Charles Herndon
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drcyclopath.bsky.social
Charles Herndon
@drcyclopath.bsky.social
200 followers 510 following 270 posts
My education site http://pathologynotebook.com Incoming PGY1 @UCSFPath All views are my own #CytoPath #PediPath #BSTPath #PathSky #Pathology
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Challenge yourself to new cyto challenges!
4 questions in each module. Can you do it??
⬇️⬇️⬇️
🍤Pancreas
pathologynotebook.com/cytopancreas-6
🫁 Lung
pathologynotebook.com/cytolung-6
🚽 Urinary
pathologynotebook.com/cytourinary-6
⬆️⬆️⬆️
#CytoPath #PathTwitter #Pathology #PathSky
✅#1 & Bonus: Endocervical Adenocarcinoma in situ (AIS)
cells in strips & rosettes
nuclear feathering pseudostratification
chromatin is coarse, evenly distributed
cytoplasm diminished, finely vacuolated, with unclear borders
background clean
#PathSky #GynPath #PathTwitter #CytoPath #Pathology
✅#2 Answer: HSIL extending into glands
clues to a squamous origin include central spindling or whorling with flattening of the nuclei at the periphery
#PathSky #GynPath #PathTwitter #CytoPath #Pathology
Read the explanation below.

Then challenge yourself to new cyto challenges!
4 questions each module. Can you do it?
⬇️⬇️⬇️
🍤Pancreas
pathologynotebook.com/cytopancreas-6
🫁 Lung
pathologynotebook.com/cytolung-6
🚽 Urinary
pathologynotebook.com/cytourinary-6
⬆️⬆️⬆️
#CytoPath #PathTwitter #Pathology #PathSky
#2 of 2: Pap from 25-year-old female.

What is your interpretation?
A) NILM
B) HSIL
C) AIS
#PathSky #PathTwitter #CytoPath #Pathology
#1 of 2: Pap from a 30-year-old female.

What is your interpretation?
A) NILM
B) HSIL
C) AIS
#CytoPath #Pathology
#PathSky #PathTwitter
Challenge yourself to some extra cyto!
4 questions in each module. Can you do it??
⬇️⬇️⬇️
🍤Pancreas
pathologynotebook.com/cytopancreas-4
🫁 Lung
pathologynotebook.com/cytolung-4
🚽 Urinary
pathologynotebook.com/cytourinary-4
⬆️⬆️⬆️
#CytoPath #PathTwitter #Pathology #PathSky
✅#1 & #3: *ABUNDANT* colloid is considered benign and satisfactory for evaluation, even if the “6 groups of 10” criterion of adequacy is not met.
#CytoPath #PathTwitter #Pathology #PathSky
✅#2: Excessive gel and precipitated stains may obstruct cellular features, rendering an aspirate non-diagnostic.
A complete lack of follicular cells in the absence of colloid (e.g., blood or cyst fluid only) is another reason for the non-diagnostic category
#CytoPath #PathTwitter #Pathology #PathSky
Challenge yourself to some extra cyto!
4 questions in each module. Can you do it??
⬇️⬇️⬇️
🍤Pancreas
pathologynotebook.com/cytopancreas-4
🫁 Lung
pathologynotebook.com/cytolung-4
🚽 Urinary
pathologynotebook.com/cytourinary-4
⬆️⬆️⬆️
#CytoPath #PathTwitter #Pathology #PathSky
#3 of 3: Interpretation?
A) Non-Diagnostic
B) Benign
#CytoPath #PathTwitter #Pathology
FNA #2 of 3: Interpretation?
A) Non-Diagnostic
B) Benign
#CytoPath #PathTwitter #Pathology
#Thyroid FNA shows abundant colloid but no follicular cells.

Interpretation:
A) Non-Diagnostic
B) Benign

#CytoPath #PathTwitter #Pathology #PathSky
Answer for #1 and Bonus: Tubal metaplasia
Cells: columnar, ciliated (terminal bar), pseudostratied
Nuclei: oval, may be pleomorphic or hyperchromatic, chromatin even, nucleoli not seen
Cytoplasm: discrete vacuoles
!! Individual ciliated cells not enough !!
#CytoPath #PathSky #PathTwitter #Pathology
Answer for #2: Atypical endocervical cells
Cells: sheets, strips, pseudostratified
Nuclei: enlarged, elongated, hyperchromatic heterogeneous & coarse chromatin
Hyperchromasia more monotonous than metaplasia
Cytoplasm: may be abundant, but N:C is increased; distinct cell borders
#CytoPath #PathSky
Bonus: How would you interpret these glandular cells?
A) Metaplastic
B) Neoplastic
#CytoPath #PathSky #PathTwitter #Pathology
Question 2 of 2:

How would you interpret these glandular cells?

A) Metaplastic
B) Neoplastic
#CytoPath #PathSky #PathTwitter #Pathology
#PapSmear

How would you interpret these glandular cells?

A) Metaplastic
B) Neoplastic

#CytoPath #PathSky #PathTwitter #Pathology#PapSmear
For reference: Non-keratinizing SCC
Syncytial aggregates, background tumor diathesis
High N:C, nucleoli prominent
Liquid based preps have less tumor cellularity, cells are rounded up (may appear glandular), and the tumor diatheses is a "clinging" diathesis
✅Keratinizing squamous cell carcinoma
Mostly single cells, aggregates less common
Variation in cell size & shape, tadpole cells
N:C can be low or high, nuclei vary markedly
Macronucleoli & tumor diathesis less common
HPV-related like non-keratinizing SCC
Worse overall survival, less radio-sensitive
❌Negative for malignancy, examples:
Atrophy: Fine, even chromatin texture and smooth nuclear borders are important clues to the benign nature of such groups.
Repair: Stretched out "pulled taffy" appearance with nuclei displaying evenly distributed chromatin, smooth borders, and
#CytoPath #PathSky