These small intestinal biopsies from a patient with markedly elevated serum IgM from a splenic plasmacytoid extranodal marginal zone (mucosa-associated lymphoid tissue) lymphoma show dramatic edema and IgM deposition that resulted in malabsorption. There is no lymphoma.
Serotonin-producing pancreatic neuroendocrine tumors have a peculiar sclerotic background that is a clue to the diagnosis.
Depoilly T, Leroux R, Andrade D, Nicolle R, Dioguardi Burgio M, Marinoni I, Dokmak S, Ruszniewski P, Hentic O, Paradis V, De Mestier L, Perren A, Couvelard…
Gastric carcinomas with enteroblastic differentiation have been food for thought for Dr. Vikram Deshpande for some time. Track back through the references in this commentary to explore the topic nicely.
J Clin Pathol. 2024 Aug 16;77(9):605-607. PMID: 38538071.
✅#2 Answer: HSIL extending into glands
clues to a squamous origin include central spindling or whorling with flattening of the nuclei at the periphery
Other HSIL features:
cells occur singly, in sheets, or syncytial aggregates
nuclear enlargement varies, but N:C is always high…
We think of a "null" (complete loss) p53 immunohistochemical staining pattern in Barrett's esophagus with high-grade dysplasia, but this example of low-grade dysplasia shows it.
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Without the intranuclear inclusions, these "oncocytoid" cells would have been a bit difficult to be called "Papillary Thyroid Carcinoma" on FNA. Follow-up, "PTC, Tall Cell Subtype".
✅ Perineurioma
This benign polyp is composed of bland spindle cells with perineurial differentiation, which characteristically entrap colonic crypts and arrange in a concentric, "onion-skin" pattern within the lamina propria.
Perineurial cells are positive for Epithelial…
Soft Signs for Hyperplastic Polyp 👗 > Sessile Serrated Lesion (SSL) 🥾
- Former often has more thickened basement membrane ⬇️
- Former often has more scattered neuroendocrine cells; Proliferation in SSL often pushes those cells away
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