#PathSky Laryngeal mass, older adult male. Primitive, highly vascular round cell neoplasm for the most part.

This is a duodenal mass is a patient with inflammatory bowel disease presenting with 1 week of nausea and vomiting. What IHC do you want to order? #pathsky #pathology #histology

#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 “melanotic schwannoma”) in an unusual location.

#PathSky I’m afraid I need 6 images for this one…Older adult with a large retroperitoneal mass. Most of it looks like this. Desmin (shown), SMA, and caldesmon are strongly positive.

Here is a bipartisan #pathology case. It's relevent to DVMs and MDs. Lots of red (at least pink) and blue, too. Rhinoscopy and nasal biopsy from a dog. What’s your diagnosis? It's a classic. #vetpath #pathsky #Mesomycetozoea #pathology #respiratorypathology #endoscopy #rhinoscopy

#PathSky. Mass next to knee, 27F. A hypocellular tumor with striking vascular changes, like we see in pleomorphic hyalinizing angiectatic tumor or schwannoma. But also some small fascicles of monomorphic spindled cells and a calcification. SS18::SSX fusion antibody +. Sneaky synovial sarcoma.

Now that I have a few followers, most of whom are pathologists, I thought I'd give you an unknown. This is small intestine from a dog. What's your diagnosis? Any rule-outs? Our Biopsy Conference participants had one principal rule-out with two alternates.

#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/

This, as featured in my avi, was a cute little finding. Enterobius in a tubular adenoma #pathology #GIPath #histology #histopathology

A nasty testis in a teenager. Any guesses? #pathsky #gupath

Nodular lymphocyte predominant Hodgkin lymphoma exhibiting characteristic PD1+ T-cell rosettes around tumor cells #Pathsky #Pathology #Hemepath

I called this a tonsillar fibroma since I didn't know what else to call it, but it's a great section! Almost like the tonsil has its own uvula. #pathsky #pathology

#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

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

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

Patient with #CLL and geographic necrosis. What is dx? #pathsky #hemepathsky #hemesky #medsky

🔬Quiz yourself with a past #EmoryCoTW A bone marrow aspirate shows cytoplasmic vacuoles in myeloid and erythroid precursors (see images). Which nutrient deficiency should be considered? #PathSky #Pathology #PathResidents #MedSky #Path2Path #PathMatch25 #PathMatch2025

Granular cell tumor (GCT), tongue, H&Es, 10x and 40x & CD68 and S100, 20x: Large round to oval tumor cells with indistinct eosinophilic, granular cytoplasm - CD68, S100, and SOX10 positive! #pathology #pathsky #surgicalpathology #granularcelltumor #gct #headandneckpathology #pathart

Touch preparation of high-grade mullerian serous carcinoma presenting as a large abdominal mass, performed at the time of frozen section. Although not always additive, touch preparations can be a useful adjunct to evaluate tumor morphology intraoperatively #pathsky #medsky #pathology #gynpath

So glad you asked! To start, you can’t just train a set on randomly submitted diagnostic information. You need good curated information about the patients’ history. You need appropriate numbers of both positive and negative examples of all target conditions. 1/4 #pathsky #medsky

Amyloid! Everyone’s favourite exam question. Seen here in a bladder biopsy for investigation of haematuria. A not uncommon isolated finding in this location. Amorphous eosinophilic material in the lamina propria, in this case associated with vessel walls. #pathsky #pathresidents

Coffee consumption is associated with intestinal Lawsonibacter asaccharolyticus abundance and prevalence across multiple cohorts www.nature.com/articles/s41...

A few years ago, I got temporarily stumped by the morphology of these circulating leukocytes... Any guesses what these cells are? What's the diagnosis? #hemepathsky #hemesky #pathsky #bloodsky #UMichPath

Microglandular adenosis (MGA), breast, H&E, 10x and 40x: A rare breast lesion! #pathology #pathsky #surgicalpathology #breastpathology #microglandularadenosis #MGA

‘Starry sky’ appearance of Burkitt lymphoma, here involving testicle #pathsky #medsky #pathology #hemepath

Interesting case of ANCA GN apparently triggered by COVID infection. Also showed concurrent membranous features with MPO+(IHC below) IgG (IF below) deposits as has been described: www.sciencedirect.com/science/arti.... #renalpath #nephrology #pathsky

Happy Friday everyone! Extranodal marginal zone lymphoma involving salivary gland, seen forming lymphoepithelial lesions #pathsky #medsky #pathology #hemepath #oncology

It’s almost Friday so here’s a case of metastatic papillary thyroid carcinoma that now shows anaplastic transformation. The late great Dr Livolsi and I did a study on such brain metastases detailing the histologic and molecular features ❤️🧠🔬 #pathsky pubmed.ncbi.nlm.nih.gov/36889238/

Endocervical adenocarcinoma in situ (AIS). While HPV16 is the most frequent subtype detected in AIS, it shows a stronger association with HPV18 relative to high grade squamous lesions. #pathsky #medsky #pathology #gynpath

Christening my timeline with some favorite images of pesky pathogens. Can anyone name the two different organisms pictured on each H&E stain of BAL fluid? (#2 is harder 🤭) #pathsky #IDsky

Intrauterine perivascular epithelioid tumor (PEComa) exhibiting HMB45 expression by IHC. This lesion was small and lacked atypia or mitotic activity, predicting benign behavior. #pathsky #medsky #pathology

Case of cellular rejection in a transplant kidney showing Bowman's capsulitis. Not a feature in Banff schema (yet); but has been associated with severe rejection. pubmed.ncbi.nlm.nih.gov/29501487/ #renalpath #nephrology #pathsky

Endometrial clear cell carcinoma exhibits architecture that ranges from papillary to tubulocystic to solid nests. Unlike its cervical counterpart, CCC of the uterine corpus shows no association with in utero exposure to diethylstilbestrol (DES) #pathsky #medsky #pathology #oncology

Myxopapillary ependymoma grossly has a characteristic sausage-shaped appearance. Commonly found associated with the filum terminale, it has a fibrillary glial appearance in a myxoid background. Though previously categorized as CNS WHO grade 1, it is now considered grade 2 #pathsky #medsky #neuropath

So-called ‘flame cells’ present in IgA plasma cell myeloma #pathsky #medsky #pathology #oncology

Nice example of nodal marginal zone lymphoma that exhibits plasmacytic differenitation and frequent dutcher bodies #pathsky #medsky #pathology

Sarcina photobombing! #pathsky

Sarcina Ventriculi present on gastric biopsy. This gram positive bacteria is notable for its construction in tetrads and its association with delayed gastric emptying, which may be rarely complicated by emphysematous gastritis and gastric perforation. #pathsky #medsky #pathology

Mast cells with atypical spindled morphology forming aggregates within the bone marrow, diagnostic of mastocytosis. In this case, there is coexistent chronic myelomonocytic leukemia (systemic mastocytosis with an associated hematological neoplasm) #pathsky #medsky #pathology