The surf's up and the heat and humidity are on overdrive as we enter Miami summer - it's pilonidal disease and hidradenitis suppurativa season. This pilonidal cyst shows a lovely nidus of hair. #umiamipath

Help! Someone needs to call the emperipolice! We have a Rosai Dorfman situation presenting as a large pelvic mass. #UMiamiPath

We are back.... FUCS/UM Training session in Thyroid Cytopathology with Jaylou M. Velez Torres, MD 🇵🇷🇺🇸. Outstading revision of diagnostic categories. UMiami Pathology Carmen Gomez-Fernandez, MD Merce Jorda Martin Poveda Fundación Universitaria de Ciencias de la Salud #thyroid #tiroides

It's just pseudo-invasion (epithelial misplacement) in an adenoma, but the hemosiderin deposition is striking. Curiously, mostly non-neoplastic mucosa has prolapsed into the submucosa since adenomas have 'top-down' growth. #UMiamiPath

Another fascinating Miami case.

This is a hepatic explant from a relatively young patient who began drinking in the early teen years. The patient presented emergently with hepatic failure. The abundance of Mallory-Denk bodies (arrows) is shocking. #UMiamiPath

#UMiamiPath

Autoimmune enteropathy pattern of injury. Missing in action: goblet cells, Paneth cells. Present - increased apoptotic bodies. This pattern is attributed to several underlying causes, including use of angiotensin receptor blocker anti-hypertensive medications. PMID: 33607573.

Epithelioid hemangioendothelioma involving the lung. The patient had extensive disease in several organs; the primary site was unclear. In the lung, there is an organ-encasing growth pattern similar to that of mesothelioma. #UMiamiPath

Clear cell renal cell carcinoma (CCRCC) with sarcomatoid areas. 2 patterns are present, one with necrosis (the sarcomatoid/spindle cell component, grade 4). The sarcomatoid component lacks sinusoidal-like vasculature, present in the usual CCRCC (grade 1). innovativesciencepress.com

A wicked epithelioid angiosarcoma has burrowed into the gastric mucosa and mimicked an adenocarcinoma.

Another interesting case.

This is a beautiful example of Barrett's esophagus with high grade dysplasia and complete loss of nuclear staining (null pattern) in keeping with bi-allelic inactivation of the TP53 gene.

Iron medication-associated carditis has resulted in striking reactive epithelial changes. The PAS stain shows a slender strip of neutral mucin in the epithelial cells in question. #UMiamiPath

Explore #PathologyCME in Whistler!
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An anastomosing hemangioma presenting as a colorectal polyp. These are uncommon, initially described in the genitourinary tract. They can create concern for angiosarcoma and share mutations with other hemangioma types; PMIDs: 23887160, 19606014, 29574926, 31707589. #UMiamiPath

Another portal hypertension-associated antral polyp. The endothelial cells have a hobnail appearance. Because of a large liver transplant service at our institution, we encounter these polyps with some frequency. #UMiamiPath

Superficial acral fibromyxoma (also termed digital fibromyxoma) was described in 2001. It is benign but prone to recurrences in up to 25% of patients. It is often chock full of mast cells (arrow) and shows consistent CD34 expression. #UMiamiPath
PMIDs: 11486169, 22367301.

A splendid spindle cell hemangioma. These were initially reported as spindle cell hemangioendothelioma but additional data indicated otherwise. They are associated with the Maffucci syndrome (multiple enchondromas). #UMiamiPath

Today's renal cell carcinoma has spread to the duodenum. #umiamipath