Papillary carcinoma of the thyroid, so called ‘Warthin-like’ variant due to superficial similarity to Warthin tumour of salivary glands. No prognostic implications but pretty to see. Typically it has florid inflammation in normal thyroid as did this case. Happy weekend!
Blocks. Blocks. Blocks: 7 slides of pure seminoma and this 2mm focus of embryonal carcinoma changes prognosis, treatment and follow-up. Good example of the differences and what to see at low power.
Let us finish the week with a beauty and a real rarity. A papillary cystadenoma of the rete testis. Somehow I feel I might persuade others, a WSI can make its way into the WHO 2021 testis blue book which I have the privilege of editing with
@ro36693000
and Dr Satish Tickoo.
A very well nested paraganglioma with a convincingly negative SDH-B and a far to high Ki-67. Wish someone had told me how important the Kreb’s cycle would be to my job 35 years ago!
The best, nicest and hardest working pathologist at
@NHSBartsHealth
who I have been a friend and colleague for 30 yrs as SHOs at
@RoyalLondonHosp
got Covid today. Mike Sheaff we are all with you mate. You will be back to your 6:45AM starts in no time!! Lung and renal need you! Xx
Devastated that Prof Naveena Singh, after over a yr of illness, has passed away. She was my colleague and friend for over 25 years. She achieved so much: a huge loss for
#gynaepath
. Condolences to her devoted husband Stuart and family. We are bereft. Rest in peace my darling. 💔
Delighted my friend/colleague Naveena Singh has been awarded an hon Professorship with
@QMULBartsTheLon
. She has done pioneering work on ovarian ca, inc this review from 2017 in
@Histo_Journal
. She will be editing the ARI 2020 with Prof Blake Gilks.
Last night I had the honour of being awarded the Cunningham medal by the
@BritishDivIAP
for services to the BDIAP after a lovely meal at the RAC club. Great evening and feel very lucky! If a little hung-over….
For those of you trainees who had an abstract rejected from
@TheUSCAP
…well so did I. Having also been an USCAP abstract reviewer and journal editor: it’s a tough job and not easy. Please don’t blame the system: rework, find another forum. Move on: I will!
Welcome to the all new home working pathology lab. Many many thanks to the management and IT in
@NHSBartsHealth
for getting me on line, able to videoconference and a lovely microscope so smoothly.
Berney’s 12 rules of endocrine pathology. (Some controversial!!)
1. The endocrinologist can help you. Often.
2. So can the surgeon! Sometimes.
3. Nothing beats a good macro and blocking.
4. Nuclear clearing is not specific for pap ca. Ignore the books. 1/
Invasive urothelial ca of renal pelvis with a big twist! This is in an immune suppressed man with a renal transplant. This is a BK virus driven tumour and as in this case is micropapillary ( often the case) . Strong SV40 (polygoma large T cell ag) positivity!
Regarding time pressures; I recently refused my clinical colleague’s and MDT coordinators time lines which involved reporting huge numbers of prostate biopsies on a Monday night before the 8am Tuesday meeting. It invited Path error. Safety first for a non urgent Dx!!
Today I made a mistake. A diagnostic inaccuracy. The culprit: me. The cause: excessive pressure from the oncologist. I'd like to think it won't happen again, but... Let the pathologists do their job and not demand answers in a hurry.
#PatientSafety
#Pathology
Finally!! After working here since 1991, Whitechapel station has a proper makeover and patients of
@RoyalLondonHosp
can have step free access to the hospital!
RIP Steve Jones. Steve was lab manager at
@NHSBartsHealth
for over 40 years was married to our wonderful head of service, Dr Abi Lee and has two gorgeous boys. Abi is not on Twitter but the whole of pathology at
@RoyalLondonHosp
send massive condolences to Abi and family.
A very exciting package arrived today! Thank you to
@SunnyKaoMD
for the heavy lifting on our small contribution and congratulations to
@JLHornick
,
@CaboFishDoc
and Drs Victor Reuter and Teri Longacre on a fantastic achievement.
1/17 Tweetorial on path risk factors in GCT treatment. They are among the most curable malignancies, even after metastasis. But when is orchidectomy ✂️enough when no mets? 🧐 Adjuvant chemo has serous side effects❤️🩹,🫁 and 2ary malignancy. Best avoided especially BEP for NSGCT.
Seminoma with florid pagetoid invasion of the rete. This can be mistaken for true stromal rete invasion but pagetoid invasion had no adverse prognostic implications.
#GUpath
Ondra Hes was an amazing pathologist who became a firm friend. Here we are in China where I will now treasure a fantastic time we had together. World expert GU pathologist and and original thinker, I am devastated. Ondra RIP, with condolences to all family and friends.
Florid Intratubular embryonal carcinoma in a nice wedge shape. The invasive tumour is just present on the right. Note necrosis and expansion of the tubules. All of the fun of intraductal prostate carcinoma but none of the politics….
Very proud of the ranking of Histopathology: second highest and above Am J Surg Path! But I will always choose practical histo pathology papers over IF chasing to make us a ‘go to’ journal for all Histopathologists!
Delighted to share our new Impact Factor of 6.4: maintaining our current ranking. We will continue to prioritise practical and helpful articles for Histopathologists and work hard to make submission and revision as easy as possible!
Darling urologists, I love and respect you all* but please take your foot of the 🤬 diathermy pedal for a second! I don’t want the pt to bleed to death either, but you might as well just have chucked this one on a BBQ! *(possibly)
It’s
#ComingOutDay
 A long time ago, my mother’s reaction was priceless. ‘Well darling, I realised when you bought that purple jacket’. Blessed to work in a supportive environment
@NHSBartsHealth
@BartsLGBT_Group
, as unthinkable,when I trained, as my current family life. 👨👨👦🐶🏳️🌈
A
#pathologistsforpuppies
stream is the obviously the best way to gain followers. Please note the sneak preview of the cover of
@Histo_Journal
in November so I can pretend this is a serious post.
The joy of pathology is seeing something you have never seen before after 25 years shifting glass: here is a Medullary carcinoma invading a normal parathyroid.
Bonkers numbers of prostates today. And when I saw this I began to wonder what was ‘through the Arched Window’. Only more mature U.K. residents may get this. Who remembers Playschool?
All subspecialists in Pathology must be generalists. This bladder biopsy with no clinical arrived one damp dark weds. I was going to call severe inflammation...but no: Myeloid sarcoma!
#pathology
#gupath
Feeling very sad today on what would have been Naveena Singh’s 59th birthday. For 25 years on this day I used to remind her I was 2 years younger than her, for one day! ( it’s my 58th tomorrow). We miss her every day but especially today.
Here is our new puppy who arrived yesterday. I may have found something even prettier than a mixed germ cell tumour of the testis. You decide..
#fluffypuppies
Gonadoblastoma is fascinating, somewhat mysterious and misunderstood. Great article in
@Histo_Journal
by Liang Chang explains the complexities, and here is one I photographed myself.
NOT AGAIN! Rectal Bx and NKX3.1. Working in East London and prostate cancer can present disastrously late. We need to do more especially in high risk groups.
Testis replaced by a post pubertal Teratoma with mostly “embryonic neuroectodermal elements, amounting to somatic transformation. Rare, challenging…and a paper in the offing!
@MuraliV72899596
@MichelleDunno17
This is Prostate cancer with Paneth cell like neuroendocrine differentiation. 🔵 Not related to Paneth cells🔵Positive with NE markers. 🔵probable adverse effect on prognosis. 🔵Association with Aurora Kinase A amplifications makes a possible drug target!
Dear ST1 pathology trainees, good luck! Your first year in Histopathology can be challenging and confusing: you often feel like a spare part and this can be frustrating. My advice? Listen, be patient, learn, be enthusiastic, love your microscope and a wonderful career awaits. 🥰
'Expect the unexpected' or 'Why being a specialist means you still have to be a generalist'. Bone biopsy showing metastatic seminoma! Great spot from another centre: H&E and OCT4.
En route to Basel and
#ECP2022
by train! Greta would approve. Sorry to miss ISUP bladder today but new Dan rule is family first. Looking forward to see old friends and making new.
Bladder mass in 60 yr old female. No clinical info given ( he said, weeping on his pile of template biopsies). Is it possible they could have thought to mention the previous ( but recent) Clear cell Carcinoma of the Ovary?
I'm a Pathology consultant and am triple jabbed because I want to minimise my risk of hospitalisation for COVID-19. My husband, family and friends are also triple jabbed. My son will be vaccinated as soon as vaccines are available for his age group.
#VaccinesWork
Just another case of chronic cystitis? Wait! Those plasma cells look a bit unusual. Metastatic lobular breast carcinoma is scary! The history was on the form thankfully but Dr Beltran was sneaky when he showed it to me!
Delighted to announce a significant rise in our Impact Factor to 3.626, our higher in over 5 years. With grateful thanks to the editorial team for all theor work, authors and reviewers.
Testis number 6🥵and most dramatically, embryonal carcinoma with trophoblast, with soft tissue deposits in the cord. Welcome all to my slightly skewed germ cell world!
5/5 So how much does all this cost in the U.K? NOTHING. No bills, no insurance and no worry. So grateful for the
#NHS
@QAHospitalNews
QA Portsmouth for superb treatment. Love our NHS.
Just heard my wonderful and fit 91 yr old mum who still lives alone is going to get the Pfizer vaccine tomorrow. Could not be happier or more relieved.