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folpe-mn-st.bsky.social

I like my wife and family, bikes, music, dogs, baking bread and soft tissue tumors. Only the last here though.

139 posts 285 followers 70 following

Posts 15 Comments 35

#PathSky 30F with shoulder mass. Nice example of low-grade fibromyxoid sarcoma, with heavily collagenized areas and a very abrupt transition to more cellular nodules with a whorling pattern and a well-developed vasculature. MUC4 IHC is confirmatory. This case has another helpful H+E feature (below)

submitted 3 days ago • 1 comment

#PathSky Fatty-appearing thigh mass in a 69M. A solid nodule was present, concerning for dedifferentiation. The solid nodule is lateral in the mass.

submitted 10 days ago • 1 comment

#PathSky Perianal mass, 38F. Well-circumscribed, modulated, myxoid. Diffusely S100-positive. Nerve sheath myxoma? Not quite right.

submitted 11 days ago • 2 comments

#PathSky Intravascular papillae are fun to photograph. We tend to associate them with Dabska tumor (papillary intralymphatic angioendothelioma), but you can see them in other hemangioendotheliomas, angiosarcomas and non-neoplastic lesions.

submitted 12 days ago • 0 comments

#PathSky 43F with a solitary lung mass. Relatively circumscribed, nests and interesting micropapillae of lightly eosinophilic epithelioid cells. Negative for everything except TFE3. Dx?

submitted 17 days ago • 1 comment

#PathSky 79M with a superficial neck mass. Wildly pleomorphic, quite cellular- undifferentiated pleomorphic sarcoma, right? There are basically no mitoses though, the cells have abundant granular-glassy cytoplasm, there is a lot of inflammation, and many bizarre cells have nuclear inclusions.

submitted 18 days ago • 1 comment

#PathSky Slowly growing superficial leg mass, 38M. Well-circumscribed, phleboliths, thrombosed vessels, cellular spindle cell areas, cavernous vascular channels. Dx?

submitted 18 days ago • 1 comment

#PathSky It seems rather appropriate, in this NGS era, that I should have been given a CREM1 chocolate.

submitted 23 days ago • 0 comments

#PathSky 43M with a giant, pendulous mass of the inner thigh. The outside clinician and pathologist were concerned for WDL, but their MDM2 FISH was negative. Certainly there is nature fat with fibrous septae and an increased number of somewhat atypical stromal cells? False negative FISH?

submitted 24 days ago • 2 comments

#PathSky 5F with a small bowel mass. Ideas?

submitted 26 days ago • 1 comment

#PathSky 76M with a testicular mass. The outside was quite convinced this was a germ cell tumor with ITGCN, but it was resolutely negative for germ cell markers, and a broad panel of other markers. What to do next? NGS? Methylation? NGS + methylation?

submitted 27 days ago • 2 comments

#PathSky Older adult with a large, prolapsing esophageal mass. An excellent example of a “giant fibrovascular polyp” of the esophagus. Except that essentially 100% of these turn out to be well-differentiated ( or less often dedifferentiated) liposarcomas. pubmed.ncbi.nlm.nih.gov/28984298/

submitted 30 days ago • 0 comments

#PathSky Infant with leg mass. Looks like a circumscribed deep mass, but there is subtle involvement of the superficial subcutaneous fat. Small, infiltrating fascicles of rather bland spindled cells. The nodule itself is more cellular, fascicular to storiform, but still bland.

submitted 31 days ago • 1 comment

#PathSky 22M, referred here for a “high-grade sarcoma” of the leg. Everyone agree? Wide excision plus chemo plus RT?

submitted 32 days ago • 1 comment

#PathSky Recently pregnant 30F. Scattered small “green” nodules noted on C-section. This is a two-for-one. The nodules are an excellent example of so-called granular cell reaction, an unusual histiocytic pseudotumor to blood breakdown products. See page 415 of the most recent Enzinger/Weiss.

submitted 34 days ago • 1 comment