Ahmed Shah

I spoke with UN Secretary-General António Guterres today. In this time of rising conflict, Canada is ready to lead.

We will build coalitions, defend democracy, and stand up for our values on the world stage. As others step back from global leadership, Canada is stepping up.

#PathSky Large, myxoid paraspinal mass, 79M. Transferred from HemePath to BST as “myxoid sarcoma”. MDM2 was negative.

Just voted as a Canadian living abroad for Mark Carney’s Liberals @mark-carney.bsky.social

No to the maple MAGA copycats

🇨🇦🇨🇦🇨🇦

#MarkCarney #electionscanada #vote #canada

Rhabdomyosarcomas of Bone: An Update

www.sciencedirect.com/science/arti...

This article discusses the very rare intraosseous RMS harboring FET::TFCP2 or MEIS1::NCOA2 fusions.

Was a pleasuring writing this with @folpe-mn-st.bsky.social

#PathSky Abdominal wall mall mass, 65M. Multinodular with thick fibrous septa. Bland spindled to ovoid cells surrounding prominent vessels. Microcystic, pseudoglandular spaces.

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.

For better or for worse (worse), MEASLES are back, so here's a #skytorial on recognizing this once thought eradicated disease.

MEASLES: a tutorial!

#dermsky #medsky #MedEd
1/

#PathSky I’ve been bad about posting, my apologies. Ok, 86M with destructive T12 lesion. Sent in to subclassify the malignant spindle cell lesion. Keratins, melanocytic markers, muscle markers, SATB2 negative.

#PathSky Large retroperitoneal mass in a 44M. Some of it looks like this.

CD34

#PathSky I usually like to show cases where the morphology makes sense of the molecular, but here’s one where you kind of need the molecular. Axillary mass, 9 month male. Very hyalinized, infiltration of fat, cracking artifact. Strongly CD34-pos. Giant cell fibroblastoma?

🚨 1st reported primary cutaneous spindle cell sarcoma with FN1-rearrangement. Unlike other FN1-fusion tumors like PMTs and CCMNs, this one truly stands apart histologically.

Read more also with clinical and radiological images: pubmed.ncbi.nlm.nih.gov/39945063/
#pathsky #bst #dermsky #dermpath

The Dark Age, round 2

Executive wants to frame the NIH indirects cut as $4B in savings.

But given that NIH returns $2.5 on every $1 investment, this would actually cost US economy a net $6 BILLION (per year!). Not to mention the human costs of wrecking education and research sectors and the communities they serve.

Check out our paper reviewing current practices of pathologist-driven reflex biomarker testing for #melanoma across #canada.

We propose a standardized minimum criteria for reflex testing.

#dermpath #pathology #dermatology

#PathSky 43M with a giant, pendulous mass of the inner thigh. The outside clinician and pathologist were concerned for WDL, but their MDM2 FISH was negative. Certainly there is nature fat with fibrous septae and an increased number of somewhat atypical stromal cells? False negative FISH?

I asked RFK Jr. a simple question:

Ladies and gentlemen: we did it

#PathSky 5F with a small bowel mass. Ideas?

this Friday 🎉 - please join us
#dermpath #dermtwitter #pathtwitter #dermatologia #dermatology #pathology
#dermatopathology
& if anyone would be interested in speaking to your Canadian colleagues sans tariffs, please reach out! #dermpath and where we intersect #gynepath #pedipath also welcome 🤝💥🇨🇦🔬

Here is Glut1

Beautiful example of reticular perineurioma with IHC obeying textbooks

(60s, male, finger mass)

#pathsky #bst #dermsky

SMA 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/

#PathSky Cystic leg mass, 31F. The outside pathologist thought this was probably a BFH/DF, but wasn’t sure how to explain the epithelium. This is a siderotic BFH with “adnexal induction”. You can get basically any imaginable adnexal proliferation. Siderophages are a good BFH clue.

Outside caldesmon.

Outside desmin.

Outside SMA.

#PathSky Since I was on vacation, here’s one more. 47M, arm mass. Don’t overthink it- it’s just an undifferentiated pleomorphic sarcoma. But- the outside was concerned for LMS, because of the diffusely positive caldesmon. Oddly, all the other muscle markers were negative. Can you explain this?

MUC4.

#PathSky 32M with extra-axial, dural-based, frontoparietal mass. Clearly malignant epithelioid cells arranged in cords and nests in a sclerotic background. Looks a lot like a sclerosing epithelioid fibrosarcoma, and it is strongly MUC4-positive. So, we’re done, right?