#GUpath nephrectomy for single 4cm renal mass from adult, no priors #LPpath Dx (or Dx'es😉) ❓🔬

#GUpath renal mass biopsy from an adult human any wagers from this #LPpath shot?

🔬Notice how this proliferation is well circumscribed @ #LPPath. Great clue for its benign nature Compare with this IBC-NST from the same px 🚨Extension into fatty parenchyma is a good indicator of an invasive process (not always = cancer though -> see microglandular adenosis)

I'll be kind and add a #LPpath shot to go along with gross showing 2 masses: larger (orange, 2.6cm) and smaller (white, 0.3cm) Diagnoses?

the point of this case was to👀that many times BENIGN seminal vesicle epithelium (as shown here) can really mimic prostate cancer! on higher👀super faint+rare slightly bizarre cells 😅but admittedly...MUCH easier at #LPpath this was 3+4 pT2 case

nothing wild (this time😈...) just nice #beautyinb9 #LPpath correlate to CYSTIC ATROPHY

✅Correct! This was an immature, high-grade teratoma (G3). Extensive areas of primitive neuroectodermal elements are seen at #LPPath 🔬

Dan Graham Immanuel Paul Annamária Ribiánszky, MD Olaleke Folaranmi Wondweson64 Alemu Guannan Zhang ，张冠楠，MD, PhD But as a main DDx I'd say, as others aptly already did: Leiomyoma Inflammatory myofibroblastic tumor Nodular fasciitis. So let's see a #LPPath view before we order any stains 😉

😍#LPpath #GUpath with perfectly lined up delineation: When grading clear cell RCC, scan🔬at low power and 👀the “pink” foci (usually these areas with more eosinophilic cytoplasm as shown👇🏽are higher grade)

higher power pic: Dx: spermatocele! I think another DDx just off the uber-challenging #LPpath only knowing #GUpath clue could be benign cortical cyst (from renal cyst decortication)

3/To distinguish between ESN and LG-ESS you have to 👀 at #LPPath and be able to examine the entire tumor-myometrial junction! You might get "lucky" on a myomectomy specimen & see unequivocal 🔬 LVI, but generally the dx of LG-ESS is best reserved for hysterectomy specimens.

#PathTip #GUpath #LPpath: when screening prostate biopsies at low power &👁️ small glands traversing from one side of the core to the other ("glands crossing the street"): definitely🛑stop &📷 go down on high power!

this😍#LPpath #GUpath nephrectomy pic shows 3 features 🔬Dx: clear cell RCC 🔬stage: pT3a (sinus+vascular invasion) 🔬Px: necrosis

#GUpath nephrectomy: able to make #LPpath Dx?🔬🤨

#PathTip #GUpath #LPpath: when screening prostate biopsies at low power &👁️ small glands traversing from one side of the core to the other ("glands crossing the street"): definitely🛑stop &🧐 go down on high power!

#GUpath partial nephrectomy: elusive multilocular cystic renal neoplasm of low malignant potential (MCRNLMP)🤨❓ it's possibly at initial🧐mag... but #LPpath reveals solid tumor nodules in wall, taking this out of that Dx & 👉🏽clear cell RCC (with cystic change) ⏬cont'd⏬

if you go back &👀original, there's transition to nodfasc-like elements + hemosiderin Dx: florid bx site changes/scar (s/p neoadj chemo, ypT0) ✔️lower mag pics #beautyinb9 #LPpath

#GUpath clear cell RCC with rhabdoid diff breaks the rule "when scanning at #LPpath for high grade CC-RCC foci, 👀🔬usually pale clear are low grade & the PINK cytoplasmic areas are high grade"

follow-up on this case: highpower shots of putative "BN invasion" are🚨a 🔬pitfall, b/c you can't assess landmarks (I'd have selected "can't tell from pic") 👇🏽here, you have benign prostate glands along parallel plane at #LPpath, so I would NOT consider this BN invasion

#LPpath #IHCpath #GIpath