17 March 2021: Images of the Week

Here is a selection of new images from our free, online textbook:

Skin nontumor > Warts (verrucae)

Hyperkeratosis, papillomatosis, hypergranulosis, koilocytosis and inward bending of rete ridges at borders of lesion. Dermal papillae show dilated capillaries.

Contributed by Heba Ahmed Abdelkader, M.D.

Small intestine & ampulla > Lymphangioma

Scanning magnification shows the dilated lymphatics in the submucosa of the small intestine (H&E, 2x).

Contributed by Haider A. Mejbel, M.D.

Stomach > Pyloric gland adenoma

High power view of PGA showing small tubular glands with low cuboidal epithelium and bland nuclei.

Contributed by Supriya Srivastava M.D., Ph.D.

Bone & joints > Adamantinoma

Anastomosing thin trabeculae of mildly atypical epithelioid and spindled cells within fibrous stroma.

Contributed by Borislav A. Alexiev, M.D.

How can you search the textbook?

For desktop / tablet, you can either use the Google search bar in the upper right corner or visit PathologyOutlines.com and then scroll down to where the 60 chapters are listed, as demonstrated below.

For mobile, visit PathologyOutlines.com, click on “Chapters by Subspecialty” (as demonstrated below) and then click on the subspecialty, chapter and topic.

For any device you can use your favorite browser and type in PathologyOutlines.com in addition to the search term.

6 August 2020: Meet the Editor – Andrey Bychkov, M.D., Ph.D.

Please introduce yourself

I am the Director of Digital Pathology at Kameda Medical Center in Japan and have a visiting position at Nagasaki University. I consider myself an academic pathologist and am involved daily in clinical practice, research and education.

I attended medical school and did a surgical pathology residency in Russia, and started using English while teaching medical students from India. I obtained my Ph.D. from the Atomic Bomb Disease Institute in Nagasaki, where I became interested in thyroid disease. I then moved to Bangkok and was involved in establishing a thyroid pathology group for Asian doctors interested in thyroid pathology so they would have a voice on an international scale. Three years ago I moved to Japan to develop digital pathology in our multi-hospital network.

Why did you become a pathologist?

This was entirely due to a Russian professor who kept an eye on me and guided me from my undergraduate years.

What do you like most about being a pathologist?

I like the intellectual challenge and the breadth of surgical pathology. I like the need to stay updated, that I affect clinical decisions and that I drive the research.

What is special about your subspecialty?

Thyroid pathology is a relatively narrow field. Since thyroid specimens are rather uncommon, many general pathologists lack confidence in them. My other interest, digital pathology, helps me connect remotely and be more productive. For over 2 years in Japan, I have not even used a microscope, just a screen and a mouse, and feel happy with that. I also enjoy the artificial intelligence aspects of digital pathology, which are quite challenging.

How does your typical day go?

To balance clinical practice, education and research, I need to plan my days in advance to make sure nothing gets left behind. I tend to work better during the night, which works well with PathologyOutlines because of the time difference.

What is the most memorable experience you’ve had at work?

Although almost every week is memorable, some incidents stand out. In Russia, I was in charge of a small hospital when a deceased patient disappeared. I did my best to think rationally about where the body could be, and checked all the rooms and windows, with no answers. After two days, I learned that relatives came during the night and took the body for the funeral. Another time, my assistant cut his finger during an HIV autopsy. We quickly did research to learn what to do (start prophylactic treatment). It turned out fine but was very stressful. The most difficult times involved pediatric autopsies. Many parents were determined to blame the treating physicians, regardless of the underlying patient diseases, and dealing with them was difficult for me.

Regarding academia, it is always exciting to come up with ideas in the middle of the night, develop them into a project, share them with others, get support and ultimately confirmation of my ideas and a publication.

What most surprised you about being a pathologist?

I have been in this field since I was 19 visiting the pathology department, so there were few surprises. However, I do find surprising the enormous amount of new information that gets published. Just to update the Recommended Books page at PathologyOutlines.com requires that I screen 10,000 publications that appear annually just for thyroid disease.

Could you say a few words about your association with PathologyOutlines?

I first emailed Nat in 2008 and he kept responding; he is very approachable and easy to communicate with. At the time it was not related to being an author, but I kept track of how the website was developing. I noticed the increasing traffic and decided now was the time to become part of it. I was then in Thailand, and started actively writing, and put a lot of time into each topic.

Did you know that the Thyroid chapter was the first chapter written on PathologyOutlines.com? As the Thyroid chapter Editor, it is an honor and profound responsibility to maintain it to the highest standards. I want all users to be confident with its content so I review carefully its information and images. Based on my background, I am very particular about image quality, and this has spread to the entire website.

I actively promote the website in Asia, where many pathologists have limited access to journals or other publications. I am pleased to be the first Editorial Board member from outside North America.

Click here to stay connected with Dr. Bychkov on LinkedIn.

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