Non-Gynecologic Cytopathology Center of Excellence

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Non-Gynecologic Cytopathology Center of Excellence

Faculty

UPMC Presbyterian

N. Paul Ohori, MD - Medical Director of Cytopathology
Sheldon Bastacky, MD
Sarah Navina, MD
Reetesh K. Pai, MD
Robert Peel, MD
Frank Schneider, MD
Karen Schoedel, MD
Department of Pathology
Rm. A610
UPMC Presbyterian
200 Lothrop Street
Pittsburgh, PA 15213
Telephone: 412-647-9843
Fax: 412-647-3455

UPMC Shadyside

Walid E. Khalbuss, MD - Medical Director of Cytopathology
Sara E. Monaco, MD
Liron Pantanowitz, MD
Alka Palekar, MD

Mission Statement

The Department of Pathology of the University of Pittsburgh has long promoted excellence in diagnostic services, teaching, and research. The mission of the Cytopathology Center of Excellence is to promote these aspects and in particular fulfill the role as diagnostic consultants, educators, and investigators in bringing the practice to the forefront of cytopathology.

Cytopathology at the University of Pittsburgh encompasses three institutions of the UPMC Health System - UPMC Presbyterian, UPMC Shadyside, and UPMC Magee-Womens Hospital. The focus at UPMC Presbyterian and Shadyside is on non-gynecologic cytopathology and outcomes analysis for quality improvement. Ancillary techniques such as molecular analysis are tested for their applicability to practice. UPMC Magee-Womens Hospital is the center for gynecologic medical care and the cytopathology section is devoted to the improvement of cytologic diagnosis for cervical vaginal pap smears and other related gynecologic specimens.

Clinical Work

The UPMC Presbyterian Cytopathology Center of Excellence (COE) is focused primarily on head and neck, thoracic, and gastrointestinal cytopathology. In particular, we have high volumes of thyroid, head and neck, and lung FNAs – many of which are radiologically guided. In addition, recent advances in endoscopy have resulted in endoscopic ultrasound (EUS) and endobronchial ultrasound (EBUS) procedures. Both of these procedures are utilized by surgeons, pulmonologists, and gastroenterologists in establishing tissue diagnosis, staging, prognostication, and predicting response to therapy. Our cytopathologists also perform FNA procedures on superficial palpable lesions in multiple settings (e.g. Otolaryngology Clinic and patient rooms). Immediate on-site cytology evaluations for radiologically guided, EUS, EBUS, and cytopathologist performed FNA procedures are done when requested by the clinical groups. The on-site information is useful in triaging specimens so that appropriate ancillary studies are performed to answer clinically relevant questions.

Diff-Quik stain (left x200, right x400) from a liver mass in a case of metastatic GIST, epithelioid type

At UPMC Presbyterian, the practice of cytopathology is closely aligned with the organ based surgical pathology specialty practices. Each cytopathologist also participates in at least one of the subspecialty surgical pathology Center of Excellence (COE) services. This diversity among our members results in the depth and breadth of our non-gynecologic cytopathology expertise and is an asset to our specialty based practice. Furthermore, clinicopathologic conferences held regularly with the clinical subspecialty groups provide a multidisciplinary environment for optimal patient care.

Research

Research in Non-gynecologic Cytopathology at UPMC Presbyterian Cytopathology COE involves the following areas which emphasize surgical pathology correlation and application of ancillary technologies:

thyroid and head and neck cytopathology
pancreaticobiliary cytopathology
thoracic cytopathology
quality improvement in cytopathology laboratory performance.

Teaching

UPMC Presbyterian Cytopathology COE is actively involved in teaching cytotechnology students. Cytotechnology students spend time in the Presbyterian Cytopathology Laboratory to learn non-gynecologic specimen processing. They review non-gynecologic cases and observe immediate evaluation procedures in radiology suites, gastrointestinal laboratories, and operating rooms. The faculty members are involved in a lecture series which is a part of the core curriculum of the School of Cytotechnology.

Training

Cytopathology fellows and pathology residents at UPMC Presbyterian handle non-gynecologic specimens, including a large volume of complex fine needle aspiration (FNA) cytopathology cases. FNAs occur in multiple settings - in clinics (e.g. Endocrine and Otolaryngology Clinic) by clinicians, in radiology suites (Computerized Tomography, Ultrasound) by radiologists, in the operating rooms by surgeons, in the GI Laboratory by gastroenterologists, and in patient rooms and clinics by pathologists. The cytopathology fellows and residents are involved in immediate evaluation of specimens in radiology suites, operating rooms, and gastroenterology laboratories. They are involved in the initial evaluation of the cases and communicate the findings to the faculty cytopathologist. Decisions are made regarding triaging the specimen and possibly requesting additional aspiration specimens for diagnostic purposes and/or ancillary studies. The fellows and residents also have the opportunity to interact with patients directly when performing FNAs on superficial lesions. Throughout the course of the academic year, the fellows receive graduated levels of responsibility in preparation for practice as attending cytopathologists.