Laryngeal carcinosarcoma (sarcomatoid SCC). Sometimes you have to look v hard to find any evidence of epithelial differentiation. This was the only 1mm focus +ve for p40 and cytokeratins. Don’t believe it’s a sarcoma until you’ve done levels and every CK in your armoury #ENTPath

Pitfall alert ‼️ SOX10 positivity in basaloid-type SCC. Don’t confuse it for a salivary carcinoma in head & neck (this case was from oral tongue and p16-). Avoid using “basaloid” loosely its a specific subtype with dysplasia and characteristic cribriform collagen (PMID:3770734)

Multilocular lucency posterior mandible curettage. This is an example of the rare granular cell variant of ameloblastoma. The stellate reticulum is replaced by granular cells full of lysosomes (CD68+ S100-) #PathTwitter #OralPath

Warthin’s tumour can undergo infarction and extensive squamous metaplasia mimicking SCC. Here CAM5.2 reveals the prior dual layer no longer visible on H&E. Ki67 and p53 IHC were also reassuring and the lesion was well circumscribed @pathkids @ENTpathology #Pathtwitter

3/3. Antrochoanal polyp of angiectatic type, a diagnosis requiring clinical insight. With polyp removed Joanna can now breathe easy, and relief from the end of this poem most cheesy. #Pathtwitter

1/2. A classical case of IgG4 sialadenitis, with storiform fibrosis, obliterative lymphocytic phlebitis in the 2nd(H&E) and 3rd (EVG) pics, and >40% of the IgG+ve plasma cells in the last pic. #Pathologists

What do you make of this atypia in a parathyroid lesion? Do any of you use parafibromin? @EndoPath @sakhurram @AnnieMcLeanDMD @TheKarenPinto @IHeartPathology @ssaunders279 @Pathmath1 @kriyer68 @diagnexia @TristanRutland7 @MPThomas_Path @SingJamieD #PathTwitter

Squamous metaplasia with keratinisation in a salivary pleomorphic adenoma. A benign metaplastic/degenerative feature but can be challenging when seen on a small biopsy or FNA. #ENTpath #Pathologists #oralpath

Inflammatory antrochoanal polyp of angiectatic type with Masson-like papillary endothelial hyperplasia and benign perivascular bizarre stromal cell atypia. As in the last figure (from lesterthompsonmd.com) these benign myofibroblastic cells are SMA+/ desmin-/ S100-/ keratin-