T.JeffLimMD

I aim to locate a case of BPDCN locally... Although I don't have CD123 available anywhere.

I don't really see these cases as often as I should. Can't help feel excited 😆 #heme #Hematology #hematopathology

@drstaphaureleus Yes!

@TjLimMD ALCL?

@MeredithKHerman @leon_metlay @UMichPath I can only agree on the 80 to 100 mark... 😁 Tough way to make an assessment.

How do you determine bone marrow cellularity?…it’s a vibe, or is it? Made this diagram today to help my PGY1 brain solidify the “vibes” of hemepath #hemepath #PathTwitter #pathx #pathstudytips @UMichPath

@zhang_xuchen @kitagawa_yukiko @Teclis82 Is it possible to have normal or reactive proliferation of mast cells like that?

@kitagawa_yukiko @Teclis82 Did not do it.

Cecal polyp

Chew your bones very well next time before you swallow. Got this from a sigmoid colon obstruction... Absolutely sharp point. Stabbed me in the finger.. Too bad, it was a few inches shy of exiting the rectum.

@DrMarkOng Would gray zone lymphoma also fit?

Difficult case. Too much B-cell programme retained to call it cHL. Also the other markers mostly favoured NLPL. Posting this before I accidentally delete the drafts...

I'm working on a teaching presentation on Hodgkin's lymphoma. Picture below contains HRS-like cells from 9 different cases. Which ones are classical Hodgkin's lymphoma and which ones are something else? #hemepath #pathtwitter #pathology

@DrMarkOng EBV+ mucocutaneous ulcer..

Incisional biopsy from oral cavity in an adult. H&E diagnosis? #pathology #pathX #pathtwitter

Soft tissue Rosai-Dorfman disease. The S100 protein stain is wonderful - it stains nuclei (white arrow) and cytoplasm in the abnormal histiocytes but not the lymphocytes that they have engulfed but not destroyed (emperipolesis). Vintage article: 1733347.

Workup of high-grade B-cell lymphoma/diffuse large B-cell lymphoma - Establish cell of origin: Hans algorithm - Assess for double-expressor lymphoma (DEL): MYC and BCL2 IHC - Assess for double-hit lymphoma (DHL): FISH for MYC, BCL2, and BCL6 Dr. Sohani - 46th Annual Current Concepts in Surgical Pathology

Quandary over atypia. How can you really tell? My tolerance has always been high but I've known someone who cries atypia at the slightest hint of uncomfy clearing. What's your criteria? #gynepath

When Hodgkins like this cone across your table. Just incredible. #hodgkin #lymphoma

If you diagnose a nodal T-cell lymphoma with these features: -Morphology is blastoid -No monotypic pattern of TRBC1 by flow cytometry analysis -No TCR gene rearrangement by PCR Add a marker of cell immaturity like TDT, CD34, CD117 etc, even if the clinical features are not screaming T-ALL, not to miss a myeloid/lymphoid neoplasm with eosinophilia and tyrosine kinase gene fusions. This group of diseases is rare and driven by rearrangements of PDGFRA, PDGFRB, FGFR1, JAK2, FLT3, and ETV6::ABL1 fusion. Although eosinophilia seems to be always present, some cases may lack it, which can create a great diagnostic pitfall. The clinicopathological features of this group of diseases are quite heterogeneous, presenting as chronic eosinophilic leukemia NOS, MDS/MPN, MDS, MPN, systemic mastocytosis, T-ALL, B-ALL, AML, blastic phase of MPN, or MPAL. Extramedullary involvement at diagnosis or during progression is common. Below pictures of a case of myeloid/lymphoid neoplasm with ETV6::FLT3 fusion with nodal involvement at presentation and no associated eosinophilia, are from ➡️pubmed.ncbi.nlm.nih.gov/37985498/ #Hemepath #PathX #Pathtwitter #Leusm #lymsm

📊 Staging Cancer in Colonic Polyps 🔬 1️⃣ Polyp type: Stalked vs Sessile 🧐 2️⃣ Classification: Haggitt 🏷️ | Kikuchi 📏 Master staging & predict invasion risk like a pro! 🩺✨ #ColorectalPathology #Histopathology #FRCPathPrep #PolypCancer #ExamPrep #PathologyMastery

(5/5) Features of plasmablastic lymphoma and differential diagnosis of lymphomas with plasmacytic features #hemepath #hemepathmda #virtualpath #virtualhemepathmda

Another of #hemepath 🩸 🔬marathon in the books, on the new #Leukemia service. Here’s a select handful of interesting cases I saw today… 🧵 1. Acute erythroid leukemia, TP53 mutated. Note the elongated “carrot – like” nucleoli, often membrane-bound (arrow) on H&E, the large blast with raw nuclei and deeply basophilic cytoplasm with vacuoles on the smear, and the P 53 IHC showing strong nuclear over expression (mutant pattern). By flow, the blast were CD117 +, CD123 - and CD36 bright + with partial CD 34 expression.

@sanamloghavi @ZhuoerXie @Stanford Definitely a big thanks to my mentors at Toronto General Hospital, Drs Jiong Yan , Delabie, Xia, Chang, Reis, Sakhdari, Tierens, they took a chance on an overseas fellow at the height of COVID19 epidemic.

Amazing @ZhuoerXie ♥️ Most of us are here today because someone was kind and generous enough to take a chance on us. For me it was Eugene Butcher at @Stanford … 😍 I remember sending this email like it was yesterday… (2007) I sent 100+ emails and he was the only person that answered

@sza_jhcyto @whosainastro Heard it, seen it, read it.. but not sure what it can do that I can't fix by moving the stage , focusing and raising and lowering the condenser by trial and error..

Nearly 9 of 10 Pathology trainees in my experience have no idea of “Köhler illumination”, an important step in optimizing microscopy by evenly illuminating the field of view. The procedure, which revolutionized microscopy design and use was invented by the German scientist, “August Karl Johann Valentin Köhler” (1866 – 1948).