #microscopy #PathSky #MedSky

Ok, my third attempt at a first post. I like surgical pathology and sharing cases.

New genetic promiscuity. Superficial neurocristic EWSR1::FLI1 fusion tumor. Same fusion as Ewing sarcoma but benign. There is life in this whole morphology thing yet.

pubmed.ncbi.nlm.nih.gov/38866368/

#PathSky

Hybrid tumor: Oncocytoma and Chromophobe Renal cell Carcinoma! #GUpathsky #pathsky #pathology #surgicalpathology #pathart #Nephsky

Ameloblastoma (follicular type), mandible, H&Es, 20x and 40x: Epithelial nests with a peripheral layer of columnar cells showing "palisading" and "reverse polarity", surrounding a central area resembling the “stellate reticulum” of a developing tooth! #pathology #pathsky #surgicalpathology #pathart

Cytokeratin 7 immunohistochemical stain

Chromophobe renal cell carcinoma (ChRCC), kidney, H&Es, 20x and 40x, CK7, 20x: Plant-like tumor cells - Vimentin negative; CK7 and C-Kit positive!
#pathology #pathsky #surgicalpathology #renalpathology #renalcellcarcinoma #renalpathology #RCC #kidneypathology #ChRCC #pathart

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Columbia Virology course by Vincent Racaniello for free on youtube youtube.com/watch?v=GEC3...

@doctoryizhu.bsky.social @drchuanchen.bsky.social 👋

I haven’t seen a #pathsky starter pack yet! I’ve 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 😁 @kmirza.bsky.social @clilleymd.bsky.social @brettkurpiel.bsky.social go.bsky.app/6bWDSjT

Hello 👋 , I am Chuan joining #PathSky 😊🔬