#pathnuggets

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“THOSE GHOSTLY BASTARDS “ • Good lesson from • @pathnuggets Promonocytes in the peripheral blood. Promonocytes are considered blast equivalents. Promonocytes have irregular nuclear contours that have a delicately folded appearance. The chromatin is fine. Usually see small nucleoli and some small cytoplasmic granules. Typically express CD4, CD64, CD11b, CD14. Lack CD34 and CD117 frequently. #pathnuggets #pathologynuggets #pathology #pathologyeducation #heme #hematology #hemepath #hematopathology https://www.instagram.com/p/CkSXm0gDHwFT-GDSVJ8B2SYAc3T8j4q-RNgUe80/?igshid=NGJjMDIxMWI=

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From • @pathnuggets Cytoplasmic vacuolization of myeloid and erythroid precursors in bone marrow. Commonly seen in copper deficiency. Copper deficiency can be confused with MDS because patients typically present with pancytopenia. Can also see dysplasia in copper deficiency (why it should be ruled out when working up for MDS). Since copper is mostly absorbed in the stomach and proximal duodenum, think about possible copper deficiency in patients who have undergone GI surgery such as gastrectomy. TPN and Zinc supplements can also cause copper deficiency. Zinc and copper compete for absorption in GI track and zinc usually wins. (Be careful and don’t take too many zinc supplements) #pathnuggets #pathology #pathologyeducation #pathologynuggets #bonemarrowpathology https://www.instagram.com/p/CjUfM7LDnOD4fYBZxDaj5IjxWFp0on8qI9RmiY0/?igshid=NGJjMDIxMWI=

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From • @pathnuggets Cytospin preparation of follicular lymphoma. Here we can see many small cleaved lymphocytes consistent with centrocytes. Follicular lymphoma is composed CD10 positive B cells from the germinal center. IgH/BCL2 rearrangement is found in about 90% of cases. By Immunohistochemsitry the B cells will also express BCL2 and BCL6. LMO2 is another marker for follicle center. Ki67 proliferation index is useful and helpful with grading. Cases are graded by the number of centroblasts per high power field on histology sections. #pathnuggets #pathologynuggets #pathology #pathologyeducation #heme #hemepath #cytology https://www.instagram.com/p/CfyRiRRjYiXNfvJ9gO49nYyqSZ4WwI_oN5nkgA0/?igshid=NGJjMDIxMWI=

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A day in a haematopathologist’s life: • From • @pathnuggets Promonocytes in peripheral blood - here you can see several promonocytes. Promonocytes have delicately folded nuclei and fine chromatin. Sometimes you can also see small nucleoli. Promonocytes are considered blast equivalents. Acute monocytic leukemia will have mostly promonocytes in the marrow aspirate. Monocytes tend to mature a little bit when they move into the blood so in some acute monocytic leukemias you may see some immature monocytes and more mature monocytes in the blood. #pathnuggets #pathologynuggets #pathology #pathologyeducation #peripheralbloodsmear #hemepath #hematopathology https://www.instagram.com/p/Cekw2y2D3kSZJizU72kx0bR0WqiRh8RTRW7jMw0/?igshid=NGJjMDIxMWI=

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From • @pathnuggets Acute myeloid leukemia without maturation in the peripheral blood. Here we can see several blasts in this image collage. The blasts have some small azurophilic granules. Well defined Auer rods are not seen. You would need flow cytometry to say for sure these are myeloid blasts. The blasts will usually have at least partial expression of myeloperoxidase along with other myeloid associated markers such as CD13, CD33, and CD117. Most cases have CD34 expression too which can also be performed by immunohistochemistry. Can sometimes have some more lymphoid associated markers detected including CD7, CD2, CD56, and CD19. On marrow aspirate maturing myeloid precursors will be less than 10% of the differential. #pathnuggets #pathologynuggets #pathology #pathologyeducation #peripheralbloodsmear #hemepath #hematopathology https://www.instagram.com/p/CeiXAJXjnTqLc_fpbAQX-3OMTpBeRAvKMFiDDo0/?igshid=NGJjMDIxMWI=