One of the greatest truths I have seen in the medical literature is this sentence in Up to Date about urine drug testing. In my experience, most docs understand there are limitations, but not the extent of them.

This is how people talk about AI in medicine too - it's always everyone else's specialty that is most at risk. Never yours.

This is a really good and informed article about the state of Pathology AI. Great to read something from a person who has actually made the effort to actually understand what a pathologist does. www.owlposting.com/p/what-happe...

In #GUPATH we talk about comedo necrosis in high grade prostate cancer being associated with intraductal spread - but not always - this is a lymph node metastasis, so no intraductal spread here!

Hello - The American Board of Pathology is soliciting nominations for a new trustee - as you can see in the posting there are no specific subspecialty qualifications or desires, we are just looking for someone who would make a good trustee. Please nominate! #pathsky abpath.org/2025/02/nomi...

The RFK Jr. confirmation hearing has been scheduled for 1/29/25. The nomination is on shaky ground. Here's the call to action: Reach Out To Your Senators and Urge Them To Oppose RFK Jr's nomination to be HHS Secretary Here's how to do that, step-by-step:

📢 Exciting news! @intsocuropath.bsky.social and @GU_Path_Society are hosting an Expert Consultation Conference on IDC-P during #USCAP2025! 🗓 Saturday, March 22, 2025 ⏰ 1-5 PM 📍 Boston (in-person, free for members) 🔗 Register: www.eventbrite.com/e/expert-con...

Have a look at the FREE TO READ! Annual Review Issue in Histopathology’s #hempath. ( Histopathology will shortly follow me here!) onlinelibrary.wiley.com/toc/13652559...

#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.

#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/

We should start a discussion about reducing workload without reducing quality. Molpath in Barrett's without dysplasia us a good starting point...

Skin/subcutaneous tissue. #pathsky #medsky what is your diagnosis. Low power pic is all you should need 💪🏽

#slidearchiveseries SMARCB1 deficient renal medullary carcinoma #gupath #pathsky #pathoutpic 🩸 young pts with sickle cell trait 🔬 cribriform, reticular, nested growth 🎨 PAX8, broad spectrum CKs, CEA, p53 ⚠️ OCT3/4 ➕ (50%), pitfall with GCT 🔑 SMARCB1 / INI1 inactivation

If I ran CMS, pathologist coding for lipomas would change. Sure, small lipomas can be 88304, even 88302 as a compromise, but larger, subfascial lipomas should not in any world be an 88304. These are very difficult specimens both for the histo lab and for us pathologists. #pathsky

I talk to docs about this all the time - a reference interval is not a "normal" range, it's a population based statistic which applies to healthy people (many people getting blood drawn would be rejected from reference range studies). "Abnormal" does not always imply disease (and vice versa)

Our blood tests are interpreted by average reference values. That's missing a lot of rich information! Each person has their own tightly regulated setpoints. One healthy person's complete blood count setpoint can be differentiated from 98% of other healthy adults. www.nature.com/articles/s41...

Amazing what can happen in a chronic infection in a toe - distal part here was nearly obliterated by chronic infection, repair process starting re-covering the bone with the adjacent skin, and grew into the actual bone. All benign, amazing! #pathsky

I mean, I know this has happened and this kind of thing is the reason why CLIA exists, but it's still shocking to see it. #pathsky

Strong work, Nebraska!

Beautiful football weather #goblue

#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?

Scrotal calcinosis - such a beautiful entity #pathsky #gupath

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

A cooking competition where the cleanup is part of the time you get to complete the meal.

Love when this particular therapy dog visits (Koda).

A strongyloides organism in a lung washing. #pathology #cytopath

Since I need a first post, this is an image of a pulmonary embolus, stained with a Movat (pentachrome) stain). The stain doesn't tell you anything but it's kind of cool. #pathology