Fatima Shamsuddin

@Javerianajam810 Have put up a poll. Kindly answer.

👉 42YO female - pap smear. #PapSmear #Pathology #PathTwitter #MedTwitter #FOAMed #MedEd #Cytology #Screening #HPV

Diagnosis?

@BrownPathology Nice case and explanations.

For more information on PAMRAGs, here is the seminal paper by Pritt et al: pmc.ncbi.nlm.nih.gov/articles/PMC18… Actinomyces image source: PMID 25896158

#Gynpath #surgpath #pathresidents A 37 female was found to have a cervical polyp during IUD removal. The polyp was excised. Poll in reply.

Answer

👉 68 YO postmenopausal woman presents with a persistent erythematous plaque on the right labia majora. ⁉️ What is the most likely diagnosis? #Pathology #Dermatopathology #GynPath #PathTwitter #MedTwitter #HistoPath #PathPearls

💎 Extramammary Paget Disease (EMPD)   •Rare intraepithelial adenocarcinoma of apocrine gland–bearing skin, most commonly involving the vulva, perianal region, scrotum, and axilla. •It typically affects elderly patients and clinically presents as a persistent erythematous, pruritic eczematous plaque, often leading to delayed diagnosis. 🔬 Histology   The hallmark is pagetoid spread of malignant glandular cells within the epidermis.   Key features: - see histology pictures   Typical immunoprofile: Primary EMPD: CK7⁺ / EMA⁺ / CEA⁺ / GCDFP-15⁺ / CK20⁻ Secondary EMPD: CK7⁺ / EMA⁺ / CEA⁺ / CK20⁺ / GCDFP-15⁻ (suggests epidermotropic spread from colorectal or urothelial carcinoma)   🔎 Prognosis & Treatment   •Most cases are intraepidermal with relatively good prognosis, though local recurrence is common. Prognosis worsens if dermal invasion or associated malignancy is present.   •Treatment usually involves: - Wide local excision or Mohs surgery - Selected cases may receive topical therapy, radiotherapy, or HER2-targeted therapy.   ⚓️ Differential Diagnosis (Pagetoid Epidermal Lesions)   Melanoma in situ • Pagetoid melanocytes with atypia and pigment • S100, SOX10, HMB45 positive and CK7 negative   Pagetoid Bowen disease (SCC in situ) • Atypical keratinocytes with epidermal dysplasia • p63/p40 and HMWCK positive and CK7 negative   Langerhans cell histiocytosis • Cells with grooved nuclei and eosinophilic infiltrate • CD1a, langerin, S100 positive and Epithelial markers negative   #Dermpath #ExtramammaryPaget #Pathology #GynePath #Histopathology #PathTwitter #TeachingCase

Diagnosis?

Diagnosis: Ectopic thymus with associated ectopic parathyroid tissue. A classic example of third pharyngeal pouch derivatives migrating together — a key embryologic concept reflected in surgical pathology.

💎 Ectopic Thymus with an Interesting Companion – A Pediatric Neck Mass ! 2-year-old boy with right-sided neck swelling.   Histology shows beautifully lobulated thymic tissue with cortex–medulla differentiation and Hassall corpuscles.   But what is this small adjacent nest of uniform cells highlighted on IHC? 👀   🔎 Clue: Think embryologic migration.   #Pathology #PediatricPathology #HeadAndNeckPathology #Embryology #PathTwitter #MedTwitter

@_Wondweson64 Thank you 💐

@FatimaShamsPath Lovely images!!

@DrGeeONE @_Wondweson64 @DanGrahamMD @RFutoran @Immanuel_Paul30 @DrDanok @teddy_wub @MirunaPopescu13 Agree with these. These will be up in my differentials too. Other lesions with somewhat similar morphology - dermatofibroma, neurothekeoma and other neural tumors, LGFMS - less likely

@_Wondweson64 @DanGrahamMD @RFutoran @Immanuel_Paul30 @DrDanok @teddy_wub @MirunaPopescu13 @FatimaShamsPath Differentials: Plexiform fibrohistiocytic tumour Giant cell tumour of soft tissue Nodular fasciitis

A 22 Yr 👱‍♀️ 📑Recurrent scalp soft tissue mass, 2x2cm! 💡What do you think X-fam? 👇More in the comments #pathx #pathtweeter #softtissue

Answer provided here

👉 26 YO female. Site of lesion - Left tonsil Diagnosis? #PathTwitter #TonsilPathology #HeadAndNeckPathology #Histopathology #SurgicalPathology

💎 Tonsillar lymphangiomatous polyp   Case history: 26 YO female presented with a left tonsillar polyp.   🔬 Histology Highlights •Polypoid lesion lined by stratified squamous epithelium •Subepithelial proliferation of numerous dilated lymphatic channels containing proteinaceous fluid •Prominent lymphoid aggregates with germinal centers •No cytologic atypia or infiltrative growth   IHC: D2-40 highlights lymphatic endothelial lining → confirms lymphatic nature    🎓 Key Teaching Points   •Rare benign hamartomatous lesion •Can clinically mimic papilloma or neoplasm •Composed of: ◦Dilated lymphatic channels ◦Fibrous stroma ◦Lymphoid tissue •Complete excision is curative •No malignant potential #Pathology #ENTpathology #HeadAndNeckPathology #Lymphangiomatouspolyp #Histopathology #PathTwitter

Presented our poster “Clinicopathologic Spectrum of Syphilis – A Diagnosis Not to Be Missed” at the 30th HSC Scientific Conference (11 Feb). A reminder that syphilis remains a true master mimicker — clinicopathologic correlation is key. Courtesy @annsmiley78 #Pathology #Syphilis #HSCConference #MedicalResearch #Kuwait

Answer provided here

👉 64 YO male presents with a slowly growing soft tissue swelling over the right arm. Excisional biopsy shows the following histomorphology. What is your diagnosis? #Pathology #Dermatopathology #Histopathology #PathTwitter #PathologyCase

@Markie27070028 Since clear cells are prominent here, it would be a clear cell hidradenoma.

@FatimaShamsPath Poroid hidradenoma?