Andres Matoso
@Andres_Matoso
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Surgical pathologist at Johns Hopkins Hospital
Baltimore, MD
Joined January 2015
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Metastatic endometrial stromal sarcoma to the bladder is extremely rare, can happen many years after the primary resection. The differential diagnosis includes large nested subtype of urothelial carcinoma. History taking could be helpful to order the right IHC
#GUpath
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Pseudocarcinomatous urothelial hyperplasia (PCUH) occurs in patients with prior radiation therapy or vasculopathy. Nests of reactive urothelium deep into lamina propria surrounded with hemorrhage and fibrin.
#GUpath
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This is a great example of why it's not safe to definitively make a diagnosis of oncocytoma in needle biopsies or FNAs. Look at the high grade component in the bottom right corner, similar morphology as tumor in focus of LVI (2nd pic).
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Bladder schistosomiasis is caused by egg-laying Schistosoma haematobium worms dwelling within the veins vessels. The parasite is endemic in subsaharan Africa, the Middle East, Southeast Asia, and the Caribbean. It can cause bladder squamous cell carcinoma.
#gupath
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Working tirelessly to finish this masterpiece soon! This authoritative, concise book features hundreds of illustrations and diagnostic tips helpful for path residents and surgical pathologists. Coming soon!
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Rosai Dorfman D of testis mimicking neoplasm clinically. S100 highlight cells with emperipolesis
#gupath
#pathology
@juan_rosai
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Beautiful case of Biphasic Hyalinizing Psammomatous Renal Cell Carcinoma (BHP RCC). These tumors have variable morphologies but areas like the one shown here are very characteristic. Enjoy!
@JHUPath
@LatinAmericanPF
@mreyesm
PMID: 35941722, 32217839
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Large cells up to 100 microns, lack of prominent lymphocytic infiltration or granulomatous inflammation. Intratubular spread but no GCNI, OCT4(-), CD117 can be (+). Spermatocytic tumor!! ~10% in younger than 30yo but more common >50. Happy Friday!
#GUpath
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Paratesticular tumor. Unusual location but classic morphology for a glomus tumor! 😀😀
#gupath
#pathology
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Granulomas in the prostate can be due to NSGP, BCG therapy for bladder cancer, post biopsy, or infectious. When associated with eosinophils, deeper levels can show you the visitors! Find more tips at .
#gupath
#urology
@science_press
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Colonic glands in prostate biopsy can mimic prostate cancer, specially if they are dysplastic. Key is to recognize the presence of lamina propria and not to misinterpret a PIN4 stain.
#GUpath
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Testicular teratoma gone bad. Primitive looking somatic malignancy. See glomeruloid structures. PanCK should prompt WT1 staining. "Nephroblastoma arising from Teratoma"
#GUpath
#pathology
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Another beautiful bladder fibroepithelial polyp. This one with florid cystitis cystica glandularis, one of the most common morphologic patterns. When the epithelial component is so prominent, it makes it more difficult to identify the spindle stromal cells. Happy 2024!
#gupath
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Continuing with weird location for a tumor with classic morphology... Look at this epithelioid hemangioendothelioma in the penile urethra! CD31+, CK-, HHV8-.
#gupath
#pathology
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Florid cystitis cystic et glandular with intestinal metaplasia. No dysplasia but formed a polypoid mass simulating a tumor.
#gupath
#urology
@kara_lombardo
@JCensits
@drphil_urology
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What mutation is frequently present in this testicular tumor? 1)FH; 2)CTNNB1; 3)PRKAR1; 4)STK11. First resident winner gets a "grande latte" (must be claimed at JHH or USCAP18) Have fun!
#GUpath
#pathology
#pathresident
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Sertoli cell tumor can show similarity to NETs. In fact, they are often SYN+, CHR+. Can 🐝 a dx pitfall in metastatic sites!!
#gupath
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Primary renal carcinoids are extremely uncommon. The characteristic trabecular pattern might be difficult to identify in a needle biopsy. Monotonous nuclei with inconspicuous nucleoli and abundant eosinophilic cytoplasm are helpful diagnostic clues. Nice weekend everyone!
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Benign florid mesothelial hyperplasia of the tunica vaginalis in hydrocele specimens can be scary🎃. Key is to recognize bland cytology and linear growth parallel to the surface.
#gupath
#pathology
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Renal medullary carcinoma usually presents with metastasis. Located in the medullary region shows tubulopapillary, cords or solid sheets of cells w/ high nuclear grade and eosinophilic cytoplasm. Neutrophilic infiltration is characteristic.
#gupath
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Prostate cancer w/ Paneth cell-like cells often shows nests or single cells but does not usually follow the aggressive clinical course of Gleason 5 cancer. The recommendation is to not grade these areas. Also note it could be negative for prostate markers.
#GUpath
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Prostate cancer can occasionally express CDX2. This could be problematic when the cancer is invading the rectum and encountered in a biopsy. Performing prostate markers and obtaining clinical history helps.
#gupath
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Primary urethral melanoma are rare and can be amelanotic. Should be in ddx of urothelial carcinoma, sarcomas, and sarcomatoid ca.
#gupath
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Patient with uncontrolled hypertension and a unilateral peripherally located solitary renal mass. Laboratory features of hyperaldosteronism and hypokalemia. Juxtaglomerular cell tumor. inset CD34.
#gupath
(Pics by Dr Mangray)
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This hybrid AML/RCC FMS are two phenotypes of the same molecular alterations, both strongly and diffusely positive for GPNMB. See ().
#GUpath
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20+yo man with elevated LFTs found to have low CD4 count-tested positive for HIV. Hard to see in H&E but look at GMS!
#pathology
#GIpath
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In contrast to retraction artifact, true micropapillary carcinoma is characterized my multiple nests of tumor within one lacunae, as seen in this example. Who wouldn't wish more urothelial micropapillary were this classic?
#gupath
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Composed of cytologically bland large irregular nests, large nested subtype of urothelial carcinoma often invades muscular propria (detrusor), which can help in making this, sometimes challenging, diagnosis.
#gupath
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Invasive urothelial carcinoma, nested variant. GATA3 positive. Note low-grade nuclear features but deeply invasive.
#gupath
#pathology
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Graduation day at Hopkins! Congratulations residents and fellows!
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Young man with inguinal mass: Lipoblastoma-like tumor of the genital area. DD: myxoid liposarcoma, spindle cell lipoma, lipoblastoma
#gupath
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Single atypical gland at the edge of a needle core biopsy can only be diagnosed as cancer in the presence of perineural invasion.PIN4 staining is reassuring. Many more practical tips are coming up in the Survival Guide to Prostate Biopsy!
@innovpathpress
@GU_Path_Society
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Invasive urothelial carcinoma, nested variant, found in TURP. Note the low grade cytology but deep invasion.
#gupath
#pathology
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This PUTIP is from prox ureter. PUTIPs are characterized by (1) inverted PNLMP lacking exophytic component; (2) florid VBN within the polypoid lesion; and (3) an IP with hyalinized stroma. See
@SaraEWobker
's PMID: 27574810
@brady_urology
@JHUPath
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Meeting my friends from the other side of the planet is one of the most gratifying things of USCAP. Here with
@mdlozanoe
at USCAP23!
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Neuroglial differentiation in testicular tumors is rare and is more commonly associated with teratomas. They can show a variety of morphologic features. Below are some examples. Enjoy! 😀
#gupath
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Early phase of vasitis nodosa with many spermatozoa present in the ductular lumina. Ductules lined by single layer of cuboidal cells with prominent nucleoli and pale cytoplasm. See nice paper by
@Williamson_SR
's group.
#gupath
#urology
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Cytotroph rimmed with syncytiotrophoblast is a classic pattern. Freq necr +vasc inv. MGCT with lots of CC worse prog.
#gupath
#pathology
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Excellent masterclasses by Carlos and Alejandro in the LAPF course!
@LatinAmericanPF
@MarcosLepeMD
@CPHpath
@cjesteva
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Nos vemos en Lima esta semana para un congreso espectacular con presentaciones de primer nivel y muchas oportunidades para encontrarse con amigos!
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This case tested positive for histoplasma but the dd is very difficult based on morphology alone
@bansar_bansaria
@LMBarton1
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Be careful when trusting PAX8 in the DD of nested ca vs. NA. Here is an example of a nested ca PAX8+.
#gupath
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