Anna Vasileva (@pathoblog) header
Anna Vasileva (@pathoblog) profile picture

Pathologist who loves a good diagnostic puzzle 🔬 | Educator at heart | Here to share cases, tips & the occasional plot twist under the microscope

Joined March 2020
7/9 Look at these numbers. 65% of patients had tumor shrinkage on tucatinib + trastuzumab. Median OS: 24.1 months (95% CI 20.3–36+). For context — standard salvage chemo in the same line gives ~6–7 months These aren't abstract statistics. This is what HER2 testing can unlock 👆
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6/9 Good news: there are now real options 🎯 FDA approved two regimens for HER2+ mCRC: — tucatinib + trastuzumab (MOUNTAINEER, 2023) — trastuzumab deruxtecan / T-DXd (DESTINY-CRC02, 2024) (old but gold picture)
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🧵 1/9 Elderly male. Metastatic colorectal cancer with liver mets. RAS wild-type — looks straightforward. Then the molecular profile comes back: HER2 IHC 3+. This changes the entire treatment plan. Here's why 👇
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2/6 H&E shows sheets of clear cells with abundant pale cytoplasm, small uniform nuclei, and a prominent vascular pattern. Your differential? 🤔 Clear cell hidradenoma? Sebaceous carcinoma? Something else entirely?
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🧵 1/6 A nodule on the face. Sent as a skin biopsy. No clinical history provided. Spoiler: this is NOT a primary skin tumor. 👇 #pathtwitter #dermpath #uropath #pathology
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🧵 Not all breast carcinomas are created equal 🧬 Here's how p63 expression shifts as tumors progress toward a basal/stem-cell phenotype👇 #pathtwitter #breastpath #pathology
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Gastric biopsy — almost called it poorly differentiated carcinoma. Lesson learned: always dig deeper on low-grade gastric tumors. Turned out to be metastatic melanoma. Patient had a history of melanoma. Never skip the clinical context. 🔬 #pathology #pathtwitter #gipath
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Metastasis of goldfishoma to lymph node 🐠 #pathtwitter #pathart
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Phyllodes tumor of the breast with liposarcoma. Beautiful bizarre cells! 👻 #pathtwitter #breastpath
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So cute and classic molluscum contagiosum 🌸 #pathtwitter #dermpath
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Hemangioma in the pelvic lymph node, an incidental finding. #pathtwitter #hemepath
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Patient with tuberculosis in anamnesis. Gray nodule from the periphery of the lung, d 2 cm. Thick fibrous capsule on the outside, necrosis on the inside. Inside the capsule a lining of atypical cells + lymphovascular invasion. #pathtwitter #lungpath #pulmpath
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Interesting growth of mts melanoma in the brain #PathTwitter #neuropath #dermpath
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This is what a pathologist looks like according to the neural network :) #pathtwitter #pathart #midjourney
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