Robert Futoran

It’s like meeting an old friend in an unexpected place. This is an Inverted Papilloma. As izzypath noted “basiloid cells with peripheral palisading”. They most commonly occur in the trigone region of the bladder so it’s reasonable to assume that this was biopsied during the TURP.

It’s the result of talc peurodesis. A procedure that involves injecting sterilize talc powder into the plural space, causing a tissue reaction, coating the plural, and trying to prevent the recurrence of pneumothorax.

I signed the PAP as HSIL. with comment that despite being HPV- I am worried about invasive carcinoma. I received the call about 2 weeks later telling me he found an endocervical polyp. Bx showed Metastatic melanoma. :)

P16-, ER+,S100- Alright then a beautiful example of tubular carcinoma. Have a great weekend.

This gentleman’s story began at birth with a bivalve aortic valve. Overtime the valve became stenotic and he required an artificial valve. A while later, he developed cardiomyopathy and left ventricular failure. His ejection fraction worsened over time and eventually required a pacemaker. He outlived his first artificial valve which became leaky and required a second mechanical valve. As he entered his 50s, he had more frequent hospital visits for cardiac tune ups. At his final Hospital visit he presented in cardiogenic shock for which modern medicine could no longer fix. Findings included nutmeg liver (chronic passive congestion), marked splenic congestion, and dense lung tissue. The images show what results from slowly progressive left heart failure, which undoubtedly resulted in pulmonary hypertension. The lungs show impressive collateral vessel development. While this looks like pulmonary capillary hemangiomatosis, PCH as I understand is a rare condition characterized by primary capillary proliferation not secondary to PH. But I am not a pulmonary pathologist and will defer to comments from our esteemed Dr. Mukhopadhyay. @smlungpathguy