Kelly Magliocca DDS, MPH
@kmagliocca.bsky.social
Oral, Head and Neck Pathology I Service Director H&N Pathology I Professor @emorypathology.bsky.social
📸 Amazing how the background parotid tissue fills in so nicely on permanent sections (it is the same block! I promise!) Can better appreciate variations in cellularity and patchy hemorrhage that contribute to the gross appearance
📸 chondroid matrix, ducts and myoeps on permanent sections
#PathSky
📸 chondroid matrix, ducts and myoeps on permanent sections
#PathSky
November 22, 2025 at 3:00 AM
📸 Amazing how the background parotid tissue fills in so nicely on permanent sections (it is the same block! I promise!) Can better appreciate variations in cellularity and patchy hemorrhage that contribute to the gross appearance
📸 chondroid matrix, ducts and myoeps on permanent sections
#PathSky
📸 chondroid matrix, ducts and myoeps on permanent sections
#PathSky
📸 frozen section, tumor capsule
📸 frozen section, epithelial cells (ducts) and myoepithelial cells
📸 frozen section, nests of myoepithelial cells in myxochondroid matrix
Dx: pleomorphic adenoma
#Pathsky
📸 frozen section, epithelial cells (ducts) and myoepithelial cells
📸 frozen section, nests of myoepithelial cells in myxochondroid matrix
Dx: pleomorphic adenoma
#Pathsky
November 21, 2025 at 4:21 PM
📸 frozen section, tumor capsule
📸 frozen section, epithelial cells (ducts) and myoepithelial cells
📸 frozen section, nests of myoepithelial cells in myxochondroid matrix
Dx: pleomorphic adenoma
#Pathsky
📸 frozen section, epithelial cells (ducts) and myoepithelial cells
📸 frozen section, nests of myoepithelial cells in myxochondroid matrix
Dx: pleomorphic adenoma
#Pathsky
Frozen-section-Friday:
Adult with 2 cm parotid mass sent for intraoperative consultation
📸: solitary, largely circumscribed, cut surface w internal heterogeneity
📸: touch prep - monotonous cells (myoeps) w/i basophilic matrix
📸: low mag nodule contour at frozen section
…next
#PathSky #ENTsky
Adult with 2 cm parotid mass sent for intraoperative consultation
📸: solitary, largely circumscribed, cut surface w internal heterogeneity
📸: touch prep - monotonous cells (myoeps) w/i basophilic matrix
📸: low mag nodule contour at frozen section
…next
#PathSky #ENTsky
November 21, 2025 at 3:40 PM
Partial auriculectomy for basal cell carcinoma (not shown) in pt with known history of Darier disease
📸 macro: portion of helix, formalin-fixed with multiple punctate lesions (arrow) and small plaques
📸 macro, cut-surface: firm, rust/white colored plaques confined to epidermis
#dermpath #Pathsky
📸 macro: portion of helix, formalin-fixed with multiple punctate lesions (arrow) and small plaques
📸 macro, cut-surface: firm, rust/white colored plaques confined to epidermis
#dermpath #Pathsky
November 9, 2025 at 2:56 PM
Biopsy of anterior true vocal cord, sent for intraop consult. Pt with history of glottic squamous cell ca, s/p radiation therapy. Biopsy neg for scca. However…
📸 tyrosine-like crystalloids w/i anterior macula flava (is chondroid here)
📸 TLCs not commonly seen at frozens
PMID: 39177813
#Pathsky
📸 tyrosine-like crystalloids w/i anterior macula flava (is chondroid here)
📸 TLCs not commonly seen at frozens
PMID: 39177813
#Pathsky
November 6, 2025 at 6:20 PM
Biopsy of anterior true vocal cord, sent for intraop consult. Pt with history of glottic squamous cell ca, s/p radiation therapy. Biopsy neg for scca. However…
📸 tyrosine-like crystalloids w/i anterior macula flava (is chondroid here)
📸 TLCs not commonly seen at frozens
PMID: 39177813
#Pathsky
📸 tyrosine-like crystalloids w/i anterior macula flava (is chondroid here)
📸 TLCs not commonly seen at frozens
PMID: 39177813
#Pathsky
Adult male; White corrugated plaque on lateral oral tongue
Dx: oral hairy leukoplakia
Low: epithelial hyperplasia, shaggy corrugated parakeratotic surface, often pallor in spinous layer
High: perinuclear clearing, nuclear beading
EBV ISH (red): nuclear signal in affected cells
#PathSky
Dx: oral hairy leukoplakia
Low: epithelial hyperplasia, shaggy corrugated parakeratotic surface, often pallor in spinous layer
High: perinuclear clearing, nuclear beading
EBV ISH (red): nuclear signal in affected cells
#PathSky
November 3, 2025 at 6:40 PM
Adult male; White corrugated plaque on lateral oral tongue
Dx: oral hairy leukoplakia
Low: epithelial hyperplasia, shaggy corrugated parakeratotic surface, often pallor in spinous layer
High: perinuclear clearing, nuclear beading
EBV ISH (red): nuclear signal in affected cells
#PathSky
Dx: oral hairy leukoplakia
Low: epithelial hyperplasia, shaggy corrugated parakeratotic surface, often pallor in spinous layer
High: perinuclear clearing, nuclear beading
EBV ISH (red): nuclear signal in affected cells
#PathSky
Solitary, exophytic nodule at posterior dorsal tongue.
Dx: lingual osseous choristoma
📸: oral mucosa with central focus of dense lamellar bone
📸: relation of bone to overlying oral squamous epithelium
📸: lamellar bone (slightly over-decal’d) with evidence of remodeling
#PathSky #ENTsky
Dx: lingual osseous choristoma
📸: oral mucosa with central focus of dense lamellar bone
📸: relation of bone to overlying oral squamous epithelium
📸: lamellar bone (slightly over-decal’d) with evidence of remodeling
#PathSky #ENTsky
October 27, 2025 at 9:46 PM
Mid-30’s FM w/progressive conductive hearing loss. Clin dx: otosclerosis
Intraop: stapes fixed, remainder of ossicular chain mobile.
📸: stapes with remodeling, transected above footplate
📸: evolving pseudocyst w/i the articular surface (reactive)
#PathSky #ENTpath #PathTwitter #EmoryPathology
Intraop: stapes fixed, remainder of ossicular chain mobile.
📸: stapes with remodeling, transected above footplate
📸: evolving pseudocyst w/i the articular surface (reactive)
#PathSky #ENTpath #PathTwitter #EmoryPathology
October 27, 2025 at 3:37 PM
Mid-30’s FM w/progressive conductive hearing loss. Clin dx: otosclerosis
Intraop: stapes fixed, remainder of ossicular chain mobile.
📸: stapes with remodeling, transected above footplate
📸: evolving pseudocyst w/i the articular surface (reactive)
#PathSky #ENTpath #PathTwitter #EmoryPathology
Intraop: stapes fixed, remainder of ossicular chain mobile.
📸: stapes with remodeling, transected above footplate
📸: evolving pseudocyst w/i the articular surface (reactive)
#PathSky #ENTpath #PathTwitter #EmoryPathology
📸Transverse section through the cricoarytenoid joint (CAJ) of the larynx, a true synovial joint. Arrows delineate joint space
📸 Same, just higher mag
📸 Generally surfaced by fibrocartilage (but may be mixed). Synovium present
📸 Synovial lining
#PathSky #ENTPath #PathTwitter
#EmoryPathology
📸 Same, just higher mag
📸 Generally surfaced by fibrocartilage (but may be mixed). Synovium present
📸 Synovial lining
#PathSky #ENTPath #PathTwitter
#EmoryPathology
October 20, 2025 at 10:02 PM
📸Transverse section through the cricoarytenoid joint (CAJ) of the larynx, a true synovial joint. Arrows delineate joint space
📸 Same, just higher mag
📸 Generally surfaced by fibrocartilage (but may be mixed). Synovium present
📸 Synovial lining
#PathSky #ENTPath #PathTwitter
#EmoryPathology
📸 Same, just higher mag
📸 Generally surfaced by fibrocartilage (but may be mixed). Synovium present
📸 Synovial lining
#PathSky #ENTPath #PathTwitter
#EmoryPathology
Squamous cell carcinoma of the edentulous alveolar ridge and palate. Cut surface (ms=maxillary sinus; nc=nasal cavity); corresponding low mag image; endophytic (arrow) with cystic cuniculatum-like growth; additional cystic change in scca.
#PathSky #ENTPath #HeadNeckPath #OralPath #PathTwitter
#PathSky #ENTPath #HeadNeckPath #OralPath #PathTwitter
October 13, 2025 at 4:21 PM
Squamous cell carcinoma of the edentulous alveolar ridge and palate. Cut surface (ms=maxillary sinus; nc=nasal cavity); corresponding low mag image; endophytic (arrow) with cystic cuniculatum-like growth; additional cystic change in scca.
#PathSky #ENTPath #HeadNeckPath #OralPath #PathTwitter
#PathSky #ENTPath #HeadNeckPath #OralPath #PathTwitter
This particular case is high grade.
📸 tumor necrosis, solid growth, and increased mitotic rate (3 in this high power field alone).
📸 EWSR1 break apart FISH positive
#PathSky
📸 tumor necrosis, solid growth, and increased mitotic rate (3 in this high power field alone).
📸 EWSR1 break apart FISH positive
#PathSky
August 19, 2025 at 10:08 PM
This particular case is high grade.
📸 tumor necrosis, solid growth, and increased mitotic rate (3 in this high power field alone).
📸 EWSR1 break apart FISH positive
#PathSky
📸 tumor necrosis, solid growth, and increased mitotic rate (3 in this high power field alone).
📸 EWSR1 break apart FISH positive
#PathSky
Nasopharyngeal mass, adult male.
Dx: Hyalinizing clear cell ca.
➡️Nests of eosinophilic and/or clear cells. Helpful: 2 ‘types’ of fibrosis (dense hyalinization and fibrolamellar stromal fibrosis).
#PathSky #ENTsky #HeadNeckSky
Dx: Hyalinizing clear cell ca.
➡️Nests of eosinophilic and/or clear cells. Helpful: 2 ‘types’ of fibrosis (dense hyalinization and fibrolamellar stromal fibrosis).
#PathSky #ENTsky #HeadNeckSky
August 19, 2025 at 10:04 PM
Nasopharyngeal mass, adult male.
Dx: Hyalinizing clear cell ca.
➡️Nests of eosinophilic and/or clear cells. Helpful: 2 ‘types’ of fibrosis (dense hyalinization and fibrolamellar stromal fibrosis).
#PathSky #ENTsky #HeadNeckSky
Dx: Hyalinizing clear cell ca.
➡️Nests of eosinophilic and/or clear cells. Helpful: 2 ‘types’ of fibrosis (dense hyalinization and fibrolamellar stromal fibrosis).
#PathSky #ENTsky #HeadNeckSky
Expansile sinonasal mass, adult FM:
Dx: Epithelial-myoepithelial carcinoma. Biphasic salivary gland carcinoma composed of tightly coupled eosinophilic ductal cells and abluminal myoepithelial cells. Diffuse RAS Q61R IHC expression supportive while working thru the ddx.
PMID: 33481388
#PathSky
Dx: Epithelial-myoepithelial carcinoma. Biphasic salivary gland carcinoma composed of tightly coupled eosinophilic ductal cells and abluminal myoepithelial cells. Diffuse RAS Q61R IHC expression supportive while working thru the ddx.
PMID: 33481388
#PathSky
August 15, 2025 at 1:49 PM
Expansile sinonasal mass, adult FM:
Dx: Epithelial-myoepithelial carcinoma. Biphasic salivary gland carcinoma composed of tightly coupled eosinophilic ductal cells and abluminal myoepithelial cells. Diffuse RAS Q61R IHC expression supportive while working thru the ddx.
PMID: 33481388
#PathSky
Dx: Epithelial-myoepithelial carcinoma. Biphasic salivary gland carcinoma composed of tightly coupled eosinophilic ductal cells and abluminal myoepithelial cells. Diffuse RAS Q61R IHC expression supportive while working thru the ddx.
PMID: 33481388
#PathSky
Adult FM with temporomandibular osteoarthritis
Dx: Subchondral cyst (SC)
SC identified on sagittal CT & subsequently on microscopic examination. 📸➡️ TMJ SC is spherical subchondral lesion w/myxoid change surrounded by reactive bone. Articular cartilage with degenerative changes.
#PathSky #RadSky
Dx: Subchondral cyst (SC)
SC identified on sagittal CT & subsequently on microscopic examination. 📸➡️ TMJ SC is spherical subchondral lesion w/myxoid change surrounded by reactive bone. Articular cartilage with degenerative changes.
#PathSky #RadSky
August 13, 2025 at 2:06 PM
DICER1-associated atrophic changes in this min. invasive FTC. Rim of pale, flattened tumor cells adjacent to non-affected tumor. Circumferential, no cellular debris, apoptotics or inflammation; argues against necrosis.
🙌 🙏 to author KV in PMID:38637342 for teaching me!
#PathSky #Thyroid #Endosky
🙌 🙏 to author KV in PMID:38637342 for teaching me!
#PathSky #Thyroid #Endosky
August 11, 2025 at 2:03 PM
Lytic lesion of mandible, prior extraction site; years ago.
Myospherulosis represents altered RBCs in cyst-like spaces, surrounded by fibrosis. At high magnification, note the pigmented spherical bodies (‘bag of marbles’). Potentially a fungal mimic ➡️ PAS/GMS neg.
#PathSky #OralPath #PathTwitter
Myospherulosis represents altered RBCs in cyst-like spaces, surrounded by fibrosis. At high magnification, note the pigmented spherical bodies (‘bag of marbles’). Potentially a fungal mimic ➡️ PAS/GMS neg.
#PathSky #OralPath #PathTwitter
August 9, 2025 at 9:37 PM
Lytic lesion of mandible, prior extraction site; years ago.
Myospherulosis represents altered RBCs in cyst-like spaces, surrounded by fibrosis. At high magnification, note the pigmented spherical bodies (‘bag of marbles’). Potentially a fungal mimic ➡️ PAS/GMS neg.
#PathSky #OralPath #PathTwitter
Myospherulosis represents altered RBCs in cyst-like spaces, surrounded by fibrosis. At high magnification, note the pigmented spherical bodies (‘bag of marbles’). Potentially a fungal mimic ➡️ PAS/GMS neg.
#PathSky #OralPath #PathTwitter
Concentric layers of bacteria and debris: pics➡️Center of the calculus; layered regions; and two pics demonstrating the peripheral textured region of the calculus that originally caught my eye macroscopically
August 8, 2025 at 2:01 PM
Concentric layers of bacteria and debris: pics➡️Center of the calculus; layered regions; and two pics demonstrating the peripheral textured region of the calculus that originally caught my eye macroscopically
Submandibular sialolith is a gross-only specimen for us. However…the interesting surface texture piqued my interest. Intact appearance, sectioned, faxitron (in our lab) and low mag histology with arrows highlighting the textured region.
#PathSky #RadSky #OralPath #ENTPath #HeadNeckPath
#PathSky #RadSky #OralPath #ENTPath #HeadNeckPath
August 8, 2025 at 1:57 PM
Submandibular sialolith is a gross-only specimen for us. However…the interesting surface texture piqued my interest. Intact appearance, sectioned, faxitron (in our lab) and low mag histology with arrows highlighting the textured region.
#PathSky #RadSky #OralPath #ENTPath #HeadNeckPath
#PathSky #RadSky #OralPath #ENTPath #HeadNeckPath
SNP may (or may not?!) be distracting at intraoperative consultation. Below, an incidental focus in a en face margin of posterior-lateral oral tongue. The epithelium with taste buds is only a few layers thick and lacks a substantial surface keratin layer. Neural elements tough to see.
#PathSky
#PathSky
August 8, 2025 at 12:50 PM
SNP may (or may not?!) be distracting at intraoperative consultation. Below, an incidental focus in a en face margin of posterior-lateral oral tongue. The epithelium with taste buds is only a few layers thick and lacks a substantial surface keratin layer. Neural elements tough to see.
#PathSky
#PathSky
Will find SNP tissue (arrows in these two low magnification examples) near fungiform, foliate and/or circumvallate papillae of the tongue.
#PathSky #ENTPath #OralPath #HeadNeckPath #PathTwitter
#PathSky #ENTPath #OralPath #HeadNeckPath #PathTwitter
August 7, 2025 at 8:59 PM
Will find SNP tissue (arrows in these two low magnification examples) near fungiform, foliate and/or circumvallate papillae of the tongue.
#PathSky #ENTPath #OralPath #HeadNeckPath #PathTwitter
#PathSky #ENTPath #OralPath #HeadNeckPath #PathTwitter
At high magnification, subgemmal neurogenous plaque (normal regional microanatomy) may overlap with neurofibroma: spindle cells, buckled nuclei, collagenous stroma. Key clue: localization near taste buds (s100+/keratin+) in the overlying epithelium.
August 7, 2025 at 8:54 PM
At high magnification, subgemmal neurogenous plaque (normal regional microanatomy) may overlap with neurofibroma: spindle cells, buckled nuclei, collagenous stroma. Key clue: localization near taste buds (s100+/keratin+) in the overlying epithelium.
Sinonasal mass, adult. DEK::AFF2 sinonasal carcinoma, FISH+. We do not have this testing in-house, we used a reference lab in the US for this case. (Attached ancillary testing results were non-specific)
Other sites:
Middle ear/temporal bone: PMID: 32366754
Larynx PMID: 40299135
Lung PMID: 35773081
Other sites:
Middle ear/temporal bone: PMID: 32366754
Larynx PMID: 40299135
Lung PMID: 35773081
August 6, 2025 at 3:06 PM
Sinonasal mass, adult. DEK::AFF2 sinonasal carcinoma, FISH+. We do not have this testing in-house, we used a reference lab in the US for this case. (Attached ancillary testing results were non-specific)
Other sites:
Middle ear/temporal bone: PMID: 32366754
Larynx PMID: 40299135
Lung PMID: 35773081
Other sites:
Middle ear/temporal bone: PMID: 32366754
Larynx PMID: 40299135
Lung PMID: 35773081
More recent paper describes a non-canonical fusion
#PathSky #Pathology #ENTPath #HeadNeckPath #EmoryPathology
#PathSky #Pathology #ENTPath #HeadNeckPath #EmoryPathology
August 4, 2025 at 1:09 PM
More recent paper describes a non-canonical fusion
#PathSky #Pathology #ENTPath #HeadNeckPath #EmoryPathology
#PathSky #Pathology #ENTPath #HeadNeckPath #EmoryPathology
Tracheal adenoid cystic carcinoma. At high magnification (next 2 pics), areas of ‘signet-ring like’ or vacuolated, clear cell change is noted in ducts. Unknown clinical significance but when present in small biopsy material, may lead to diagnostic uncertainty.
PMID: 23379326
PMID: 39235305 (fig 3)
PMID: 23379326
PMID: 39235305 (fig 3)
August 4, 2025 at 12:59 PM
Tracheal adenoid cystic carcinoma. At high magnification (next 2 pics), areas of ‘signet-ring like’ or vacuolated, clear cell change is noted in ducts. Unknown clinical significance but when present in small biopsy material, may lead to diagnostic uncertainty.
PMID: 23379326
PMID: 39235305 (fig 3)
PMID: 23379326
PMID: 39235305 (fig 3)