Geronimo Junior MD

23/05/2026

SBP INSPIRA EM AÇÃO !

08/05/2026

Gastric Polyp.
Dx?

07/05/2026

Final Diagnosis: PARAGANGLIOMA.
Immunohistochemistry (see images): diffuse positivity for chromogranin and synaptophysin. S100 + in sustentacular cells.

07/05/2026

Nice pic with two types of cells side by side.
Examining a sample of the left colon and re**um, we know that a paneth cell is a sign of chronicity. A mistake is to confuse it with Enterochromaffin (EC) cells.
🎯Tip: Paneth = granules to lumen; EC = periphery granules

06/05/2026

🔴Pancreatic Solid pseudopapillary neoplasm
⚠️Don't be alarmed by these cellular atypia (degenerative), and don't change your dx for a HG malignancy
-SPN can have bizarre nuclei w/ virtually mitosis, unlike HG transformation
IHC: ki67

Credit pics: Dr. Haeryoung Kim

05/05/2026

Male, 35yo, retroperitoneal mass.
Dx? Markers?

05/05/2026

👉Esophagus - Granular cell tumor.
The focus could be even smaller and go unnoticed
Tip: In sites where GCT is common, pay attention to the stroma in the context of epithelial hyperplasia
Ask for deep cuts + be careful not to confuse pseudoepith hyperpl of this tu w SCC.

04/05/2026

01/05/2026

30/04/2026

🔬 Diagnostic Challenge: Identifying SISCCA! 🔬

Because it is defined by minimal invasion (< 3 mm in depth and < 7 mm in width), the morphologic alterations are very subtle. To help you in your daily reporting routine, look for these 5 key criteria when evaluating lesions with suspected early invasion:
📌 1. Small Irregular Tumor Nests: The most frequently recognized finding in cases with an absolute consensus of invasion. 📌 2. Desmoplastic Response: Evaluate the stroma! Inflammation, myxoid changes, or capillary angiogenesis are strong indicators of underlying stromal invasion. 📌 3. Paradoxical Maturation: The abrupt cytologic transformation from an immature, basaloid morphology to a more differentiated and keratinized form. 📌 4. Loss of Palisade-like Cell Arrangement: Look out for the loss of the typical, aligned organization of the basal cells at the stromal interface. 📌 5. Blurred Epithelial-Stromal Interface: Poorly defined borders or a breach of the basement membrane also indicate that tumor cells are invading the underlying stroma.
💡 Golden Tip: Many of these criteria are already well-established for early invasive squamous cell carcinoma of the cervix and v***a. Integrating these "gynecology-derived" features into your evaluation significantly improves diagnostic accuracy and consensus in a**l lesions!
📖 Ref: Arch Pathol Lab Med. 2025 Jul 10;150(2):155-159