If your path practice is thinking about adopting AI, go lay down on the couch until that urge disappears. #PathSky

#PathSky #Pooh

A rarity - colleague's case. Young man c/o testicular swelling for a month which he attributed to contact sports. Then upon workup was found to have a very high b-hCG and lung mets. Orchiectomy showed pure choriocarcinoma. This focus here shows LVI. #PathSky

Look at this perfect lil focus of LVI (invasive mucinous carcinoma of the breast). #PathSky

A classic my breast attending would present on at conferences - usual ductal hyperplasia with comedo type necrosis. This finding was seen in a radial scar. Important not to overcall! #PathSky

Consult from a colleague. Radical prostatectomy for prostate cancer and incidental CIS cancerizing the ducts. A doubly justified surgery. #PathSky

Older woman with history of breast cancer. New focus found on imaging mid chemo regimen. My initial concern was heme related until these stained nicely for CAM5.2. This is treated invasive ductal carcinoma. #PathSky

Nothing particularly interesting - prostatic adenocarcinoma with a mitosis that reminds me of the Batwing. Also been experimenting with raw images on my iPhone and editing them. Curious if there's a difference in sharpness. #PathSky

A devastating day for American healthcare.

Soft tissue mass in the axilla. S100 and SOX10+, no h/o skin malignancies. An example of a Schwannoma with ancient changes. #PathSky

I swear I see more interesting breast diagnoses in private practice than I ever did at academic institutions. Invasive micropapillary carcinoma from today's pile. #PathSky

Update: Cultures grew Crypto neoformans.

A beautiful glomangioma! Presented on the forearm of an older man. #PathSky

I spy with my eye a Savi scout reflector. #PathSky

The King has spoken - PIPS is the best academic conference in the tri-state area! #PathSky #PIPS2025 #Princeton

Biopsy of one of multiple white patches seen in esophagus. H&E showed no acute inflammation and only the barest hint of parakeratosis. No glycogenic acanthosis either. GMS teased out these critters. #PathSky

#PathSky - Does anyone here use AI programs for any sort of path at their practice? If so, could you please dm me? Thx in advance!

Corpora amylacea in prostate adenocarcinoma, an uncommon sighting. #PathSky

I'm slowly realizing one of the breast surgeons may not understand that there's breast tissue in the axilla...

Beautiful CIS from today. #PathSky

Another case from this past week. Lung biopsy for new lung nodule suspected to be cancer. Nearly thought I had to sign out medical lung but then I saw granulomas with asteroid bodies. And then the numerous yeast! Currently pending cultures and PCR. #PathSky

Beautiful Warthin tumor from today's pile. #PathSky

It's kind of astonishing how some clinicians in the community do not do or take CME seriously. They just go through training and never get updates for the rest of their lives. It's a shame for us and for their patients.

A slightly messy set of pictures. Young female, breast mass, post partum. This is a lactating adenoma with infarction. I love seeing entities I only previously read or heard about. #PathSky

Gastric biopsy in an older male with a history of anemia. If I weren't in private practice I would have done the iron stain but I did the next best thing and confirmed he was taking iron sulfate. #PathSky

Work enemy is acting up today and I want him to stub his toe real bad. Here's a beautiful pleomorphic adenoma from the submandibular gland! #PathSky

Colleague's case. They were very kind to share this with me. There was a clinical concern for malignancy and this biopsy thankfully will get the patient the appropriate line of treatment. Likely hepatic sarcoid. #PathSky

For some reason the clinician didn't think this was a horn. Regardless, a beautiful little squamous cell ca in situ. #PathSky

I feel like the more I hear about the state of academic medicine in the US, especially path, it really makes me wonder when the other shoe is going to drop. It seems like we're all hurtling towards imminent collapse and there'll be no one left to train the next generation. #PathSky

No shade to my GI peeps but I feel like I rarely get good pancreatic FNAs. This was a great one and stained nicely with INSM1, synapto, and chromo. Overkill IHC but it was nice to see. #PathSky

Clear cell cribriform hyperplasia with lipofuscin. A benign finding with a benign finding. #PathSky

Granular cell tumor found in the breast. Beautifully S100 positive (not pictured sadly). #PathSky

This year feeling more apocalyptic than usual...

Reminds me of the moon, or a planet. #PathSky

Breast tissue. I feel like the duct is reminding me of a leafy seadragon. #PathSky

Happy V day! #PathSky

The ugliest urothelial carcinoma I've seen in a while. #PathSky

Fibrin thrombi at the periphery of an angiolipoma. It's the little things. #PathSky

I've officially made a work enemy ❤️ Anyhow something that stuck with me since residency is how these adenomas can have a shuttering artifact. Unsure why they do that. A soft sign of sorts at best. #PathSky

Looks like pleomorphic/grade 3 lobular initially. E-cad only partly lost and p120 catenin had mixed membranous and cytoplasmic expression. Areas with ductal feat elsewhere. Final dx - Invasive carcinoma with ductal/lobular features. #PathSky

Breast biopsy from a young teen. Noted to be circumscribed and oval on imaging. Biopsy showed diffuse PASH instead which was a relief. #PathSky

I hate looking for lone plasma cells in endometrial biopsies but sometimes they present themselves quite readily. #PathSky

I've never seen tyrosine crystals in a live pleomorphic adenoma until now and they're beautiful! Only took what, 7 years into path, to finally see one? #PathSky

I guess the price of eggs isn't going down anytime soon then...

Mucocele-like lesion on breast core needle biopsy. Never saw one in residency but just came across two this past week while looking at priors. Thankfully no malignancy associated with it. #PathSky

I spy with my weary eye a cell that is not like the others around it. #PathSky

A vessel twisting like a river. Happy Friday #PathSky

Second week is going... 😂 Anyway here's a spindle cell GIST that was found on an GI workup. Noted to be perigastric and stained very nicely for DOG1 and CD117. #PathSky

Survived my first week! Here's a beautiful example of melanosis coli that I came across.

New year, new job, new post! A pterygium excised from a young woman's eye. There's a nicely demonstrable area of elastosis. #PathSky