Academic Head and Neck Pathologist; Specialist in HPV and Squamous Cell Carcinomas
Joined April 2017
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Jim Lewis Jr. retweeted
A basic unit of laryngitis = 1 hoarsepower!
I just couldn't resist the pun for my buddy @LewisPath
Please share: we welcome additional applicants and look forward to learning and practicing with you all. #path_SIG
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We would love to see your applications, budding surgical pathologists!
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Jim Lewis Jr. retweeted
Now this is a cool diagnosis - myelolipoma. A thin rim of adrenal cortex lines an area of mature fat and hematopoietic elements. This case even had some osseous metaplasia. #PathTwitter #MSGPath
Tricky tumors when they arise in the thyroid gland because they can resemble papillary carcinoma, showing papillae, abortive nuclear irregularities like PTC, and PAX8 expression. Must look for the secretory material!
An important consideration in thyroid gland pathology: Secretory Carcinoma of the Thyroid Gland link.springer.com/article/10…
#HeadNeckPathol #HNPJ #HeadandNeckPath #Pathology #ENTPath #SalivaryGland #Carcinoma #PathologyTweet
This was a great event - thanks to CAP for supporting the Guidelines process and this event. @bfaquin @LewisPath #capchat @Pathologists
Nuclear only or cytoplasmic staining only does not count, no matter the intensity or distribution - must be nuclear and cytoplasmic. For any equivocal p16 stains (borderline), your can do HPV-specific testing to resolve (RNA ISH best). #capchat @LewisPath @bfaquin @Pathologists
p16 should be positive in >70% of tumor cells, in both nucleii AND cytoplasm, and with at least moderate intensity in order to use as prognostic marker and surrogate if high risk HPV. #capchat @bfaquin @Pathologists @LewisPath
Cytology specimens get complicated. Bill F can tackle your questions best. #capchat @bfaquin @ALBoothMD @Pathologists @LewisPath
Same is true for all non-oropharyngeal head and neck SCC. No testing for p16 or high risk HPV because of lack of data on significance nor known implication for treatment. @RMeunierMD @LewisPath @entpath @bfaquin #capchat
There is no convincing data that p16 expression in laryngeal SCC means anything for the patient so at this time, we recommend no routine testing of laryngeal SCC for p16 or directly for high risk HPV @RMeunierMD @Pathologists @bfaquin @LewisPath
And 50-60% present with neck symptoms (mass) and 95% of the time this mass is in levels II and III (mid and upper jugular nodes) in the neck.
Most oropharyngeal SCC that are HPV-related have a nonkeratinizing morphology (80-90% of them) which is quite characteristic. #capchat @pathologists #entpath @LewisPath @bfaquin
Join in for the HPV in HN cancer discussion just starting.
(1/3) Good evening and thank you for joining us for our inaugural #capchat discussing the CAP’s published guidelines for HPV testing in Head & Neck Carcinomas bit.ly/2BZwq8y, I’m Dr. Adam L. Booth (@ALBoothMD) and I’ll be moderating from the CAP handle.
Don't miss tomorrow night's #capchat; @ALBoothMD takes over @Pathologists to host with Bill Faquin @bfaquin & me @LewisPath: twubs.com/capchat .
(Pictured: typical nonkeratinizing squamous cell carcinoma. This is classic morphology for HPV-related oropharyngeal SCC.)
Looking forward to more HPV Testing discussions at our October 9th 7PM CST CAP chat!!! #capchat
Recent pub on H&N SCC unknown primary - largest to date - Many HPV related, now showing also better prognosis#pathJC#ENTpathology#ENTpath
Expected, right? HPV 16 90% of HPV+OPSCC, but not proven yet. Long lag time to efficacy likely #pathJC #ENTpath#headandneckpath xitter.cf/Sara_Jiang/status/8545…
The other question is whether we will see a decrease in these tumors in many years if we get better vaccination levels! #pathJC
Look for the new CAP HPV H&N Recommendations in Arch Pathol Lab Med within the year - long, rigorous process nearing completion! #pathJC
CAP should help with the confusion - lots of it out there, for good reason. A very nice visual algorithmic approach figure coming #pathJC xitter.cf/Dr_OrophSCC/status/854…
Time to plug the pending CAP Evidence Based Guidelines HPV Testing in Head and Neck Cancer Recs - expected in 4-6 months #pathjc #ENTpath xitter.cf/LinskeyKaty/status/854…
Time to plug the pending CAP Evidence Based Guidelines HPV Testing in Head and Neck Cancer Recs - expected in 4-6 months #pathjc #ENTpath xitter.cf/LinskeyKaty/status/854…
anyone know when CAP recs will come out for HPV testing? WHO recs direct HPV testing but CAP seemed like it might rec p16 only #pathjc
Good point Simion - p16 testing in Oroph regardless of SCC type or keratinization 70% cutoff. Careful with p16 alone in neck LNs #pathJC xitter.cf/chioseasi/status/85450…
No, p16 IHC oropharynx only! p16 HC and DNA ISH for metastatic nonkerat SCC on unknown primary #pathjc