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Karen Shore @TheShorePath
Joined February 2024
  • Tweets 25
  • Following 39
  • Followers 257
14 Photos and videos
Stained glass or adenomatous hyperplasia of the thyroid? There's so much beauty in pathology! @ElaineHuMD @Maicroanatomy @JuanPathMD @LordoftheSlides @GIJamesMD
DICER1 syndrome and thyroid disease. Michael Canfarotta et al. Journal of Pediatric Surgery Case Reports 11(C). June 2016. DOI:10.1016/j.epsc.2016.05.014

ALT DICER1 syndrome and thyroid disease. Michael Canfarotta et al. Journal of Pediatric Surgery Case Reports 11(C). June 2016. DOI:10.1016/j.epsc.2016.05.014

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You receive a GI case and see this. Diagnosis? Are you worried for the patient?
Photo Credits: Bella Lingjia Liu, M.D. (Pathology Outlines)

ALT Photo Credits: Bella Lingjia Liu, M.D. (Pathology Outlines)

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Dx: Signet ring cell adenocarcinoma (note the abundant intracellular mucin that peripherally displaces the nucleus) Unfortunately, this is an aggressive cancer that carries a poor prognosis as it is typically diagnosed at advanced stages
Photo Credit: Mikael Häggström, M.D. (Wiki)

ALT Photo Credit: Mikael Häggström, M.D. (Wiki)
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Ever wonder what scabies looks like under the microscope? They really do burrow! #Pathology #pathX #dermpath
Photo credits: Eric W. Hossler, M.D. (Pathology Outlines)

ALT Photo credits: Eric W. Hossler, M.D. (Pathology Outlines)
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You see these collections of spherules filled with an acellular pink material on a breast biopsy. Diagnosis? #pathology #pathX @ElaineHuMD @Maicroanatomy @JuanPathMD @LordoftheSlides @GIJamesMD
Credit: Iskender Sinan Genco, M.D. and Sabina Hajiyeva, M.D. (Pathology Outlines)

ALT Credit: Iskender Sinan Genco, M.D. and Sabina Hajiyeva, M.D. (Pathology Outlines)

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Collagenous spherulosis (CS)! This benign finding is caused by an accumulation of basement membrane material forming eosinophilic spherules.
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Adenoid cystic carcinoma of the breast (ACCB) can mimic CS. How can we differentiate? - ACCB diagnosis requires dual population of cells-- basaloid and luminal epithelioid cells - IHC: Smooth muscle myosin heavy chain and calponin are strongly positive in CS and negative in ACCB
Credit: Pathology Outlines and Puri S, Mohindroo S, Gulati A. Collagenous spherulosis: An interesting cytological finding in breast lesion. Cytojournal. 2015;12:25. Published 2015 Nov 30.

ALT Credit: Pathology Outlines and Puri S, Mohindroo S, Gulati A. Collagenous spherulosis: An interesting cytological finding in breast lesion. Cytojournal. 2015;12:25. Published 2015 Nov 30.
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How can the CAIX (carbonic anhydrase IX) IHC stain be used to differentiate subtypes of renal cell carcinoma (RCC)? #pathology #pathX #gupath @ElaineHuMD @Maicroanatomy @JuanPathMD @LordoftheSlides @GIJamesMD
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CAIX is a membranous stain: - Box-like/complete staining= clear cell RCC - Cup-shaped staining= clear cell papillary RCC - Focal (often <50%)= papillary RCC - Negative= chromophobe RCC
Figures 1 and 3: Pathology Outlines Figure 2: Courcier et al. Carbonic Anhydrase IX in Renal Cell Carcinoma, Implications for Disease Management. International Journal of Molecular Sciences. 2020; 21(19):7146.

ALT Figures 1 and 3: Pathology Outlines Figure 2: Courcier et al. Carbonic Anhydrase IX in Renal Cell Carcinoma, Implications for Disease Management. International Journal of Molecular Sciences. 2020; 21(19):7146.

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How can we remember this? CAIX is overexpressed in hypoxia, and hypoxia inducible factor (HIF) is controlled by the VHL gene (associated with RCC)!
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Beyond excited! Can't wait to join the MGB path family!
Mass General Brigham Pathology@MGBpathology
22 Mar 2025
We couldn’t be more thrilled to introduce this stellar new class of 19 (yes, 19!) PGY1s joining the Mass General Brigham pathology family! 🥳 Welcome to the team — we can’t wait to have you on board and see you thrive! 🧬🔬💫
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Microscopic flowers-- so cute! @ElaineHuMD @Maicroanatomy @JuanPathMD @LordoftheSlides @GIJamesMD (Asteroid bodies in multinucleated giant cell)
Dr. Yale Rosen Atlas of Pulmonary Pathology (Flickr)

ALT Dr. Yale Rosen Atlas of Pulmonary Pathology (Flickr)

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Radiological-pathological correlation in breast in patient with history of silicone implants (MRI and H&E) #pathology #pathX @ElaineHuMD @Maicroanatomy @JuanPathMD @LordoftheSlides @GIJamesMD
1) Indian J Radiol Imaging. 2016 Apr-Jun;26(2):216–225. doi: 10.4103/0971-3026.184409 2) Julie M. Jorns, M.D. (Pathology Outlines)

ALT 1) Indian J Radiol Imaging. 2016 Apr-Jun;26(2):216–225. doi: 10.4103/0971-3026.184409 2) Julie M. Jorns, M.D. (Pathology Outlines)

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MRI: High signal intensity deposits, demonstrating rupture with free silicone conglomerates in breast parenchyma H&E: Refractile foreign material (silicone) with giant cell reaction
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You see this in a breast biopsy… what is the diagnosis? #pathology #pathX
Credit: Indu Agarwal, MD (Pathology Outlines)

ALT Credit: Indu Agarwal, MD (Pathology Outlines)

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Pseudoangiomatous stromal hyperplasia (PASH) Characterized by complex inter-anastomosing slit-like spaces in a dense collagen stroma. "Pseudoangiomatous" because the spaces resemble vascular spaces. It's benign!
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Saw 2 of these cases in 2 weeks earlier this year. Both patients had recently immigrated from South America and presented with enlarging ulcerative lesions on their upper extremities. Diagnosis? #pathology #PathX #dermpath #pathmatch2025
Cutaneous Leishmaniasis, Alexia Knapp, MD, Jonathan Alpern, MD https://www.nejm.org/doi/10.1056/NEJMicm1908092

ALT Cutaneous Leishmaniasis, Alexia Knapp, MD, Jonathan Alpern, MD https://www.nejm.org/doi/10.1056/NEJMicm1908092

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Cutaneous leishmaniasis! On H&E, we can see intracellular leishmania amastigotes within monocytes/histiocytes. Never thought I'd see this outside of SketchyMicro
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The Giemsa stain can also help highlight the Leishmania parasites!
Joachim Richter https://www.researchgate.net/figure/Leishmania-amastigotes-Giemsa-stain-in-a-smear-of-the-buccal-mucosa-patient-1_fig3_51057580

ALT Joachim Richter https://www.researchgate.net/figure/Leishmania-amastigotes-Giemsa-stain-in-a-smear-of-the-buccal-mucosa-patient-1_fig3_51057580

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Both are nevi! What’s the difference? Hint: note the shapes of the melanocytes! #dermpath #pathology
Credit: pathology outlines, Yuri Tachibana, MD and Carlos Torres-Cabala, MD

ALT Credit: pathology outlines, Yuri Tachibana, MD and Carlos Torres-Cabala, MD

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Answer: Melanocytes in common blue nevi are spindle-shaped or dendritic in background of dense collagen. Intradermal nevi have a more uniform nested appearance.
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