No abstract

Our novel method provides the foundation to create a robust teaching library. AP is inherently a visual discipline, and by building on the strengths of traditional teaching methods, our dynamic approach allows viewers to appreciate the procedural actions involved in specimen processing.

Rosai-Dorfman disease (RDD) is a rare entity characterized by proliferating S100-positive histiocytes. Originally described in lymph nodes, it can involve extranodal sites. Pancreatic involvement is rare, with <10 cases previously reported. Recent studies demonstrate a possible overlap between RDD and the more common IgG4-related disease (IRD), which could further complicate pathologic diagnosis. We describe distinct morphologic characteristics as well as overlapping histologic features of IRD in 5 cases of pancreatic RDD at our institution and compare these to a cohort of nonpancreatic extranodal RDD cases. All pancreatic cases were mass forming and had spindled patterns of elongated histiocytes with smaller areas of more classical appearing RDD; all cases had areas of storiform fibrosis and dense lymphoplasmacytic infiltrates with no increase in IgG4-positive plasma cells, and all cases had some degree of vasculitis (4 cases had obliterative vasculitis). Thirteen nonpancreatic extranodal RDD cases had dense lymphoplasmacytic infiltrates; most (85%) had some fibrosis with 46% showing storiform fibrosis, 85% had vasculitis with 31% demonstrating obliterative vasculitis and 2 cases had increased IgG4 staining. Extranodal (pancreatic and nonpancreatic) RDD often shows overlapping morphologic features with IRD, including lymphoplasmacytic inflammation, storiform fibrosis with elongated histiocytes and vasculitis. This can create a diagnostic challenge in the pancreas where IRD is more commonly encountered. Pathologists need to be aware that RDD can occur in the pancreas and should include RDD in the differential of any mass forming pancreatic lesion in which morphologic features of IRD are present.

No abstract

Less than 2 months after the first case of coronavirus disease was reported in the United States, its incidence has started to grow exponentially. Without an available vaccine to slow the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), many pathology departments are following the guidance of public health professionals, who recommend the practice of social distancing by avoiding common spaces and generally limiting human interactions. Nationally, at many academic medical centers, this has led to the deferrals of elective procedures and the consolidation of clinical services, thereby considerably reducing the number of attendings, fellows, and residents physically present on campus. To minimize disruptions to the practice of academic pathology, one can leverage modern information and communication technologies to create virtual connections.Daily consensus conferences in our pathology laboratories, including cytology, are valuable, educational, and necessary, but sitting around a multihead microscope with several colleagues neutralizes the goal of social distancing. Using web-based video conferencing tools with an end-to-end encrypted connection allows pathologists to share diagnostically challenging cases remotely. Once the online conference is initiated, invited participants can join the session. One or more participants can share their computer screen, enabling them to broadcast the feed of a microscope-mounted camera as they drive a slide in real time (Fig. 1). Other windows, such as the electronic health record or laboratory information system, can be shared. Participants communicate via chat or voice (computer microphone or telephone call). A collaboration interface component facilitates on-screen annotations, which are ideal for highlighting diagnostic findings. Similarly, other clinical activities such as multidisciplinary tumor boards can benefit from the same setup, in which clinicians, diagnosticians, and surgeons can broadcast patients' charts and diagnostic imaging while openly discussing management plans.One of the pillars of academic pathology is the education of residents and fellows. In emergencies wherein workforce preservation is of the utmost importance, residents and fellows may be asked to stay home unless covering a critical service. To mitigate the loss of teaching "scope" sessions, pathologists continue to review cases with residents and fellows following an approach similar to that of consensus conferences. Another essential educational effort is a daily "unknown" session. These sessions present a unique challenge when most residents are remote, considering they need to review the glass slides before the meeting. Using whole-slide imaging scanners capable of producing multilayer captures, which are particularly important for cytology specimens, enables us to distribute digitized slides for remote viewing through our web-based educational platform.At the Massachusetts General Hospital, the resiliency of our anatomic, clinical, and cytology laboratories has been ...

The complementary use of either precut technique provides a satisfactory biliary cannulation rate. However, the rates of pancreatitis and other severe complications are higher for transpancreatic versus needle-knife precut, therefore the indications for both techniques should be modified.

Pancreatic tuberculosis (TB) is a rare but important entity to consider when evaluating a pancreatic mass, especially in patients from endemic areas. Its clinical and radiologic features may mimic those of a pancreatic neoplasm, making it a difficult clinical diagnosis. We present a case of a 31-year-old Indian man who presented with fevers, night sweats, weight loss, and epigastric pain. Abdominal magnetic resonance imaging (MRI) showed a pancreatic head mass. Biopsy of the mass was consistent with pancreatic tuberculosis.

Social networking platforms have created a unique venue for pathologists and associated stakeholders to communicate and share information in a rapidly proliferating field. Among the myriad of available platforms, Twitter has become one of the most widely accepted by healthcare professionals, for its ease of use, similarities to a real life conversation, and vast global reach. Although the adaptation rate of Twitter continues to grow, many healthcare professionals perceive the establishment and maintenance of an online presence to be a daunting task, leaving some on the outside, looking in. By creating this practical reference, we hope to elucidate the necessary steps for pathologists and their organizations to join and effectively engage the healthcare community on Twitter. The reader is encouraged to review the provided glossary of key terms (Table 1) and the anatomy of a tweet (Figure 1) before reading this Timely Review. Diagn. Cytopathol. 2017;45:621-628. © 2017 Wiley Periodicals, Inc.