Humberto Trejo Bittar, MD, FCAP

Hope to see you there !

Today is Dr. Evita Henderson-Jackson’s final day as USF Pathology Residency Program Director after 9 years. She inspired countless residents and was named 2024–2025 USF Program Director of the Year. Thank you for your leadership and dedication—wishing you continued success!

This is the Hep-Par1

I recently reviewed the topic of "hepatoid lung adenocarcinomas" and came across this excellent recent article by @natasharekhtman. Interestingly, a few days later I think I found a case of solid and granular adenocarcinoma of the lung metastasizing to mediastinal lymph nodes. This case indeed has a STK11 mutation and has a very aggressive presentation. Hep_Par1 is diffusely positive, TTF-1 is negative and mucicarmine highlights intracellular mucin. The current case illustrates the increasingly recognized overlap between hepatoid adenocarcinoma of the lung and the recently described entity of pulmonary solid and granular adenocarcinoma expressing HepPar-1/CPS1. Historically, diffuse HepPar-1 expression and granular eosinophilic cytoplasm have been interpreted as evidence of hepatoid differentiation; however, emerging evidence suggests that such findings may instead reflect mitochondrial adaptation and metabolic reprogramming, particularly in STK11-altered pulmonary adenocarcinomas. As a result, tumors that would previously have been classified as hepatoid adenocarcinoma may represent a biologically distinct subset of primary lung adenocarcinomas. This distinction is particularly challenging in small biopsies and cytology specimens, where architectural features are limited and HepPar-1 expression may be overinterpreted as evidence of hepatocellular differentiation. The presence of intracellular mucin and the absence of more specific hepatocellular markers in the current case support consideration of this emerging category and underscore the importance of integrating morphology, immunohistochemistry, molecular findings, and clinical-radiologic correlation when rendering a final diagnosis. #lungpathology #thoracic #patholgy @USFpathology sciencedirect.com/science/articl…

Welcome to Quebec ! At the Pulmonary Pathology Society Biannual Meeting ! #pathology #pps2026 #lung #thoracicpath #lungpath

Pathology plays a central and indispensable role in helping @MoffittNews achieve its mission of advancing cancer care, research, and education. As a leading cancer institution, Moffitt’s goals focus on improving patient outcomes, developing innovative treatments, and expanding scientific knowledge—and pathology is foundational to each of these objectives. We are meeting today as a Department to discuss our responsibility to be an active part of achieving these goals.#pathology #moffitt #retreat

Congratulations to all of our #pathology fellows on their graduation! We are very proud of all of you. We can't wait to hear about all your accomplishments! #moffitt @MoffittNews @DrBuiPathology @rezaesh58 #path @USFpathology #graduation

History is being made right now, and I’m proud to be part of it. This is week 1 of Digital Pathology Go Live at my home institution Moffitt Cancer Center. @MoffittNews @ml4onco @MoffittGR @dpatweet @Pathologists @FLPathologists @CAPA_comm @USFpathology

I was quite proud to hear about the QA project of our graduating fellows! Congratulations on your imminent graduation! What an amazing accomplishment and feeling to finally be the one directing the show! You will do great! Thanks to the pathology faculty @MoffittNews for bringing lunch! #moffitt #pathology #moffittpath

@smlungpathguy @atman_ci @natasharekhtman @DrGeeONE @LizaMQuintana @Path_Matt @SansanoValero @raghupillappa @JMGardnerMD @kis_lorand Thanks to all the colorful circles ! Very subtle indeed !!!

O Brave and Wise Tweeples, how do you deal with such cases (lung biopsy)? Blood only? Alveolar hemorrhage? Rare atypical cells? Capillaritis? Clinicopathologic correlation? Cyto-histo correlation? Radiologic correlation?

I am very happy to share that I signed out my first case using WSI workflows @MoffittNews. Thanks to everyone involved in making this a reality! I look forward to the improvements in patient care that this technology will allow. #moffitt #moffittpathology @USFpathology @PatrickHwuMD @bmwenigmd @DrBuiPathology @rezaesh58

#ASCO26 #MoffittASCO26 Attending ASCO 2026 & contributing the pathologist’s perspective was an incredibly rewarding experience. @MoffittNews @ml4onco @FLPathologists @USFpathology @CAPA_comm @dpatweet @Aparwani_dpath @MerceJorda1 @MeredithKHerman @KMirza

CAMTA1 immunostain confirmed EHE !

Case of the week, of course just before leaving for USCAP: Elderly male with a large right hilar mass and a separate spiculated smaller right lower lobe mass. Any suggestions based on the histologic sections (of the right lower lobe mass)? Clue: this is not a carcinoma, and the classic description of the neoplastic cells rhymes with “twister.” Final diagnosis will be shared after USCAP. #lung #pulmonary #pathology #lungpath #pulmpath #moffitt #meded #pathtwitter #raretumor @USFpathology @DrBuiPathology @rezaesh58

Meet our 2026 FSP Summer Conference faculty!🌟 This expert group will cover GU, thoracic & placenta pathology for a weekend of valuable insights and cutting-edge research. View the agenda & register: flpath.org/summer2026 @DrCristinaMagi @smlungpathguy @mreyesm @drHTBlungpath

Do not miss ASC cytology crash course by these great cytopathologists Dr. Anna-Lee Clarke and Dr. @KatyRezaei from Moffitt Cancer Center. @MoffittNews

Do not miss this great opportunity for SurgPath courses in beautiful Hawaii. In addition to attending on-site, live-streaming and recorded options for this course are available for anyone who is unable to travel. LINK TO REGISTER: scientificsymposiums.com/11th-annual-dr…

It was a long day with many amazing poster and platform presentations and interesting courses. Our RTD (our research autopsy program) did terrific work presenting our experience at @MoffittNews, and I had the opportunity to give a quick review of HER2 biomarker testing in non-small cell lung carcinoma (a hot topic). Looking forward to tomorrow for even more learning and networking! A big part of the day was catching up with former colleagues, trainees, and mentors. #USCAP2026 #learning #pathology #path #networking

Great time showcasing our work comparing FNA vs FNB for serous cystadenomas during the Stowell-Orbinson session at #USCAP2026. Thankful for my great mentors (Dr. Centeno & Dr. Tabbara) from @MoffittNews & @USFpathology 🤩 bonus: characterizing tp53 mutations in MDS! #uscap26