- ¿Padece alguna enfermedad crónica? -No. -¿Toma algún medicamento? -Metformina, Lord-satan.

Uh oh! 😱 ✅ Adenomyoepithelioma This papillary lesion is composed of a biphasic proliferation of epithelial cells and nests of spindled myoepithelial cells, representing a papillary variant of adenomyoepithelioma. #PathX #PathTwitter #breastpath

"Common things are common"; until they aren't. 17 Y/M, C/O pain abdomen. Colonoscopy: Colonic submucosal lesion & central ulceration. Microscopy never ceases to surprise. Differentials ❓ (IHC will follow) #PathTwitter #GIPath #CaseChallenge #Oncopath #PathResidents

Invasive urothelial carcinoma with lipoid and micropapillary features — a frequent association worth recognizing. Lipid-filled cytoplasmic vacuoles alongside micropapillary clusters/retraction spaces make for a striking diagnostic image. #GUPath #UroPath

Half of cellular blue nevus are S100 negative but SOX10 positive Potential pitfall and also a clue when evaluating these lesions Dr. Folpe #USCAP2026 #pathology #PathX #PathTwitter

Medullary thyroid carcinoma pathology #pathology

Tumor emboli and LVI as seen with invasive breast carcinoma, NST. #pathology #breastpath #LVI

🔬 TESTICULAR GERM CELL TUMORS: KNOW YOUR TUMOR MARKERS Serum tumor markers are more than just numbers—they guide diagnosis, staging, prognosis, treatment response, and relapse detection in testicular germ cell tumors (GCTs). 📌 AFP ✔ Elevated in yolk sac tumors, embryonal carcinoma, and mixed GCTs ✔ NEVER elevated in pure seminoma 📌 β-hCG ✔ Highest in choriocarcinoma ✔ May be mildly elevated in seminoma ✔ Can cause gynecomastia and hyperthyroidism when markedly elevated 📌 LDH ✔ Reflects tumor burden ✔ Important prognostic marker in IGCCCG risk classification 🚨 High-Yield Pearl: Persistent elevation of tumor markers after orchiectomy suggests residual disease (Stage IS). 🧬 Future of GCT Biomarkers: miR-371a-3p is emerging as a highly sensitive and specific marker for active germ cell tumors and may transform surveillance strategies in the coming years. Early detection. Accurate staging. Better outcomes. #TesticularCancer #GermCellTumor #MedicalOncology #Oncology #UroOncology #Seminoma #NSGCT #AFP #BetaHCG #LDH #CancerEducation #MedEd #FOAMed #OncologyTeaching #MedicalStudents #Residents #DrRupamManna #CancerConceptsExplained

Everything about PDL1 #pathology #pathtweet

𝗦𝘂𝗴𝗴𝗲𝘀𝘁𝗲𝗱 𝗥𝗲𝘃𝗲𝗿𝘀𝗮𝗹 𝗦𝘁𝗿𝗮𝘁𝗲𝗴𝗶𝗲𝘀 𝗼𝗳 𝗢𝗿𝗮𝗹 𝗔𝗻𝘁𝗶𝗰𝗼𝗮𝗴𝘂𝗹𝗮𝗻𝘁 𝗨𝘀𝗲 𝗳𝗼𝗿 𝗠𝗮𝗷𝗼𝗿 𝗕𝗹𝗲𝗲𝗱𝗶𝗻𝗴 𝗮𝗻𝗱 𝗯𝗲𝗳𝗼𝗿𝗲 𝗘𝗺𝗲𝗿𝗴𝗲𝗻𝗰𝘆 𝗦𝘂𝗿𝗴𝗲𝗿𝘆. As shown in Panel A, reversal management depends on the urgency of surgery or the invasive procedure. Reversal management includes administration of oral or intravenous (IV) vitamin K with or without 4F-PCC, depending on the timing of the procedure (emergency or urgent), baseline international normalized ratio (INR) value, and presence (or absence) of active bleeding. For patients receiving direct oral anticoagulants (DOACs), the decision also depends on time to surgery. Decision making is informed by DOAC type, time since last dose, half-life, presence (or absence) of active bleeding, and renal function tests to estimate residual drug activity. Panel B shows reversal strategies for patients presenting with major bleeding while receiving an oral anticoagulant. The reversal strategy of vitamin K antagonists includes vitamin K given intravenously or orally, combined with 4F-PCC and INR testing. Management of anticoagulant reversal of direct oral FXaIs is based on four key factors (shown as the 4Ts): type of bleeding, timing of the last dose, thrombotic risk, and need for invasive procedures in the next 48 hours that would result in the administration of UFH. These factors may facilitate the use of specific (e.g., andexanet alfa) or nonspecific (e.g., 4F-PCC) antidotes. The reversal of dabigatran is informed by three clinical variables (shown as the 3Rs) — the type of bleeding, time of the last dose of dabigatran, and preserved renal function. Learn more in the Review Article “Antidotes for Anticoagulation Reversal” by Bianca Rocca, MD, PhD, and Hugo ten Cate, MD, PhD: nej.md/4xgOUdI NEJM subscribers: Explore this article deeper with AI Companion.

Frozen sections for sentinel lymph nodes after neoadjuvant chemotherapy (NACT) can be challenging In cN0 HER2 or TNBC patients post-NACT, positive SLNs are uncommon and frozen section sensitivity is modest Deferring SLN evaluation to final pathology is often reasonable, these findings support that approach ➡️ Frozen sections post-NACT are specific but not sensitive • Positive LN after NACT (pic 1) • Negative LN with biopsy/therapy-related changes (common pitfall: exuberant treatment effect can mimic carcinoma) Dr Gilmore #USCAP2026 #pathology #PathX #PathTwitter

Gleason grading #pathology #uropath #prostatepath #pathtweet

NCCN POTENTIAL ACTIONABLE THERAPEUTIC BIOMARKERES: PART 1 2 #NCCN #BIOMAKERS #Therapeutics #FDA #ASCO #IASLC #WHO #NEET #NEETSS #pathology #pathognosis

Immunohistochemistry 101 🔬 (c): Sumit Kumar

Seguro en su mente pensó: “no lo hice con mala intención”… pero el racismo no es un tema de intenciones, sino de los efectos negativos que tiene sobre las personas. #AltoAlRacismo ⚽️

When you eat Mexican food, your brain releases endorphins and dopamine. Capsaicin, the compound in chili peppers, binds to pain receptors in your mouth. Your brain reads this as a threat and counters with feel-good chemicals. The burn in a good salsa triggers the same pathway as a runner's high. This is all happening on top of a food tradition more than 3,000 years in the making. The tortilla in a chicharron taco exists because of nixtamalization, a process Mesoamerican cooks developed roughly 3,200 years ago. Corn kernels are soaked in lime water, which releases niacin, a B vitamin that corn otherwise locks away in an indigestible form. Without this step, corn-heavy diets cause pellagra, a B-vitamin deficiency that killed around 7,000 Americans per year at its peak in the early 20th century. Southern sharecroppers were eating corn without the process Mexico had preserved for three millennia. In 2010, the UN added Mexican cuisine to its Intangible Cultural Heritage list, the first year any national food culture had ever qualified. The application covered seed preservation, farming customs, ritual preparation, and thousands of years of cooking knowledge passed through communities. The diversity inside that designation is hard to picture. Mexico has 59 varieties of heirloom corn, more than 60 distinct chili pepper types, and 32 states with cuisines different enough that Oaxacan mole negro (a dark sauce from dried chili and chocolate) and Yucatecan cochinita pibil (slow-roasted pork in a smoky red spice paste) share almost no ingredients. Oaxaca alone has more than 20 types of mole. Mole poblano uses more than 20 ingredients, including several chili varieties, dark chocolate, and cinnamon, in a single sauce. Chicharron fires three systems at once. Fat carries flavor deep into the palate. The crunch comes from pork skin dried, then dropped in 375-degree oil. The trapped moisture turns to steam, puffs the skin, and produces thousands of flavor compounds through the same browning chemistry that makes coffee and seared meat smell incredible. Then the salsa lands capsaicin on top of everything and the dopamine kicks in. The "best food ever" reaction has a chemical basis. You are tasting dopamine from capsaicin, browning chemistry from pork fat at high heat, and a tortilla built on a process 3,200 years old. These flavors were engineered to do exactly this.

🔬📸 "Perfect Radiance" ✴️🌟 ~ Corpus Amylaceum ~ #GUpath #Histology #PathArt

TP53 myeloid neoplasms….. easy to diagnose, breezy to treat ….. 🤥 #EHA2026

Before making a diagnosis of invasive breast cancer in a core needle biopsy, be sure it is truly a primary breast tumor, particularly in the era of neoadjuvant chemotherapy Metastatic serous carcinoma and metastatic melanoma to breast (pic 1) Metastatic lung adenocarcinoma (pic 2) Metastatic medullary thyroid carcinoma (pic3) Of 2423 TNBC submitted to Caris for molecular profiling over 19 months there was a misdiagnosis of TNBC in 73 cases (3%). Half of those cases were non-small lung cancer (data submitted for publication) Dr. Schnitt #USCAP2026 #pathology #PathX #PathTwitter

A tumor with relatively bland nuclei can still be high-grade if it exhibits Pattern 4 or 5 architecture. This is the concept that many trainees initially miss. #path_clicks #pathology #trending #progress #Histopathology instagram.com/p/DZg9Rj3pRQC/…

#PathQuiz 🔬🧬 A) Renal Oncocytoma B) Chromophobe Renal Cell Carcinoma C) SDH-Deficient Renal Cell Carcinoma D) Low-grade Oncocytic Tumor #Pathology #GUPath