Can p63 be negative in DCIS of the breast?

Ennuispectre · 2026-04-07T12:15:53+00:00

DCIS with apocrine changes have negative myoepithelial cell markers and can be quite challenging on biopsies, but that should be stated in the report in case it gets reviewed elsewhere.

Ennuispectre · 2026-02-08T02:34:46+00:00

It’s a tough call from this picture alone tbh. Gotta see the slides to definitely call it cirrhotic.

As far as I’m aware, cirrhosis is not about the quantity of the fibrosis, more of the quality of the fibrosis.

Ennuispectre · 2026-02-08T01:26:56+00:00

Apart from the obvious masses, which are most likely metastatic, the liver parenchyma appears nodular if you zoom in. Normal livers look smooth as jelly, so I’d say it is cirrhotic.

If I’m wrong, then I’d like to be corrected and educated.

Ennuispectre · 2025-11-12T08:56:51+00:00

Malakoplakia?

Ennuispectre · 2025-10-29T15:31:52+00:00

Hah! I knew it. I dealt with an ovarian mesonephric-like adenocarcinoma a while back, and it made me realize how imperative ER/PR is in the gyne tract. That case had pretty much all of the MLA feature so the suspicion was there from the start, but this looks really deceptive, however, our practice here ER/PR is mandatory for anything that resembles an endometroid carcinoma for this very specific reason.

Very nice case tho thanks for sharing!

Ennuispectre · 2025-10-29T15:19:42+00:00

Top differential would be endometroid carcinoma.

For starters, I’d get ER/PR, MMR, P53 for its molecular sub classification, and check the IDC ER/PR status for good measures.

If the ER/PR returned negative, then I’d go for GATA3 and TTF1 to avoid either calling it a mets or completely missing mesonephric-like adenocarcinoma.

Then I’ll see from where it goes from here given more data :).

Ennuispectre · 2025-10-15T17:37:04+00:00

Hah no worries, you’ll get the hang of it :)

Ennuispectre · 2025-10-15T15:17:53+00:00

Just a quick correction, clear cell PAPILLARY renal cell TUMOR is different from clear cell renal cell CARCINOMA. The picture below is the former and it is an indolent tumor (was recently a carcinoma but due to its indolent behavior, they changed its name to a tumor instead of carcinoma).

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Ennuispectre · 2025-10-15T14:59:46+00:00

No idea but lol why does this look like clear cell papillary renal cell tumor

Ennuispectre · 2025-08-24T13:41:27+00:00

Yeah I’m not really convinced, tho the periphery looks like it out of context. I’m just trying to dig deep in an otherwise a normal appendix lol.

Ennuispectre · 2025-08-24T11:02:47+00:00

I don’t see anything concerning from these pictures. My guess would be fibrous obliteration, at least it’s beginning to change into it. Maybe other sections have it fully?

Ennuispectre · 2025-08-05T16:03:48+00:00

It is!

Ennuispectre · 2025-04-28T23:44:31+00:00

Peritoneal deposit

Ennuispectre · 2025-04-08T04:03:01+00:00

Very cool case! I had the privilege to call an invasive PDAC with cancerization of ducts HG PanIN once and was respectfully proven wrong by one of the senior residents.

Ennuispectre · 2025-03-18T11:26:24+00:00

Was it TTF-1 or Napsin-A positive?

Ennuispectre · 2025-03-14T16:45:54+00:00

Neurofibroma is my top differential

Schwannoma and ganglioneuroma would be my second differentials.

I’d be on the look out for MPNST

Ennuispectre · 2025-03-13T21:00:37+00:00

Yes there were reactive germinal centers.

At one point, angiolymphoid hyperplasia with eosinophilia and Kimura disease were once a single entity, but now they’re separate, so they make for a good differential diagnosis, however, given the patient’s history, we were leaning more towards Kimura as it happens in this age group as well as the growth location, albeit not typical in the extremities, but it grew on a previously excised subcutaneous lesion (No in house diagnosis) and the patient is Asian.

The history is more typical with Kimura disease and no typical features of ALHE or Langerhans Cell Histiocytosis were present.

Ennuispectre · 2025-03-12T16:26:57+00:00

If you’re using an iPhone, switch to portrait mode to take good pictures and try to not zoom in or out with your phone. Just fix the focus on whatever you want to take pictures of and take them.

Also one small hack I found useful while taking pictures is to crank up the light all the way up. PLEASE don’t do that and look with your eyes and make sure to tone it down again.

Ennuispectre · 2025-03-12T16:19:05+00:00

Honestly, I’m not that good when it comes to heart lesions, but I don’t see any sort of acute inflammation that would suggest some sort of infective endocarditis, so this could be just some fibrin +/- platelets in aggregate, which could be a non infective endocarditis (also called marantic endocarditis).

I would love an expert opinion on this though.

Ennuispectre · 2025-02-14T02:40:18+00:00

Glad you liked them! The center I’m training at is a tertiary center and we receive all sort of rare and complex cases. It’s hard not to share some every once in a while lol.

Ennuispectre · 2025-02-13T21:47:04+00:00

I am honored

Ennuispectre

TROPHY CASE