Melissa Pulitzer, MD

Preview of the upcoming 5th edition of the World Health Organization Classification of Hematologic Cancers (WHO Blue Book) is now published in @LeukemiaJnl as two papers. Check it out. #MedTwitter 1/ Lymphoid/Plasma cell neoplasms Open Access link: nature.com/articles/s4137…

Counting Down to #ASDP20! Consults and Seminars are filling up! Register for the full meeting, then find your spots in these optional afternoon programs that focus on specific areas of dermatopathology. asdp.org/annual-meeting…

@david_terrano @JamesSampson123 @ProfRScolyerMIA you can generally tell, if there are very few mutations, that it will be an MCV+ tumor, and if there is a high TMB/# mutation calls it will often be MCV negative, but there are exceptions, and MCV IHC is probably the best way to truly know

@MPulitzerMD @JamesSampson123 @ProfRScolyerMIA And can we make that distinction by the mutational profile?

@JamesSampson123 @david_terrano @ProfRScolyerMIA Yes, that is the current understanding

@david_terrano @JamesSampson123 @ProfRScolyerMIA Most (not all) MCC even when MCV+ arise on UV damaged skin and thus we can often (not always) find evidence of UV signature despite a “quiet” mutational profile in MCV + tumors. the distinction Dr Scolyer is making is between MCV and UV as the overall driver of carcinogenesis.

@JamesSampson123 @ProfRScolyerMIA Meaning in most cases it’s UV related, I suspect. There may be a local immunosuppressive effect of UV combined with MCPV that leads to the tumor. Perhaps @MPulitzerMD can also add some insight.