🩺 increased testicular pain and swelling, evaluation for torsion; 3.9 cm mass on ultrasound 🧪 AFP 3.8, HCG 2.5
🩺 increased testicular pain and swelling, evaluation for torsion; 3.9 cm mass on ultrasound 🧪 AFP 3.8, HCG 2.5
🔬 Diverse patterns: myxoid, fascicular, hyalinized
🎨 ALK IHC (diffuse cytoplasmic) in 40-60%
🧬 50-60% ALK fusions (EML4, TPM3/4, CARS, RANBP2, IGFBP5…)
🔬 Diverse patterns: myxoid, fascicular, hyalinized
🎨 ALK IHC (diffuse cytoplasmic) in 40-60%
🧬 50-60% ALK fusions (EML4, TPM3/4, CARS, RANBP2, IGFBP5…)
#gupath #dermpath #pathsky #pathoutpic
🔬intradermal nodules varying in size and number, foreign body giant cell reaction in surrounding tissue
📊 differentials include calcification of epidermal or pilar cyst
🤔 idiopathic or dystrophic
#gupath #dermpath #pathsky #pathoutpic
🔬intradermal nodules varying in size and number, foreign body giant cell reaction in surrounding tissue
📊 differentials include calcification of epidermal or pilar cyst
🤔 idiopathic or dystrophic
🎨 collodial iron special stain 🔵💥
🎨 collodial iron special stain 🔵💥
🔬discohesive single tumor cells, eccentrically placed nuclei, eosinophilic cytoplasm
💥high grade, poor prognosis
🙅🏻♀️do not use CD138 in isolation to distinguish from plasma cells
🔬discohesive single tumor cells, eccentrically placed nuclei, eosinophilic cytoplasm
💥high grade, poor prognosis
🙅🏻♀️do not use CD138 in isolation to distinguish from plasma cells
⚠️ sarcomatoid component may overrun the epithelial component, extensive sampling may be needed to identify recognizable carcinoma
⚠️ sarcomatoid component may overrun the epithelial component, extensive sampling may be needed to identify recognizable carcinoma
☝🏼distinguish from retraction artifact
✅ multiple small nests floating within single lacunae
✅ back-to-back lacunae
✅ presence of ring formations
☝🏼distinguish from retraction artifact
✅ multiple small nests floating within single lacunae
✅ back-to-back lacunae
✅ presence of ring formations
#gupath #pathsky #pathoutpic
🩸 young pts with sickle cell trait
🔬 cribriform, reticular, nested growth
🎨 PAX8, broad spectrum CKs, CEA, p53
⚠️ OCT3/4 ➕ (50%), pitfall with GCT
🔑 SMARCB1 / INI1 inactivation
#gupath #pathsky #pathoutpic
🩸 young pts with sickle cell trait
🔬 cribriform, reticular, nested growth
🎨 PAX8, broad spectrum CKs, CEA, p53
⚠️ OCT3/4 ➕ (50%), pitfall with GCT
🔑 SMARCB1 / INI1 inactivation
#gupath #pathsky #pathoutpic
🔬 small tumor cell clusters without fibrovascular cores, floating in lacunar spaces
⚠️ may resemble vascular invasion
#gupath #pathsky #pathoutpic
🔬 small tumor cell clusters without fibrovascular cores, floating in lacunar spaces
⚠️ may resemble vascular invasion
🕵🏻♀️ usually asymptomatic, incidentally found, clinically indolent
🔬 thin papillary/tubulopapillary growth, apically located, low grade nuclei
🎨 CK7, GATA3, L1CAM
🧬 KRAS mutation
🕵🏻♀️ usually asymptomatic, incidentally found, clinically indolent
🔬 thin papillary/tubulopapillary growth, apically located, low grade nuclei
🎨 CK7, GATA3, L1CAM
🧬 KRAS mutation
🏥 prior urothelial injury (surgery, calculi, trauma)
sites: bladder > urethra > ureter
🔬 metaplastic lesion, multiple morphological patterns
🎨 PAX8, AMACR, GATA3 (40%), PSA (weak) (+)
⚠️ exclude prostate & bladder ca
🏥 prior urothelial injury (surgery, calculi, trauma)
sites: bladder > urethra > ureter
🔬 metaplastic lesion, multiple morphological patterns
🎨 PAX8, AMACR, GATA3 (40%), PSA (weak) (+)
⚠️ exclude prostate & bladder ca
☝🏼 identifiable urothelial component (may only be carcinoma in situ)
✌🏼 recommended to report percentage of squamous component
☝🏼 identifiable urothelial component (may only be carcinoma in situ)
✌🏼 recommended to report percentage of squamous component
🔬 moderately cellular with loose, myxoid stroma
✨focal areas of diffuse anaplasia, atypical mitotic figures
🎨 MyoD1, myogenin, desmin
🧬 FOXO1 gene rearrangement negative
🔬 moderately cellular with loose, myxoid stroma
✨focal areas of diffuse anaplasia, atypical mitotic figures
🎨 MyoD1, myogenin, desmin
🧬 FOXO1 gene rearrangement negative
🔬reticular, cribriform, and cord-like patterns; intratumoral inflammatory infiltrate (sometimes abscess forming); fibrotic stroma with myxoid areas
✨ metastasis common to lung, liver, LN, adrenal gland, RP, etc #gupath #pathsky #pathoutpic
🔬reticular, cribriform, and cord-like patterns; intratumoral inflammatory infiltrate (sometimes abscess forming); fibrotic stroma with myxoid areas
✨ metastasis common to lung, liver, LN, adrenal gland, RP, etc #gupath #pathsky #pathoutpic
🔬 large eccentric nuclei with prominent nucleoli, abundant eosinophilic cytoplasm, globular eosinophilic intracytoplasmic inclusions
🔬 large eccentric nuclei with prominent nucleoli, abundant eosinophilic cytoplasm, globular eosinophilic intracytoplasmic inclusions
🎨 IHC profile similar to conventional urothelial carcinoma (GATA3, p63)
⚠️ distinguish from metastatic CCRCC and clear cell adenocarcinoma
🎨 IHC profile similar to conventional urothelial carcinoma (GATA3, p63)
⚠️ distinguish from metastatic CCRCC and clear cell adenocarcinoma
✅ solid sheet-like architecture
✅ plant-like cell borders (vegetable cells)
✅ irregular, wrinkled nuclei (raisinoid)
✅ binucleation and perinuclear halos
🎨 CK7, CD117, Hale colloidal iron
✅ solid sheet-like architecture
✅ plant-like cell borders (vegetable cells)
✅ irregular, wrinkled nuclei (raisinoid)
✅ binucleation and perinuclear halos
🎨 CK7, CD117, Hale colloidal iron
🔬 solid and cystic architecture, basophilic intracytoplasmic stippling, and eosinophilic inclusions
🎨 PAX8+, frequently CK20+, usually CK7-/CD117-, majority Cathepsin K+
🔬 solid and cystic architecture, basophilic intracytoplasmic stippling, and eosinophilic inclusions
🎨 PAX8+, frequently CK20+, usually CK7-/CD117-, majority Cathepsin K+
🔬 small cuboidal cells arranged in a single layer around papillary cores containing nests of foamy macrophages
🧬 chr 7 and 17 gains, loss of Y; MET gene mutations (PMID: 26536169, 10433944)
🔬 small cuboidal cells arranged in a single layer around papillary cores containing nests of foamy macrophages
🧬 chr 7 and 17 gains, loss of Y; MET gene mutations (PMID: 26536169, 10433944)
🧐 special attention during frozen section, frequent positive surgical margins along the ureters and periureteral soft tissue that may appear grossly negative 😰🤯
🧐 special attention during frozen section, frequent positive surgical margins along the ureters and periureteral soft tissue that may appear grossly negative 😰🤯
☝🏼assoc with keratinizing squamous metaplasia / dysplasia of the mucosa
✌🏼exclude urothelial ca with squamous diff, spread from primary (cervix, penis, anus) or metastasis
☝🏼assoc with keratinizing squamous metaplasia / dysplasia of the mucosa
✌🏼exclude urothelial ca with squamous diff, spread from primary (cervix, penis, anus) or metastasis