Anat. Pathologist | St. Paul's Hospital MMC | #BSTpath | Loves 🎨 Art & Photography | Ethiopian & Orthodox Chris✟ian 🇪🇹 | ✘eets = Opinions
Addis Ababa, Ethiopia
Joined December 2022
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A 40 Yr 👩
15 yr cough, dyspnea & wt loss.
CT: Middle lobe, 6.7-cm air-filled lung cyst.
🫁 Intra-op: 10×6 cm vascularized cystic lesion, excised; suspected hydatid cyst.
🤔 Thoughts ??
#PathTwitter #PulmonaryPathology #Pathology #pathx – at Ethiopia
Wondweson64 Alemu retweeted
የጤና ሚኒስትር ዶ/ር መቅደስ ዳባ የመስቀል በዓልን ምክንያት በማድረግ በራስ ደስታ ዳምጠው ሆስፒታልና ባቡል ኸይር የበጎ አድራጎት ድርጅት በመገኘት ከታካሚዎችና ከማህበረሰቡ ጋር የማዕድ መጋራት መርሃ ግብር አካሄዱ።
facebook.com/share/p/19WE1s2…
Wondweson64 Alemu retweeted
Diagnostic Approach to Large B-Cell Lymphoma
Large B-cell lymphoma (LBCL) is the most common type of aggressive mature B-cell lymphoma. In the 5th edition of the WHO Classification of Haematolymphoid Tumors, LBCL has been further refined into as many as 17 distinct specific subtypes. Cases that do not fit into any defined subtype are classified as diffuse large B-cell lymphoma, not otherwise specified (DLBCL, NOS). The increasing precision of LBCL classification requires pathologists to adopt more accurate and comprehensive diagnostic strategies. Meanwhile, the continuous development of novel therapeutic agents and the diversification of treatment approaches have placed higher demands on precise LBCL subclassification and the identification of clinically relevant molecular alterations.
The diagnostic workup typically includes an immunohistochemical panel consisting of CD20, PAX5, CD3, CD5, CD10, BCL2, BCL6, MUM1, CD138, Cyclin D1, CD30, p53, MYC, Ki-67, and Epstein–Barr virus (EBV)-encoded RNA (EBER) in situ hybridization. In addition, fluorescence in situ hybridization (FISH) analysis is performed to detect genetic rearrangements involving MYC, BCL2, BCL6, and IRF4, among other relevant molecular abnormalities.
🤖 Made with AI
Wondweson64 Alemu retweeted
Lymph node mets. Can you guess the primary? #pathology @mvmd0908 @pembeoltulu @Missle – at Cleveland, OH
Wondweson64 Alemu retweeted
Temporal artery biopsy referred to me as a possible periarteritis. I was struck by the perineural inflammation but on deeper levels and pictured AE1/3 the answer was revealed.....
not mentioned in the history but in the EPR patient had a scalp PDKSCC excised 4 years earlier!
Wondweson64 Alemu retweeted
High-grade endometrial cancer: morphology is only the beginning
MMR → p53 → POLE
± targeted IHC for unusual morphology
A p53-abnormal tumor can wear many faces—endometrioid, serous, mixed or dedifferentiated
Don’t just ask: “What does it look like?”
Ask: What is driving it?
Wondweson64 Alemu retweeted
Case 1: SDH-deficient RCC; Case 2: Eosinophilic vacuolated tumor (EVT).
Helpful morphology clue: Both of tumor has vacuoles, SDH-deficient RCC has relatively uniform “bubbly” vacuoles/inclusions;
Key differential: FH-deficient RCC should be considered for both tumors.
Overlap: low-grade FH-deficient RCC can look SDH-like, while EVT can show high-grade-appearing nucleoli. We kept a low threshold for FH/2SC in both.
Reference: Trpkov et al., Histopathology 2025:
pmc.ncbi.nlm.nih.gov/article…
Smith et al., Histopathology 2017:
pubmed.ncbi.nlm.nih.gov/2816…
🧩 Kidney riddle 2.0
Case 1 vs Case 2.
Both have prominent intracytoplasmic vacuoles—but the vacuoles look quite different, don’t they? 👀
What are your diagnoses (Case 1; Case 2)?
Still our eosinophilic renal cell tumor series.
xitter.cf/GuannanTiffany/status/…
#DxMindMap #Kidneytumor #GUPath #Mimicker #PathTwitter @JHUpath
Wondweson64 Alemu retweeted
🧩 Kidney riddle
Continuing our eosinophilic renal tumor series…
Along with Ting’s recent LOT post, xitter.cf/TingZhaoPathdoc/status…
Here is another TSC/mTOR pathway associated RCC.
What is your diagnosis?
#DxMindMap #KidneyPath #GUPath #PathTwitter @JHUPath
Wondweson64 Alemu retweeted
A 72 year old gentleman with history of diabetes mellitus and colon cancer presented with urinary tract infection and disseminated skin nodular rash. A skin biopsy was taken.
What is your opinion?
#Dermpath
#Dermatology
#Pathology
#Pathtwitter
#PathX
Wondweson64 Alemu retweeted
🦴 Bone Quiz
A 28-year-old with knee pain has a 5 cm lytic proximal fibular lesion.
Diagnosis?
Bonus: Identify the immunostain shown and the molecular alteration it detects.
#Pathology #BonePath #Pathagonia #MedEd #Pathresidents
Wondweson64 Alemu retweeted
A young female with progressive shortness of breath and dry cough
🩻 diffuse B/L ground glass opacities
Here is the biopsy from the lung.
#PathTwitter #MedTwitter #PulmPath #PulmPathFellow
Wondweson64 Alemu retweeted
Anastomosing hemangioma it is. 😊
low power lobulated architecture and often associated with a medium-caliber vessel, and may show focal extension into adjacent adipose tissue ( 😱).
The hallmark is anastomosing sinusoidal capillary-sized vessels lined by occasional hobnail endothelial cells.
Cytologic atypia is minimal, and mitoses are absent or rare, supporting its benign nature.
Additional clues: eosinophilic hyaline globules and extramedullary hematopoiesis can be seen.
Reference: Montgomery & Epstein. Am J Surg Pathol. 2009. pubmed.ncbi.nlm.nih.gov/1960…
Kryvenko et al. Am J Clin Pathol. 2011. pubmed.ncbi.nlm.nih.gov/2184…
🧩 Kidney riddle
Is every renal tumor an RCC or AML?
Before it was described, this entity could be quite scary.
What is your diagnosis?
#DxMindMap #Kidneytumor #GUPath #PathTwitter @JHUpath
Wondweson64 Alemu retweeted
#GIPath #Pathbugs
Especially timely given the current surge in cyclosporiasis cases across the United States. A great reminder of how truly diligent we must be when examining duodenal biopsies. Repeated, similarly localized apical or supranuclear inclusions in multiple enterocytes—particularly when surrounded by clear vacuoles or containing organized internal structures—should not be dismissed as artifact, apoptotic debris, or nonspecific cytoplasmic material. Cyclospora can be subtle, focal, and remarkably easy to miss 😓.
Wondweson64 Alemu retweeted
Patient with treatment-resistant acute myeloid leukemia. A very rare phenomenon — the presence of megakaryocytes in peripheral blood.
#hemepath
#onlycells
Wondweson64 Alemu retweeted
Giant cell urothelial carcinoma: rare, aggressive, and still poorly understood.
🔬 Giant cells ~12× larger than background tumor cells
📊 Higher stage (T3/4, metastatic) at presentation
📉 Worse OS vs conventional UC (esp. even in T1/2 disease)
#Pathology #GUPath
PMID42252958
Wondweson64 Alemu retweeted
CMV cervicitis is an uncommon finding and may be underrecognized. Most patients are immunocompetent and asymptomatic. Rx is often not required, although management depends on the clinical context. CMV is a TORCH infection and may have implications during pregnancy. #pathtwitter
Uncommon find in a cervical biopsy... I spy... 🕵️♀️👀
#pathbugs #gynpath #gynepath #pathtwitter #pathx
Wondweson64 Alemu retweeted
Uncommon find in a cervical biopsy... I spy... 🕵️♀️👀
#pathbugs #gynpath #gynepath #pathtwitter #pathx