Pathology Commons^™

Sebaceous Gland Heterotopia Of The Esophagus: A Rare Incidental Finding During Upper Endoscopy, Samuel Ramos, Margaret-Anne Huntley, Eric Vargas, Jignesh Parikh, Vania Zayat

HCA Healthcare Journal of Medicine

Esophageal heterotopic sebaceous glands (EHSG) are an extremely rare finding within the esophageal epithelium. These glands are typically benign, presenting as small, yellow-white plaques or lesions observed on endoscopy, often in the middle third of the esophagus. Esophageal heterotopic sebaceous glands are generally asymptomatic, and surveillance is not required. While their origin is unclear, proposed mechanisms include metaplastic transformation and congenital development. Recognition and histologic confirmation are essential to distinguish EHSG from other esophageal lesions and to avoid unnecessary interventions. We report the case of a 55-year-old man in whom multiple diminutive plaques were identified in the mid-esophagus during esophagogastroduodenoscopy …

Comparing The Expression Of Estrogen Receptors, Progesterone Receptors, And Human Epidermal Growth Factor Receptor 2 Between Initial Biopsy And Excision Specimens In Invasive Breast Carcinoma Cases. Is There A Need For Universal Repeat Testing? Experience From A Community Hospital, Astrid M. Sacasa, Gul Emek Wymer, Susana Ferra

HCA Healthcare Journal of Medicine

Background

The current national recommendation is that breast biomarkers estrogen receptors (ER), progesterone receptors (PR), and human epidermal growth factor receptor 2 (HER2) testing should be done on all primary invasive breast carcinomas and on recurrent or metastatic tumors. Repeat testing on a subsequent excision specimen is not indicated unless results appear discordant with the histopathologic findings. The objective of the current study was to evaluate the need for adopting universal reflex re-testing of breast biomarkers in excision specimens in our institution.

Methods

The study population included 70 sequential invasive breast cancer patients where the results of ER, PR, and …

Perceived Gaps In Preparation For Pathology Residency And Opportunities For Improvement, Barbara Knollmann-Ritschel, Julie Karp, Stephanie Barak, John Childs, Kristen Johnson, Amanda Lofgreen, Mary Berg, Satyapal Chahar, Hailey Gosnell, Cindy Mccloskey, Balaram Puligandla, Kristie White, Bronwyn Bryant

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

The transition from medical school to residency is both a transformative and a challenging process. International literature suggests that there are known or perceived gaps in preparation for residency training in many areas of medicine. However, in the current published literature, there is no discussion of perceived gaps existing in pathology residency preparation. This study surveyed both pathology residency program directors and first-year pathology residents about the knowledge of pathology and basic medical skills residents received in medical school, perceptions about readiness for pathology residency, and perceived gaps in preparation for pathology residency that could be addressed. This survey found …

Genomic Reporting Practices Across 5 Molecular Disciplines: A Study From The College Of American Pathologists, Larissa V Furtado, Annette S Kim, Ann M Moyer, Joel T Moncur, Rena R Xian, Angshumoy Roy, Avni B Santani, Yassmine Akkari, Karl V Voelkerding, Rhona J Souers, Jaimie Halley, Glenn E Palomaki

Faculty, Staff and Students Publications

Context.—: Genomic reports are primarily organized in a narrative and unstructured format with variations in content and format. Regulatory requirements and professional guidelines for genetic test reporting exist but provide little guidance for effective communication of information.

Objective.—: To assess clinical genomic reporting practices across 5 disciplines within molecular diagnostics, including germline, somatic solid tumors, somatic hematologic malignancies, pharmacogenomics, and prenatal cell-free DNA screening.

Design.—: Reporting practices were assessed by using a structured review of clinical genomic reports from multiple laboratories in 5 molecular disciplines spanning different practice settings. Report content was reviewed by the presence/absence of from 27 to …

Radiologic And Histologic Findings Of Undifferentiated Sarcoma Treated With Radical Resection, Justina Kasteri, Stefan Johnson, Joseph Hatem, Joel Thompson

Advances in Clinical Medical Research and Healthcare Delivery

Case report of an 89-year-old patient presenting with a nontraumatic painless growing mass on the right thigh. This article presents the diagnostic imaging and histologic microscopic views of the mass following a radical resection. Further discussing the key findings to diagnose undifferentiated sarcomas as well as the clinical management.

Can Residents Cheat The Unknown Slide Sessions By Using The Large Language Models? Which Model Should They Use: Chat-Gpt, Claude, Or Gemini?​, Gul Emek Wymer, Susana Ferra

East Florida Division GME Research Day 2025

Introduction: In recent years, artificial intelligence tools, such as large language models (LLMs) have expanded the potential for diagnostic medicine, including histopathology. This study aims to evaluate the diagnostic ability and utility of the publicly available large language models in predicting the accurate diagnosis of the unknown cases by using the images of the hematoxylin-eosin stained slides taken by a mobile phone and compare their performance with the residents’ performance.

Method: The twenty cases, including a variety of entities, were collected from teaching sets of non-HCA patients and public available domains, which are used for unknown slide sessions for residents. …

Enhancing Clinical Trial Matching In Molecular Diagnostics: Using Natural Language Processing And Clustering Approaches In Hematological Malignancies, Gillian Fanning

Theses and Dissertations

Clinical trial matching is a critical component of personalized medicine, particularly in the management of hematologic malignancies. At Virginia Commonwealth University (VCU) Health, the Molecular Diagnostics (MDX) Lab produces somatic variant reports and recommends clinical trials based on the presence of clinically significant mutations. However, the current manual trial recommendation process is time-intensive and lacks scalability.

This study introduces a computational framework to streamline and standardize clinical trial matching using natural language processing (NLP) and unsupervised clustering. Trial brief descriptions were analyzed to extract frequent terms, and trials were grouped based on term similarity using joint dimensionality reduction and clustering. …

Developing The Openflexure Microscope Towards Medical Use: Technical And Social Challenges Of Developing Globally Accessible Hardware For Healthcare, Joe Knapper, Freya Whiteford, Daniel Rosen, William Wadsworth, Julian Stirling, Catherine Mkindi, Joram Mduda, Valerian L Sanga, Paul T Nyakyi, Thomas Hervé Mboa Nkoudou, Elisée Jafsia, Stephane Fadanka, Kelsey Hummel, Sharmila Anandasabapathy, Richard Bowman

Faculty, Staff and Students Publications

The OpenFlexure Microscope is an accessible, three-dimensional-printed robotic microscope, with sufficient image quality to resolve diagnostic features including parasites and cancerous cells. As access to lab-grade microscopes is a major challenge in global healthcare, the OpenFlexure Microscope has been developed to be manufactured, maintained and used in remote environments, supporting point-of-care diagnosis. The steps taken in transforming the hardware and software from an academic prototype towards an accepted medical device include addressing technical and social challenges, and are key for any innovation targeting improved effectiveness in low-resource healthcare. This article is part of the Theo Murphy meeting issue 'Open, reproducible …

Development Of An Online Teaching Platform To Improve Access To Postgraduate Pathology Training In Sub-Saharan Africa, Richard Byers, Anita Byers, Chibamba Mumba, Angela Mutuku, Jennifer Singer-Rupp, Michael Wilson, Kenneth Fleming, Shahin Sayed

Pathology, East Africa

Background: Resource barriers to the provision of accessible training in cancer diagnosis in lower- and middle-income countries (LMICs) limit the potential of African health systems. Long-term provision via teaching visits from senior pathologists and trainee foreign placements is unsustainable due to the prohibitive costs of travel and subsistence. Emerging eLearning methods would allow pathologists to be trained by experts in a cheaper, more efficient, and more scalable way.

Purpose: This study aimed to develop an online teaching platform, starting with hematopathology, for trainee pathologists in sub-Saharan Africa, initially in Nairobi, Kenya, and Lusaka, Zambia.

Methods: Course materials …

Considering The Histologic And Anatomic Features Of Pancreatic Heterotopia In Patient Disease Manifestation, Yeseena Alli B.S., Kelly Brenan M.D.

Tower Health Research Day

No abstract provided.

A Case Of Chronic Appendiceal Intussusception Secondary To Unsuspected Endometriosis, Matthew Lee, Susana Ferra

East Florida Division GME Research Day 2024

Introduction: Intussusception of the appendix is an exceedingly rare pathology with an incidence of 0.01%.

Case Summary: Patient is a 55 y/o female with appendiceal intussusception on CT and endoscopy. She was admitted for elective laparoscopic appendectomy, a distorted area involving the cecum and terminal ileum was identified. Procedure was converted to an open ileocolic resection due to the unclear anatomy and concern for possible malignancy. An intraoperative consultation revealed an inverted appendix.

Results: Gross examination of the specimen showed a structure protruding into the cecum lumen with an intact mucosal surface. Microscopic examination revealed a central fibromuscular core with …

The Role Of Dystrophic Microglia In Aging And Disease, Ryan K. Shahidehpour

Theses and Dissertations--Neuroscience

Microglia are the primary immune cells of the central nervous system and are crucial in maintaining homeostasis and defense from disease and injury in the brain. Recent genome-wide association studies (GWAS) have also highlighted microglia as a central player in Alzheimer’s disease (AD). However, the mechanisms of microglia’s influence are poorly understood. Traditionally, microglial subtypes characterized physiologically as “reactive” or “activated” have been linked with disease and injury in the brain. However, morphologically, a recently described microglia category known as “dystrophic,” characterized structurally by fragmented processes and cytoplasmic decay is believed to be more strongly associated with aging and neurodegeneration. …

Enhancing Pathology Report Analysis With Artificial Intelligence: A Validation Study Of Chatgpt's Effectiveness In 444 Cases, Zhenhong Qu, Megan Wang, Christian Santiago, Jack W. Qu, Ping Zhang

Conference Presentation Abstracts

Context: Despite years of efforts, the pathology report lacks standardization for its gross description. This inevitably leads to the occasional omission of key data elements, and difficulty to identify key elements in a lengthy unstructured report. A novel artificial intelligence (AI) tool, ChatGPT by OpenAI (San Francisco, California), was reportedly proficient in extracting keywords from text content. We assess the effectiveness of ChatGPT to quickly find multiple data elements in reports and detect missing data elements.

Design: Gross description of 444 pathology reports of several common organ types was submitted to ChatGPT (https://chat.openai.com/chat) that extracted and listed key data elements …

Labrad : Vol 48, Issue 1 - July 2023, Aga Khan University Hospital, Karachi

LABRAD - Departments of Pathology & Laboratory Medicine and Radiology Archives

• Editorial
• Articles
• Toxicology In Public Health: Mitigating Risk, Fostering Well-Being
• Predictive And Prognostic Biomarkers in Histopathology
• Cancer Registry and Public Health Surveillance - Role of Pathologists
• Diagnosis of Celiac Disease DQA1*02,05; DQB1*02,03:02 (DQ2&DQ8) in patients
• Magnifying The Clinical Value of Expert Review and Reassessment
• Urine Cytology: A Screening and Surveillance Test
• An Overview of Convalescent Plasma for The Treatment of COVID-19
• Role of Imaging in Public Health Care
• Microsatellite Instability (MSI) Testing
• MRI Liver with Hepatocyte-Specific Contrast Agent
• Basics and Role of Cytopathology
• Bone Tumors: From Timely Diagnosis to Improved Patient Outcome
• Differentiating Between Dengue Fever and Malaria Using The …

An Exceedingly Rare Case Of Bilateral Synchronous Germ Cell Testicular Tumors Of Different Histological Types, Joseph Kim, Ray Page, Gregory Moses, Rod Carlo Columbres

North Texas GME Research Forum 2023

It is exceedingly rare to find a case of bilateral synchronous germ cell testicular tumors of different histological types, and there have been only a handful of cases because of a lack of connections through lymphatic or vascular pathways between the testes. Here we present a unique case of a 43-year-old man who initially presented to the primary care physician for increasing right testicular swelling. He had a testicular sonogram that showed a large right testicular mass as well as a 1.7 cm left testicular mass suspicious of malignancy. Pre-surgical laboratories showed PSA 0.97, alpha-fetoprotein 1875, quantitative hCG 2508, and …

Experiential Exposure As The Key To Recruiting Medical Students Into Pathology, Ashley M. Holloman, Mary P. Berg, Bronwyn Bryant, Lisa Ross Dixson, Melissa R. George, Julie Katz Karp, Barbara E.C. Knollmann-Ritschel, Victor Gerardo Prieto, Charles F. Timmons, John Michael Childs, Amanda Lofgreen, Kristen Johnson, Cindy B. Mccloskey

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Medical student interest and pursuit of a career in pathology have been steadily declining since 2015. We conducted three separate surveys of medical students to better understand these trends. In our first survey, we focused on assessing U.S. allopathic medical students understanding and perceptions of pathology. We later surveyed U.S. osteopathic medical students as a companion to the allopathic medical student survey, in which many similarities were discovered with some key differences. In our final survey, we specifically looked at curriculum differences between the U.S. allopathic medical schools that graduate the most students who enter pathology training programs (Group 1) …

How Influential Are Medical School Curriculum And Other Medical School Characteristics In Students’ Selecting Pathology As A Specialty?, Cindy B. Mccloskey, Mark Brissette, John Michael Childs, Amanda Lofgreen, Kristen Johnson, Melissa R. George, Ashley M. Holloman, Bronwyn Bryant, Mary P. Berg, Lisa Ross Dixon, Julie Katz Karp, Barbara E.C. Knollmann-Ritschel, Victor Gerardo Prieto, Charles F. Timmons, Robert D. Hoffman

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

There has been a significant decline in the number of United States allopathic medical students matching to pathology residency programs. Data acquired from the American Association of Medical Colleges (AAMC) show sustained variation in the medical school production of students who go on to pathology residency. When divided into groups based on the medical school's historical volume of graduates entering pathology, the schools in groups labeled Group 1 and Group 2 produced significantly higher and lower proportions of pathology residents, respectively. This study aimed to identify what medical school curriculum elements and other medical school characteristics might explain the differences …

Histomorphological Spectrum Of Ovarian Neoplasms In A Tertiary Care Centre, Lionel Rohit Mathew, Shalini Karthikeyan, Jaishree Tamilmani, Prema Devi Elangovan, Sridevi Vijayasankar

Journal of Medicine in Scientific Research

Introduction: Ovary is the second most common site of gynaecological malignancies in India and therefore ovarian tumours need to be studied under the microscope for accurate diagnosis and management.

Aim: This study aims to study the spectrum of ovarian tumours and calculate their incidence and age-distribution. Materials and Methods: This study was conducted in the Department of Pathology, Sri Muthukumaran Medical College, Hospital & Research Institute, Chennai, during the year 2022. Results: Among a total of 68 ovarian neoplasms studied, benign tumours (61.7%) were more common and most of the patients were in the fourth decade of life. The commonest …

Experiential Exposure As The Key To Recruiting Medical Students Into Pathology, Ashley M Holloman, Mary P Berg, Bronwyn Bryant, Lisa Ross Dixon, Melissa R George, Julie Katz Karp, Barbara Ec Knollmann-Ritschel, Victor Gerardo Prieto, Charles F Timmons, John Michael Childs, Amanda Lofgreen, Kristen Johnson, Cindy B Mccloskey

Faculty, Staff and Student Publications

Medical student interest and pursuit of a career in pathology have been steadily declining since 2015. We conducted three separate surveys of medical students to better understand these trends. In our first survey, we focused on assessing U.S. allopathic medical students understanding and perceptions of pathology. We later surveyed U.S. osteopathic medical students as a companion to the allopathic medical student survey, in which many similarities were discovered with some key differences. In our final survey, we specifically looked at curriculum differences between the U.S. allopathic medical schools that graduate the most students who enter pathology training programs (Group 1) …

Informing Healthcare Operations With Integrated Pathology, Clinical, And Epidemiology Data: Lessons From A Single Institution In Kenya During Covid-19 Waves, Allan Njau, Jemimah Kimeu, Jaimini Gohil, David Nganga

Pathology, East Africa

Pathology, clinical care teams, and public health experts often operate in silos. We hypothesized that large data sets from laboratories when integrated with other healthcare data can provide evidence that can be used to optimize planning for healthcare needs, often driven by health-seeking or delivery behavior. From the hospital information system, we extracted raw data from tests performed from 2019 to 2021, prescription drug usage, and admission patterns from pharmacy and nursing departments during the COVID-19 pandemic in Kenya (March 2020 to December 2021). Proportions and rates were calculated. Regression models were created, and a t-test for differences between …

A Cost-Conscious Whole Slide Imaging System For Teaching And Teleconsultation In Pathology, Christopher Thorburn, Mustafa Deebajah, Keran Zhao, Zhenhong Qu

Conference Presentation Abstracts

Context: Whole slide imaging (WSI) systems can provide multiple users with concurrent access to slides without the need to be physically present at the same location. However, the cost of an all-in-one WSI system can be prohibitive for programs that do not already use WSI systems at a clinical scale. Here, we delineate a simple, inexpensive WSI system that is easy to implement and meets the need of a resident teaching environment.

Design: A digital camera (Basler acA2500, Mannheim, Germany) is mounted to a brightfield microscope with a 0.63× C-mount and connected to a computer with the manual WSI program …

Case Report: Axilla Fibroadenoma - An Atypical Presentation, Safna Naozer Virji, Lubna Mushtaque Vohra, Syeda Sakina Abidi, Romana Idress

Department of Surgery Docs

No abstract provided.

Spatially Resolved Transcriptomics Of High-Grade Serous Ovarian Carcinoma, Elaine Stur, Sara Corvigno, Mingchu Xu, Ken Chen, Yukun Tan, Sanghoon Lee, Jinsong Liu, Emily Ricco, Daniel Kraushaar, Patricia Castro, Jianhua Zhang, Anil K Sood

Faculty, Staff and Students Publications

Bulk and single-cell RNA sequencing do not provide full characterization of tissue spatial diversity in cancer samples, and currently available in situ techniques (multiplex immunohistochemistry and imaging mass cytometry) allow for only limited analysis of a small number of targets. The current study represents the first comprehensive approach to spatial transcriptomics of high-grade serous ovarian carcinoma using intact tumor tissue. We selected a small cohort of patients with highly annotated high-grade serous ovarian carcinoma, categorized them by response to neoadjuvant chemotherapy (poor or excellent), and analyzed pre-treatment tumor tissue specimens. Our study uncovered extensive differences in tumor composition between the …

Comparison Of Antimicrobial Efficacy Of Calcipex And Metapex In Endodontic Treatment Of Chronic Apical Periodontitis: A Randomised Controlled Trial Study Protocol, Momina Motiwala, Saqib Habib, Rabia Ghafoor, Seema Irfan

Section of Dental-Oral Maxillofacial Surgery

Introduction: Various intracanal medicaments have been used in cases of chronic apical periodontitis for appropriate disinfection of the root canal system to eliminate microbes especially from the inaccessible areas. Calcium hydroxide is the most common intracanal medicament available in various forms, but its effectiveness with or without iodoform using microbial culture is unknown. Therefore, our aim is to compare the antimicrobial efficacy of Calcipex and Metapex in endodontic treatment of teeth presenting with chronic apical periodontitis by assessing the bacterial load reduction.
Method and analysis: 60 single rooted teeth of patients with diagnosis of chronic apical periodontitis will be selected …

Artificial Intelligence (Ai) In Medicine, Current Applications And Future Role With Special Emphasis On Its Potential And Promise In Pathology: Present And Future Impact, Obstacles Including Costs And Acceptance Among Pathologists, Practical And Philosophical Considerations. A Comprehensive Review, Zubair Ahmad, Shabina Rahim, Maha Zubair, Jamshid Abdul Ghafar

Department of Pathology and Laboratory Medicine

Background: The role of Artificial intelligence (AI) which is defined as the ability of computers to perform tasks that normally require human intelligence is constantly expanding. Medicine was slow to embrace AI. However, the role of AI in medicine is rapidly expanding and promises to revolutionize patient care in the coming years. In addition, it has the ability to democratize high level medical care and make it accessible to all parts of the world.
Main text: Among specialties of medicine, some like radiology were relatively quick to adopt AI whereas others especially pathology (and surgical pathology in particular) are only …

Molecular Pathology Economics 101: An Overview Of Molecular Diagnostics Coding, Coverage, And Reimbursement A Report Of The Association For Molecular Pathology, A. N. Sireci, J. L. Patel, L. Joseph, M. C. Hiemenz, O. C. Rosca, S. K. Caughron, S. A. Thibault-Sennett, T. L. Burke, D. L. Aisner

Journal Articles

No abstract provided.

Social Media Engagement At Academic Conferences: Report Of The Association Of Pathology Chairs 2018 And 2019 Annual Meeting Social Media Committee, Yonah C. Ziemba, Dana Razzano, Timothy C. Allen, Adam L. Booth, Scott R. Anderson, Anne Champeaux, Michael D. Feldman, Valerie Fitzhugh, Simone Gittens, Marilea Grider, Mary Gupta, Christina Hanos, Karen Kelly, Tarush Kothari, Jennifer Laudadio, Amy Y. Lin, Kamran M. Mirza, Kathleen T. Montone, Priscilla S. Markwood

Pathology and Cell Biology Faculty Publications

The use of social media at academic conferences is expanding, and platforms such as Twitter are used to share meeting content with the world. Pathology conferences are no exception, and recently, pathology organizations have promoted social media as a way to enhance meeting exposure. A social media committee was formed ad hoc to implement strategies to enhance social media involvement and coverage at the 2018 and 2019 annual meetings of the Association of Pathology Chairs. This organized approach resulted in an 11-fold increase in social media engagement compared to the year prior to committee formation (2017). In this article, the …

Case-Based Asynchronous Interactive Modules In Undergraduate Medical Education., Tatiana Villatoro, Katherine Lackritz, Joanna S Y Chan

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Undergraduate medical education traditionally consists of 2 years of lecture-based courses followed by 2 years of clinical clerkships. However, over the past couple decades, undergraduate medical education has been evolving toward non-lecture-based integrated curriculums, requiring a collaborative curriculum. Additionally, e-learning platforms have become efficacious and essential to delivering education asynchronously to students. At Thomas Jefferson University, the Pathology and Obstetrics and Gynecology departments collaborated to create a pilot series of case-based asynchronous interactive modules to teach gynecologic pathology in a clinical context, while interweaving other educational components, such as evidence-based medicine, clinical skills, and basic sciences. The case-based asynchronous interactive …

Metastatic Breast Cancer In Kenya: Presentation, Pathologic Characteristics, And Patterns-Findings From A Tertiary Cancer Center, Etoroabasi Ekpe, Asim Jamal, Jasmit Shah, Judith S. Jacobson, Shahin Sayed

Internal Medicine, East Africa

Purpose: The purpose of this research was to describe the sociodemographic and clinical characteristics of Kenyan women with metastatic breast cancer diagnosed and treated at Aga Khan University Hospital in Nairobi, Kenya from 2012 to 2018.

Patients and Methods: We reviewed charts of Kenyan women with metastatic breast cancer and analyzed sociodemographic data, breast cancer risk factors, and tumor characteristics associated with stage at diagnosis, receptor status (ie, estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 [HER2]), and site of metastasis using χ2, analysis of variance, two-sample t tests, and logistic regressions.

Results: A total of 125 …

A Comparison Of Daxx (Death Domain Associated Protein 6) In Different Endometrial Carcinoma Histotypes, C. Jin, S. Hacking, M. K. Komforti, M. Nasim

Journal Articles

No abstract provided.