Carol N. Rizkalla, MD

I am a huge proponent of educational webinars for learning 🧠 #PathWebinarPearls 👇👇👇is a compiled list of societies that regularly host educational webinars- many of which I have listened to myself! Most of these are FREE for residents, you may need to register as a member.

#GUpath prostate biopsy for elevated PSA at first blush foamy gland pattern prostatic adenocarcinoma comes to mind... but other DDx include Cowper gland (Dx here) or mucinous metaplasia ⏬cont'd

Prostate cancer with treatment effects following radiotherapy exhibits single cells with large, eccentric nuclei and abundant pale or foamy cytoplasm. Identification can be challenging at low magnification but is distinctly highlighted by PIN4 staining. Grading is not applicable in this context, and prognosis is generally better compared to cases without treatment effects.

other areas showing extramedullary hematopoiesis (EMH)

Stunning contrast between flat urothelial carcinoma in situ (right side of each image) and reactive urothelium (left side) CIS➡️enlarged, irregular, & hyperchromatic nuclei Reactive➡️small, uniform nuclei w/vesicular chromatin + intraepithelial acute & chronic inflammation

I received this consult asking about a urothelial process given the GATA3 + in prostate tissue (NKX3.1 was+) 🔑Hx dug-up: patient had prior XRT for prostate ca 🔬Dx: benign prostatic tissue with radiation changes (and aberrant GATA3+; see refs, oddly both 🖨️around same time!)

#GUpath prostate bx showing what some refer to as "PINATYP" (HGPIN with adjacent small atypical cells, in which focal adjacent 3+3 vs tangential sectioning of HGPIN cannot be excluded)

#GUpath renal mass bx Papillary Renal Neoplasm with Reverse Polarity (PRNRP) ▶️currently listed as "emerging renal tumor" in WHO but hoping it cracks the official list in next go-around😅

mount vesuvius ain't got nothing on this... mount prostatitis #GUpath #pathart (FYI as reminder: I don't use "prostatitis" in path report - it is a clinical Dx! just describe🔬it)

80s M, cystectomy. What is your diagnosis? #PathTwitter @MGBpathology @MGHPathology

Great case of TFE3-rearranged RCC with beautiful biphasic morphology- also shows that biphasic pattern is not unique to TFEB RCC #kidneycancer #Genomics #gupath @UMichPath #pathology #pathresidents #MedTwitter

@patholojenMD Ouu that’s awesome! Congrats!

Excited to see that our paper was selected as the Editor’s Choice for the current issue in the Journal of Clinical Pathology!

Trouble learning NGS? Try out my new NGS teaching site with interactive cases you can work through (almost) like a real tertiary analysis platform- drdoubleb.com/molecular/ @ABadeti

HER2-positive invasive breast carcinoma (NST). HER2 gene-protein assay: brightfield tricolor assay (combined ICH+ISH) for the visualization of HER2 protein (brown), the HER2 gene (black), and chromosome 17 centromere (CEN17) (red).

E-cadherin is lost in this intraductal proliferation from a BI-RADS 4A biopsy. If I call classic LCIS, the patient goes home with no treatment. If I call DCIS, she heads toward lumpectomy/mastectomy ± radiation. High stakes, subtle clues—what’s the right call? #breastpath

Breast-CAP criteria for Lymphatic and/or Vascular invasion 1. LVI must be diagnosed outside the border of the invasive carcinoma - most common area to find it is within 1 mm of the edge of carcinoma (pic 1) 2. Tumor emboli usually do not conform exactly to the contours of the space in which they are found - tumor emboli usually have a smooth outline (pic 2) 3. Endothelial cell nuclei should be seen in the cells lining the space It is the same criteria published by Rosen in 1983 PMID: 6674861 Dr. Brogi- 2025 Contemporary Issues in Breast Pathology #USCAP #pathology #PathX

Doudenal gastric heterotopia (oxyntic mucosa) is just plain cute. Sometimes neoplasms characteristically detected in the stomach can arise within it.

#GUpath nephrectomy chromophobe RCC 🔬features of so-called "pigmented microcytic" pattern chromoRCC and/or "eosinophilic" pattern chromoRCC

#yourdailyGleasongrading Would you grade this prostate cancer as Gleason grad 3 or you prefer Gleason grad 4? #Gupath #pathology #PathTwitter

Endoscopic biopsy of stomach mass in elderly adult. Favoured diagnosis? #GIpath #pathX #pathtwitter #pathology

Did you know there are 5 molecular alterations that have targeted therapy FDA approved in all solid tumors? 1Tumor mutation burden high (TMB-high) 2Microsatellite instability (MSI-high) 3NTRK1, 2 or 3 fusions 4BRAF p.V600E  5RET fusions #AMPTutorials (1/2)