#slidearchiveseries urothelial carcinoma in situ colonizing prostatic urethra #gupath

#slidearchiveseries seminal vesicle invasion #gupath #prostatecancer

1️⃣ spreading along the ejaculatory duct
2️⃣ direct invasion at the base of the prostate or extension into peri-SV soft tissue and then into the wall of the SV
3️⃣ discontinuous metastases (rare)

🔗 doi.org/10.1038/modp...

#slidearchiveseries history of nephrectomy for renal cell carcinoma, received immunotherapy with complete response, later developed upper GI bleeding from metastases to the proximal jejunum #gupath #gipath

#slidearchiveseries chromophobe renal cell carcinoma #gupath #pathsky #pathoutpic

✅ solid sheet-like architecture
✅ plant-like cell borders (vegetable cells)
✅ irregular, wrinkled nuclei (raisinoid)
✅ binucleation and perinuclear halos
🎨 CK7, CD117, Hale colloidal iron

#slidearchiveseries clear cell renal cell carcinoma with rhabdoid differentiation #gupath

🔬 large eccentric nuclei with prominent nucleoli, abundant eosinophilic cytoplasm, globular eosinophilic intracytoplasmic inclusions

#slidearchiveseries urinary bladder, inflammatory myofibroblastic tumor #gupath #pathsky #pathoutpic

🔬 Diverse patterns: myxoid, fascicular, hyalinized
🎨 ALK IHC (diffuse cytoplasmic) in 40-60%
🧬 50-60% ALK fusions (EML4, TPM3/4, CARS, RANBP2, IGFBP5…)

#slidearchiveseries urothelial carcinoma, clear cell (glycogen-rich) #gupath

🎨 IHC profile similar to conventional urothelial carcinoma (GATA3, p63)
⚠️ distinguish from metastatic CCRCC and clear cell adenocarcinoma

#slidearchiveseries history of DLBCL s/p chemotherapy with residual retroperitoneal lymphadenopathy, s/p radiation therapy for bulky cauda equina leptomeningeal disease, now for management of prostate abscess #gupath #malakoplakia

#slidearchiveseries seminoma with brisk lymphocytes, rete testis invasion, and GCNIS—classic 'fried egg' 🍳 appearance with a dash of pepper #gupath #testistumor #pathoutpic

#slidearchiveseries chromophobe carcinoma with sarcomatoid differentiation #gupath #pathsky #pathoutpic

⚠️ sarcomatoid component may overrun the epithelial component, extensive sampling may be needed to identify recognizable carcinoma

#slidearchiveseries paraganglioma of urinary bladder #gupath #pathsky

🔬 polygonal cells with granular cytoplasm in Zellballen pattern
🎨 SYN/CG/often GATA3 (pitfall)
🧬assoc with germline SDH mutation
🤔confused with urothelial ca, granular cell tumor, melanoma

#slidearchiveseries history of radical orchiectomy with pure teratoma, serum tumor markers (post-orchiectomy): AFP 537, increased to 469, HCG 2; status post chemotherapy x 4 cycles ➡️ retroperitoneal lymph node dissection #gupath #pathsky

#slidearchiveseries mixed germ cell tumor, predominantly embryonal carcinoma with smaller components of yolk sac tumor and teratoma, LVI present (additionally confirmed with ERG immunostain) #gupath #pathsky #pathoutpic

#slidearchiveseries metastatic mixed germ cell tumor (teratoma and choriocarcinoma) involving lymph node #gupath #pathsky

🏥 h/o testicular mixed germ cell tumor (teratoma, choriocarcinoma, seminoma) s/p chemotherapy and RPLND with growing mediastinal mass and increasing HCG

#slidearchiveseries clear cell adenocarcinoma of urinary bladder #gupath #pathsky

🔬solid, tubulocystic, and papillary growth patterns; hobnail cells with eosinophilic or clear cytoplasm
➕ CK7, PAX8, HNF1β, p53, Napsin
➖ GATA3, p63, ER, PR, WT1

#slidearchiveseries urothelial carcinoma, clear cell (glycogen-rich) #gupath #pathsky #pathoutpic

🎨 IHC profile similar to conventional urothelial carcinoma (GATA3, p63)
⚠️ distinguish from metastatic CCRCC and clear cell adenocarcinoma

OCT4

#slidearchiveseries embryonal carcinoma #gupath #pathsky

🔬 pseudoendodermal sinus-like
🎨 OCT4
📑 pubmed.ncbi.nlm.nih.gov/29129333/

🏥 history of epididymo-orchitis; enlarged testicle with a heterogeneous mass-like area (increasing in size), serum tumor markers not known

#slidearchiveseries urothelial carcinoma, plasmacytoid variant #gupath #pathsky #pathoutpic

🧐 special attention during frozen section, frequent positive surgical margins along the ureters and periureteral soft tissue that may appear grossly negative 😰🤯

#slidearchiveseries metastatic prostatic adenocarcinoma involving adrenal gland #gupath #pathsky

#slidearchiveseries SMARCB1 deficient renal medullary carcinoma
#gupath #pathsky #pathoutpic

🩸 young pts with sickle cell trait
🔬 cribriform, reticular, nested growth
🎨 PAX8, broad spectrum CKs, CEA, p53
⚠️ OCT3/4 ➕ (50%), pitfall with GCT
🔑 SMARCB1 / INI1 inactivation

#slidearchiveseries urothelial carcinoma, plasmacytoid variant #gupath #pathsky #pathoutpic

🔬discohesive single tumor cells, eccentrically placed nuclei, eosinophilic cytoplasm 
💥high grade, poor prognosis
🙅🏻‍♀️do not use CD138 in isolation to distinguish from plasma cells

#slidearchiveseries keratinizing squamous cell carcinoma of the bladder #gupath #pathsky #pathoutpic

☝🏼assoc with keratinizing squamous metaplasia / dysplasia of the mucosa
✌🏼exclude urothelial ca with squamous diff, spread from primary (cervix, penis, anus) or metastasis

#slidearchiveseries scrotal calcinosis
#gupath #dermpath #pathsky #pathoutpic

🔬intradermal nodules varying in size and number, foreign body giant cell reaction in surrounding tissue
📊 differentials include calcification of epidermal or pilar cyst
🤔 idiopathic or dystrophic

#slidearchiveseries paratesticular embryonal rhabdomyosarcoma #gupath #BSTpath #pathsky #pathoutpic

🔬 moderately cellular with loose, myxoid stroma
✨focal areas of diffuse anaplasia, atypical mitotic figures
🎨 MyoD1, myogenin, desmin
🧬 FOXO1 gene rearrangement negative

#slidearchiveseries papillary renal neoplasm with reverse polarity #gupath #pathsky #pathoutpic

🕵🏻‍♀️ usually asymptomatic, incidentally found, clinically indolent
🔬 thin papillary/tubulopapillary growth, apically located, low grade nuclei
🎨 CK7, GATA3, L1CAM
🧬 KRAS mutation

#slidearchiveseries nephrogenic adenoma #gupath #pathsky #pathoutpic

🏥 prior urothelial injury (surgery, calculi, trauma)
sites: bladder > urethra > ureter
🔬 metaplastic lesion, multiple morphological patterns
🎨 PAX8, AMACR, GATA3 (40%), PSA (weak) (+)
⚠️ exclude prostate & bladder ca

#slidearchiveseries urothelial carcinoma, micropapillary subtype #gupath #pathsky #pathoutpic

☝🏼distinguish from retraction artifact
✅ multiple small nests floating within single lacunae
✅ back-to-back lacunae
✅ presence of ring formations

#slidearchiveseries urothelial carcinoma, micropapillary subtype
#gupath #pathsky #pathoutpic

🔬 small tumor cell clusters without fibrovascular cores, floating in lacunar spaces
⚠️ may resemble vascular invasion

#slidearchiveseries prostatic adenocarcinoma with mucinous component #gupath #pathsky

✅ prognosis similar to non-mucinous cancers of similar Gleason score
✅ subtract mucin, grade based on underlying architecture
✅ mucin present (≤25 🆚 >25%) 
✅ final classification on resection