PGY4 AP/CP @UWlabmedpath 🇺🇸 26-27 @StanfordPath #GYNpath fellow 😍 @RCSI_irl 22 alum 🇮🇪 Creator of #PathWebinarPearls 🧵I Trainee #PathTweetAward 23&24
Seattle, WA
Joined September 2020
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I am a huge proponent of educational webinars for learning 🧠 #PathWebinarPearls
👇👇👇is a compiled list of societies that regularly host educational webinars- many of which I have listened to myself! Most of these are FREE for residents, you may need to register as a member.
Carol N. Rizkalla, MD retweeted
#GUpath TURBT from today's signout showing what I call "3/4 rule" of MP invasion
(if tumor is three-quarters of the way around MP bundle but not technically IN bundle, I'll still call it MP invasion)
for good measure, lower power shots show more typically pattern MP invasion
Carol N. Rizkalla, MD retweeted
I'm honored to receive this @StanfordPath award!
helps solidify my mantra:
#ABT (always be teaching)
also, go #GUpath‼️💪🏼🔬
Carol N. Rizkalla, MD retweeted
Routine minimum IHC for metastatic tumors - prostate cancer
- Prostate markers: NKX3.1, AR
- Neuroendocrine markers: Synaptophysin, chromogranin, and INSM1
- Others to consider: Ki67, p53, RB
Per NCCN, all metastatic biopsies should undergo NGS testing.
Dr. Chan #USCAP2026 #pathology #PathX #PathTwitter
Carol N. Rizkalla, MD retweeted
A little over two years ago, I stood in front of the @LoyolaStritch Class of 2026 as their M2 pathology instructor before heading to Michigan. Last week, I had the profound honor of returning to deliver their commencement address. Full circle in the best possible way.
I spoke to them about curiosity, wonder, resilience. About the bone marrow, of course (I promise it made sense).
I want them to remember that medicine is still sacred work. In a world moving faster and louder every day, I hope they protect the part of themselves that still pauses in awe at the privilege of caring for another human being.
To the Stritch School of Medicine Class of 2026: thank you for allowing me to be a small part of your journey, both then and now. Watching you cross that stage was a privilege I will never forget.
Never stop exploring.
youtu.be/JRSdL1LpDrg?si=IuhG…
Carol N. Rizkalla, MD retweeted
📣 Join us for the next @GU_Path_Society Virtual Education Series!
🧬 Tumor Staging in GU Pathology (Part 1)
📅 June 23, 2026 | ⏰ 12–1:30 PM EST
Featuring: 👨⚕️ Dr. Tekin @buraktekinmd
👨⚕️ Dr. Sangoi @slusagar
👩⚕️ Dr. Siegmund
Register now 👉 us02web.zoom.us/webinar/regi…
Carol N. Rizkalla, MD retweeted
#GUpath orchiectomy w/embryonal carcinoma showing LVI in main specimen
spermatic cord shows discontinuous (non LVI here) involvement
current AJCC calls this pM1, but NCCN seemingly blows this off, saying to instead stage as pT3
🤔🔬🙈⁉️
⏬cont'd⏬
Carol N. Rizkalla, MD retweeted
Yet another sneaky treacherous one...
Keep your eyes wide open, children.
#breastpath
Carol N. Rizkalla, MD retweeted
#PathQuiz 🔬🧬
A) Chromophobe RCC
B) Oncocytoma
C) SDH-Deficient RCC
D) Low-grade Oncocytic Tumor
#Pathology #GUPath #KidneyPath
ALT Incidental renal mass in a 55-year-old male. The tumor is well-circumscribed and mahogany-brown on gross inspection. Solid growth of eosinophilic cells with bland nuclei lacking prominent nucleoli @IARCWHO
Carol N. Rizkalla, MD retweeted
🧩 Bloody Bladder
When signing out this lesion, what clinical question comes to mind?
👨 65-year-old man
• Prior prostate adenocarcinoma?
👩 45-year-old woman
• Prior cervical carcinoma?
not always.
So… what’s the diagnosis? 🤔
#DxMindMap #BladderTumor #PathTwitter #JHUPath
Carol N. Rizkalla, MD retweeted
while not formally staged since not "carcinoma", rarely can you get "pT3a" histology🔬
(vascular/adipose/pelvicalyceal invasion)
doesn't change Dx!
(but if occurs, probably worth confirming Dx by doing NGS to rule out DDx entities)
PMID: 38422612
Carol N. Rizkalla, MD retweeted
60 yo with diverticulitis and peritoneal nodule
Final diagnosis: Submesothelial fibroblasts with keratin expression (keratin IHC pic 3)
The cells can also coexpress desmin. They are a normal finding and reactive change and should not be interpreted as carcinoma.
Dr. Fritchie #USCAP2026 #PathX #pathology #PathTwitter
Carol N. Rizkalla, MD retweeted
45 yo female with a "bump" in tongue
Subsite not given
Pale intraepithelial structures (CK7+) with underlying S100+ spindle cells and chronic inflammation
Diagnosis: Normal taste bud (circumvallate papilla)
- Normal taste buds appear as pale structures on HE (CK7 +, Pic 2)
- S100+ spindle cells and chronic inflammation are expected underneath, Pic 3
- Most prominent in circumvallate papillae (posterior tongue)
- Do not mistake for Paget disease or neural neoplasm
Dr. Cipriani #USCAP2026 #PathX #PathTwitter
Carol N. Rizkalla, MD retweeted
✅ Endometrial atypical hyperplasia / EIN 🎯
• Defined as a geographical lesion where the glandular volume exceeds the stromal volume.
• Shows significant cytological atypia (loss of polarity, rounded nuclei) distinct from background glands.
• It is a clonal proliferation and a direct precursor to low-grade endometrioid adenocarcinoma.
• Often associated with loss of PTEN or PAX2 expression.
ALT The geographical region is visible at low magnification: its architecture shows aggregates of glands that exceed the volume of stroma. @IARCWHO
ALT Densely packed endometrial glands with little intervening stroma. @IARCWHO
ALT The nuclear and cytoplasmic features of the crowded glands differ from those of the entrapped non-atypical gland. @IARCWHO
ALT The atypical gland with enlarged, irregularly distributed nuclei (left) is distinct from an adjacent non-lesional gland (right). @IARCWHO
Carol N. Rizkalla, MD retweeted
Endometrial Adenocarcinoma: Depth of Invasion – Challenging scenarios 🔬
✅ Avoid the cornu – naturally thinner, can lead to over-staging
✅ Tumor in a leiomyoma? Include it in your invasion measurement if it’s the deepest point
✅ Invasion from adenomyosis in outer half? Stage as pT1b (per ICCR & ISGyP).
Dr. Joehlin / Dr. McGregor - Short course #USCAP2026 #pathology #PathX #PathTwitter
Carol N. Rizkalla, MD retweeted
The International Society of Gynecological Pathologists Education Committee proudly congratulates the recipients of ISGyP trainee presentation awards at USCAP Texas, March 2026! 🎉👏 #Pathology #Gynaepath #Gynpath #PathTwitter
Carol N. Rizkalla, MD retweeted
no better way to start a Monday than with #beautyinb9 #GUpath nephrogenic adenoma!
simple prostatectomy for BPH, remote h/o 3+3 prostatic adenocarcinoma
Carol N. Rizkalla, MD retweeted
#PathQuiz 🔬🦴
_______ rearrangement
A) USP6
B) FN1
C) COL12A1
D) GRM1
#Pathology #SoftTissuePath #BonePath #MolecularPath
Clue in caption 🧐
@IARCWHO
ALT A 22-year-old male presents with chronic pain in his proximal tibia. Imaging shows an eccentric, metaphyseal, lobulated lytic lesion with a sclerotic margin. Stellate cells embedded in a myxoid matrix are seen on the right with more cellular areas containing round cells on the left @IARCWHO
