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Tweetorial on vimentin. Follow the thread... #Tweetorial #pathtweetorial
The Ten Commandments of Vimentin:
1. It’s useless.
https://abs.twimg.com/emoji/v2/... draggable="false" alt="✅" title="Fettes weißes Häkchen" aria-label="Emoji: Fettes weißes Häkchen">
It’s stains carcinomas, melanomas, lymphomas. Pretty much everything. Ok, not everything, but close. https://twitter.com/drsmbean/status/1246097470175789064">https://twitter.com/drsmbean/...
The Ten Commandments of Vimentin:
1. It’s useless.
It’s stains carcinomas, melanomas, lymphomas. Pretty much everything. Ok, not everything, but close. https://twitter.com/drsmbean/status/1246097470175789064">https://twitter.com/drsmbean/...
The Ten Commandments of Vimentin:
2. Just because something is positive for vimentin doesn’t mean it’s a sarcoma.https://abs.twimg.com/emoji/v2/... draggable="false" alt="✅" title="Fettes weißes Häkchen" aria-label="Emoji: Fettes weißes Häkchen">
Check out this masterpiece by @JMGardnerMD
https://youtu.be/LNr_cLW1sV0 ">https://youtu.be/LNr_cLW1s...
2. Just because something is positive for vimentin doesn’t mean it’s a sarcoma.
Check out this masterpiece by @JMGardnerMD
https://youtu.be/LNr_cLW1sV0 ">https://youtu.be/LNr_cLW1s...
Check out this masterpiece by @JMGardnerMD https://youtu.be/LNr_cLW1s... " title="The Ten Commandments of Vimentin:2. Just because something is positive for vimentin doesn’t mean it’s a sarcoma. https://abs.twimg.com/emoji/v2/... draggable="false" alt="✅" title="Fettes weißes Häkchen" aria-label="Emoji: Fettes weißes Häkchen">Check out this masterpiece by @JMGardnerMD https://youtu.be/LNr_cLW1s... " class="img-responsive" style="max-width:100%;"/>
3. Just because something is positive for vimentin doesn’t mean it’s mesenchymal. https://abs.twimg.com/emoji/v2/... draggable="false" alt="✅" title="Fettes weißes Häkchen" aria-label="Emoji: Fettes weißes Häkchen">
Check out this sarcomatoid lung carcinomahttps://abs.twimg.com/emoji/v2/... draggable="false" alt="👇🏾" title="Rückhand Zeigefinger nach unten (durchschnittlich dunkler Hautton)" aria-label="Emoji: Rückhand Zeigefinger nach unten (durchschnittlich dunkler Hautton)">https://abs.twimg.com/emoji/v2/... draggable="false" alt="👇🏾" title="Rückhand Zeigefinger nach unten (durchschnittlich dunkler Hautton)" aria-label="Emoji: Rückhand Zeigefinger nach unten (durchschnittlich dunkler Hautton)">
https://twitter.com/smlungpathguy/status/1273997334934888451?s=21">https://twitter.com/smlungpat... https://twitter.com/smlungpathguy/status/1273997334934888451">https://twitter.com/smlungpat...
Check out this sarcomatoid lung carcinoma
https://twitter.com/smlungpathguy/status/1273997334934888451?s=21">https://twitter.com/smlungpat... https://twitter.com/smlungpathguy/status/1273997334934888451">https://twitter.com/smlungpat...
4. Vimentin is not required for the diagnosis of any sarcoma. https://abs.twimg.com/emoji/v2/... draggable="false" alt="✅" title="Fettes weißes Häkchen" aria-label="Emoji: Fettes weißes Häkchen">
As a thought experiment, take any sarcoma where vimentin was used, take it away, and ask yourself “would this diagnosis still be valid without vimentin?”.
Hint: the answer is yes.
https://twitter.com/texpathol/status/1235920633965481986?s=21">https://twitter.com/texpathol... https://twitter.com/texpathol/status/1235920633965481986">https://twitter.com/texpathol...
As a thought experiment, take any sarcoma where vimentin was used, take it away, and ask yourself “would this diagnosis still be valid without vimentin?”.
Hint: the answer is yes.
https://twitter.com/texpathol/status/1235920633965481986?s=21">https://twitter.com/texpathol... https://twitter.com/texpathol/status/1235920633965481986">https://twitter.com/texpathol...
5. A malignant spindle cell neoplasm in the lung (or any organ where carcinomas are common) is FAR more likely to be sarcomatoid carcinoma than sarcoma. https://abs.twimg.com/emoji/v2/... draggable="false" alt="✅" title="Fettes weißes Häkchen" aria-label="Emoji: Fettes weißes Häkchen">
PS: this examplehttps://abs.twimg.com/emoji/v2/... draggable="false" alt="👇🏾" title="Rückhand Zeigefinger nach unten (durchschnittlich dunkler Hautton)" aria-label="Emoji: Rückhand Zeigefinger nach unten (durchschnittlich dunkler Hautton)"> has malignant glands so it’s easy but others are pure spindle cell tumors.
https://twitter.com/smlungpathguy/status/983511970333773824?s=21">https://twitter.com/smlungpat... https://twitter.com/smlungpathguy/status/983511970333773824">https://twitter.com/smlungpat...
PS: this example
https://twitter.com/smlungpathguy/status/983511970333773824?s=21">https://twitter.com/smlungpat... https://twitter.com/smlungpathguy/status/983511970333773824">https://twitter.com/smlungpat...
6. Rare uses of vimentin in other settings may exist, but the vast majority of vimentin stains are done (wrongly) as a marker for sarcoma. https://abs.twimg.com/emoji/v2/... draggable="false" alt="✅" title="Fettes weißes Häkchen" aria-label="Emoji: Fettes weißes Häkchen">
Check out a non-sarcoma use suggested by GU guru (and my neighbor and colleague) @Williamson_SR
https://twitter.com/williamson_sr/status/1274294508637818881?s=21">https://twitter.com/williamso... https://twitter.com/williamson_sr/status/1274294508637818881">https://twitter.com/williamso...
Check out a non-sarcoma use suggested by GU guru (and my neighbor and colleague) @Williamson_SR
https://twitter.com/williamson_sr/status/1274294508637818881?s=21">https://twitter.com/williamso... https://twitter.com/williamson_sr/status/1274294508637818881">https://twitter.com/williamso...
7. No one gets a vimentin stain to check if the tissue is immunoreactive. Honestly. C’mon. Seriously?https://abs.twimg.com/emoji/v2/... draggable="false" alt="✅" title="Fettes weißes Häkchen" aria-label="Emoji: Fettes weißes Häkchen">
8. IHC that might help in spindle cell tumors of lung: pankeratin, another pankeratin, TTF-1, p40, STAT-6, ALK (esp D5F3). FISH helps sometimes. Not vimentin. Never vimentin.https://abs.twimg.com/emoji/v2/... draggable="false" alt="✅" title="Fettes weißes Häkchen" aria-label="Emoji: Fettes weißes Häkchen">
#ihcpath #vimentin
https://twitter.com/smlungpathguy/status/800257514881372161?s=21">https://twitter.com/smlungpat... https://twitter.com/smlungpathguy/status/800257514881372161">https://twitter.com/smlungpat...
#ihcpath #vimentin
https://twitter.com/smlungpathguy/status/800257514881372161?s=21">https://twitter.com/smlungpat... https://twitter.com/smlungpathguy/status/800257514881372161">https://twitter.com/smlungpat...
9. Even more helpful than IHC: history of sarcoma, imaging, H&E morphology. If all fails, consult a soft tissue pathologist. No vimentin. Nunca. Never. Kabhi nahi.https://abs.twimg.com/emoji/v2/... draggable="false" alt="✅" title="Fettes weißes Häkchen" aria-label="Emoji: Fettes weißes Häkchen">
https://twitter.com/smlungpathguy/status/998746373502767105?s=21">https://twitter.com/smlungpat... https://twitter.com/smlungpathguy/status/998746373502767105">https://twitter.com/smlungpat...
https://twitter.com/smlungpathguy/status/998746373502767105?s=21">https://twitter.com/smlungpat... https://twitter.com/smlungpathguy/status/998746373502767105">https://twitter.com/smlungpat...
10. So the next time you think about ordering vimentin to “rule out sarcoma”, ask yourself: Whymentin?https://abs.twimg.com/emoji/v2/... draggable="false" alt="😩" title="Mattes Gesicht" aria-label="Emoji: Mattes Gesicht">
I will close with this excellent paper by @IHC_guy and @LizMontgomeryMD and Jason Hornick.
https://doi.org/10.1016/j.anndiagpath.2019.151419
https://doi.org/10.1016/j... class="Emoji" style="height:16px;" src=" https://abs.twimg.com/emoji/v2/... draggable="false" alt="💥" title="Symbol für eine Kollision" aria-label="Emoji: Symbol für eine Kollision">https://abs.twimg.com/emoji/v2/... draggable="false" alt="💥" title="Symbol für eine Kollision" aria-label="Emoji: Symbol für eine Kollision">https://abs.twimg.com/emoji/v2/... draggable="false" alt="💥" title="Symbol für eine Kollision" aria-label="Emoji: Symbol für eine Kollision"> https://abs.twimg.com/emoji/v2/... draggable="false" alt="💥" title="Symbol für eine Kollision" aria-label="Emoji: Symbol für eine Kollision"> end of thread https://abs.twimg.com/emoji/v2/... draggable="false" alt="💥" title="Symbol für eine Kollision" aria-label="Emoji: Symbol für eine Kollision">https://abs.twimg.com/emoji/v2/... draggable="false" alt="💥" title="Symbol für eine Kollision" aria-label="Emoji: Symbol für eine Kollision">https://abs.twimg.com/emoji/v2/... draggable="false" alt="💥" title="Symbol für eine Kollision" aria-label="Emoji: Symbol für eine Kollision">https://abs.twimg.com/emoji/v2/... draggable="false" alt="💥" title="Symbol für eine Kollision" aria-label="Emoji: Symbol für eine Kollision">
I will close with this excellent paper by @IHC_guy and @LizMontgomeryMD and Jason Hornick.
https://doi.org/10.1016/j.anndiagpath.2019.151419
I will close with this excellent paper by @IHC_guy and @LizMontgomeryMD and Jason Hornick. https://doi.org/10.1016/j... class="Emoji" style="height:16px;" src=" " title="10. So the next time you think about ordering vimentin to “rule out sarcoma”, ask yourself: Whymentin?https://abs.twimg.com/emoji/v2/... draggable="false" alt="😩" title="Mattes Gesicht" aria-label="Emoji: Mattes Gesicht">I will close with this excellent paper by @IHC_guy and @LizMontgomeryMD and Jason Hornick. https://doi.org/10.1016/j... class="Emoji" style="height:16px;" src=" " class="img-responsive" style="max-width:100%;"/>
