The thoughts and sights of André Lametti — just a pathologist
Intercalated duct lesions are a forgotten member of the salivary gland tumour family. They are rarely targeted on their own, and are usually found in the shadows of other more consequential lesions. Panoramic view of an adenoid cystic carcinoma involving the parotid. There are intercalated duct lesions hiding right in the middle, too small to see at this magnification. I was taught that they…
A man in the fourth decade of life presents with a thyroid nodule that ends up being, well, not a thyroid nodule
Microfollicles, as seen in a fine-needle aspiration specimen of a thyroid nodule. This finding is the canonical basis to render a diagnosis in the category of "follicular neoplasm". Diagnosing follicular neoplasms in thyroid fine-needle aspiration specimens can be difficult, and for good reason: it is a diagnostic category intended for a family of lesions for whom it is generally not possible to…
Acquisition of pathology whole-slide images (WSI) generates confidential patient metadata which must be handled appropriately for non-clinical purposes. Free software with multi-vendor support to remove identifying metadata from WSI is available but may be difficult to use by teams with varying information technology comfort. This post describes my design of a cross-platform file drag-and-drop…
Is digital pathology heading the same way as music streaming? For most labs, the financial and human cost of keeping the infrastructure and delivery of digital pathology in-house is probably too high. But what this will mean for research and teaching activities that rely on easy and unfettered access to data is a tricky problem. Choosing to keep some things small and local is a tool to…
Most thyroid fine-needle aspirates fit neatly into one of the 6 categories of the Bethesda classification. But sometimes, cases are not so easy and it is worth thinking outside the boxes! The specimen showed large three-dimensional fragments composed of bland cells with moderate cytoplasm, as well as irregular edges. This case was one of the latter. Although the targeted nodule was located in the…
Although Thoracic SMARCA4-deficient undifferentiated tumour (SD-UT) is a recognized entity in the 5th edition of the WHO classification of thoracic tumors, this alteration occurs in garden-variety lung cancer as well (and in many other tumors too!) In fact, it is likely SD-UT exists on a continuum with SMARCA4 -deficient lung cancer . I recently came across an interesting case that demonstrated…
Graphical abstract of the article [ source ] I collaborated on this study by Dilhan Perera and colleagues, under the direction of Momar Ndao. The article, published in iScience, explores the effects of prior BCG exposure on the effectiveness in mice of an intranasal adenovirus-based vaccine against SARS-Cov-2, the virus that causes COVID-19. I was involved in the scoring of lung damage seen in…
The list of tumours with fusions involving the FET ( EWSR1 , FUS ) and CREB ( CREB1 , ATF1 , or CREM ) families of genes is ever-expanding . These are promiscuous genes that drive neoplasia in a wide variety of anatomical sites, often without being recognized as such – but that doesn’t mean tumours with these molecular lesions are always primary to the location where they are found!…
OncoPrint for NGS Lung Cancer MUHC Cohort I collaborated on this study that Mark Sorin and colleagues published in Cancer Treatment and Research Communications, detailing the molecular profile of a large (n=997) cohort of patients at the McGill University Health Centre, the institution where I am undergoing residency training. Québec is a province with unique outcomes and environmental exposures…
Sir William Osler I gave a presentation on Sir William Osler’s presence at McGill in the 21 st century at a symposium organized by McGill’s department of Social Studies of Medicine on February 3, 2021. You can find the recording here . In this brief presentation, I address three issues around Osler and his legacy at McGill. First, defining Osler as a “man of his time” is…
Calcified old ventricular aneurysm. The findings in the image above were seen in the anteroseptal left ventricular myocardium of an adult woman who died unexpectedly in non-suspicious circumstances. She was known for coronary artery disease and a remote myocardial infarct. Examination did indeed reveal a remote anteroseptal myocardial infarct that likely led to the formation of an inchoate…
Adrenal amyloidosis - low magnification These photomicrographs belong to the adrenal taken at autopsy of an older adult who died in hospital of renal failure and resistant shock. He had been recently diagnosed with AA amyloidosis. The cause of his resistant shock was thought to be due to sepsis, although no organisms were ever detected and he did not respond to antimicrobial therapy. Adrenal…
The opening aphorism in Ugo Benzi’s commentary on Hippocrates’ Aphorisms (manuscript held by Osler Library of the History of Medicine In 2017, I wrote an essay about a manuscript comment on the Aphorisms of Hippocrates by the 15th-century physcian Ugo Benzi (also known as Hugo of Sienna). This paper, under the direction of Prof. Faith Wallis at McGill University’s Department of…