O brave and wise Tweeples is this malignant? Adeno or squamous? Lepidic or not? Lung nodule, core needle biopsy, adult.

#pathology #pulmpath
Correct answer: melanoma

This lepidic pattern was very focal but is strikingly highlighted by the SOX-10 #ihcpath (see pic). Diagnosis was not hard (h/o melanoma). The other 2 pics are rest of tumor (H&E and SOX-10).

Kudos to @Path_Matt and others for guessing this correctly!
Correct answer: melanoma This lepidic pattern was very focal but is strikingly highlighted by the SOX-10 #ihcpath (see pic). Diagnosis was not hard (h/o melanoma). The other 2 pics are rest of tumor (H&E and SOX-10). Kudos to @Path_Matt and others for guessing this correctly!
Correct answer: melanoma This lepidic pattern was very focal but is strikingly highlighted by the SOX-10 #ihcpath (see pic). Diagnosis was not hard (h/o melanoma). The other 2 pics are rest of tumor (H&E and SOX-10). Kudos to @Path_Matt and others for guessing this correctly!
Correct answer: melanoma This lepidic pattern was very focal but is strikingly highlighted by the SOX-10 #ihcpath (see pic). Diagnosis was not hard (h/o melanoma). The other 2 pics are rest of tumor (H&E and SOX-10). Kudos to @Path_Matt and others for guessing this correctly!
Sorry for concealing history and rest of tumor. It would have been too easy with those! I was devious. Devious.
This case reminded me of a post by @JenniferBoland7

My take home message: melanoma mets to lung can grow in a lepidic pattern, at least focally

PS: makes me (again) question the dogma that lepidic = noninvasive https://twitter.com/jenniferboland7/status/1032065532839772160
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