Ana-Maria Catana

Oxyntic gland adenomas are benign. They can progress and invade the submucosa, at which point they are classified as gastric adenoma of fundic gland type. Endoscopic resection is sufficient treatment, since gastric adenoma of fundic gland type behaves as a low-grade lesion.

40 year old with a skin mass above sternum, R/O lipoma. Herniated lung??? probably not :)

@fouad_boulos Lactating adenoma :o

New thread: is it consistent with sarcoidosis? 1/ Yes!

Asteroid body in a foreign body mutinucleated giant cell. This is an axillary LB biopsy from a patient w/ breast implant #pathresidents #pathX

An example of crystal storing histiocytosis; the patient needs to be evaluated for a plasma cell disorder or other lambda-restricted B cell neoplasm. Arnold CA, et al. Am J Surg Pathol. 2018 Oct;42(10):1317-1324. PMID: 29878935.

Appendix

“Appendiceal mucinous neoplasm" is being introduced in the WHO 6th ed (beta version) to define a "circumferential proliferation of neoplastic mucinous epithelial cells confined to the mucosa, with an intact muscularis mucosae, originating in the appendix." Wouldn't exclude SSL w/ dysplasia, but again, it doesn't really matter (and MLH1 loss wouldn't help in the appendix like it does in the rest of the colon).

@MateenH79781868 @pepeheffernan @malakbehnas @FionaMacPath @AnupamaArya12 @DrGeeONE I’d call it appendiceal mucinous adenoma, on these images. Of course, mucinous lesions should be entirely submitted, and if there’s even focal architectural disturbance,I’d call it LAMN. Appendectomy is curative either way. What matters here is the absence of peritoneal disease.

If you submitted all the appendix and you don't see epithelium, just mucin in the lumen, sign it as: -Dilated appendix with mucin Comment: The differential includes LAMN or reactive processes Dr. Umetsu #CAP23 #everydayGI #GIpath #PathX #PathTwitter #pathology #pathologists

Appendix Postinflammatory mucosal hyperplasia -Associated with acute/interval appendicitis -Epithelium looks hyperplastic/serrated near surface -This is not LAMN ⚠️ #surgpath #pathology #PathTwitter #GIpath CAP today digital.olivesoftware.com/olive/odn/capt… Thanks for sharing @Voltaggiol 🌟

Challenges of staging appendiceal mucinous neoplasms Mucin outside the appendix in a LAMN case, is it pT4 or not? -Acellular mucin without inflammatory reaction, mesothelial hyperplasia, or neovascularization is presumed to be a result of carryover during handling or gross examination, and should not be designated as pT4a (Pic A) - Organizing acellular mucin with neovascularization on the serosal surface is categorized as pT4a (Pic B) Umetsu et al doi.org/10.1016/j.hump…

When large nests of tumor surround a completely normal duct, they are much more likely to be invasive cancer or lymphovascular invasion than DCIS. A useful pattern to remember on a biopsy #breastpath

#GUpath prostate bx: Gleason score 3+4, with pattern 4 comprised of glomerulation and poorly formed glands

Pagetoid Spread of ALH ⛏️👷‍♂️🔬 Dyshesive atypical lobular cells undermining and spreading along the undersurface of the ductal epithelium in a pagetoid pattern—subtle and may mimic myoepthelial cell hyperplasia. #PathX #PathTwitter #breastpath

Pagetoid Spread of DCIS ⛏️👷‍♂️🔬 Atypical ductal epithelial cells undermining the ductal epithelium of large ducts in a pagetoid distribution. #PathX #PathTwitter #breastpath

This is a superficial breast lesion in a man. What is your differential? I am stumped. #breastpath #dermpath

Let’s review the lesion named for Sir James Paget and its mimics in the breast this week! ⛏️👷‍♂️ Paget Disease of Nipple 🔬 Atypical epithelial cells with infiltrating the epidermis, often associated with underlying DCIS or invasive carcinoma. #PathX #PathTwitter #breastpath

Esteemed #pathresidents, let's go through some particular aspects of this appendiceal neoplasm. ➡️ First, Dx? ➡️ How would you stage if confined to the M propria? ➡️ If it extended to subserosa? ➡️ Any gross findings important to report? (if +) ➡️ What makes it pM1b? #GIpath

50s M, testicular mass. Diagnosis? Gross photo in the chat. #PathTwitter #PathX @MGHPathology @MGBpathology