Sara E. Monaco, MD
Associate Professor of Pathology

Dr. Monaco
Dr. Monaco is as associate professor in the Department of Pathology at UPMC. She is also the Director of the FNA Clinic at UPMC-Shadyside Hospital and the Director of the FNA Biopsy Service at Children's Hospital of Pittsburgh of UPMC. In addition, she is the Cytopathology Fellowship Director at UPMC (fellowship web page:

Office Location:
UPMC Shadyside Hospital
5150 Centre Avenue
POB2, Suite 201
Pittsburgh, PA 15232
Contact Information:
Office Phone: (412) 623-3745
Fax: (412) 682-4779


  • BS - Cornell University, 1999
  • MD - Columbia University College of Physicians & Surgeons, 2003

Clinical Expertise

Dr. Monaco's interests include fine-needle aspiration (FNA) biopsy diagnosis, cytology-histology correlations, and the application of ancillary studies and molecular diagnostics in cytopathology. She is also interested in breast/gynecologic surgical pathology and cytology. In addition, she is interested in pediatric cytopathology and has expertise in the use of FNA in children. Dr. Monaco has also presented several educational courses at national meetings, including the United Stated and Canadian Academy of Pathology (USCAP), American Society of Cytopathology (ASC) and the American Society of Clinical Pathologists (ASCP).

Research Expertise

Dr. Monaco's research interests include non-gynecological cytopathology and pediatric cytopathology. She has also focused her research on the application of ancillary studies and molecular testing in cytopathology.

Selected Publications

View Dr. Monaco's publications on PubMed

Monaco SE, Colaizzi A, Kanbour A, Ibrahim AS, Kanbour-Shakir A. The role of axillary lymph node FNA in breast cancer staging prior to chemotherapy with histological correlation. Acta Cytologica 2012;52:139-145.

Yildiz-Aktas IZ, Monaco SE, Khalbuss WE, Parwani AV, Jaffe TM, Pantanowitz L. Testicular touch preparation cytology in the evaluation of male infertility. Cytojournal 2011;8:24.

Purgina B, Jaffe R, Monaco SE, Khalbuss WE, Beasley HS, Dunn J, Pantanowitz L. Cytolomorphology of Erdheim-Chester Disease In a Retroperitoneal Soft Tissue Tumor. Cytojournal 2011;8:22.

Khalbuss WE, Yang H, Lian Q, Elhosseiny A, Pantanowitz L, Monaco SE. The Cytomorphologic Spectrum of Small Cell Carcinoma and Large Cell Neuroendocrine Carcinoma in Body Cavity Effusions: A Study of 68 cases. Cytojournal; 8:18.

Arya P, Khalbuss WE, Monaco SE, Pantanowitz L. Salivary Duct Carcinoma with striking neutrophil-tumor cannibalism. Cytojournal 2011;8:15.

Kamat S, Parwani AV, Khalbuss WE, Monaco SE, Kelly SM, Wiehagen LT, Piccoli AL, Lassige KM, Pantanowitz L. Use of a laboratory information system driven tool for pre-signout quality assurance of random cytopathology reports. J Pathol Inform 2011;2:42.

Gilbert C, Monaco SE, Cooper S, Khalbuss WE. Endoscopic ultrasound-guided fine-needle aspiration of pancreatic metastases: a retrospective look at 25 cases. Cytojournal 2011;8:7.

Lang T, Khalbuss WE, Monaco SE, Michelow P, Pantanowitz L. Review of HIV-Related Cytopathology. Pathology Research International 2011 April; 256083.

Gao FF, Khalbuss WE, Austin RM, Monaco SE. Fine Needle Aspiration Findings of Crystal Storing Histiocytosis in the Breast Associated with Lymphoma. Acta Cytologica 2011;55:302-306.

Stamm JA, Nguyen MH, Monaco SE, Toyoda Y, Boujoukos AJ. A 62 year-old male heart transplant recipient with progressive hypoxia. Chest 2011;139:954-957.

Lang TU, Khalbuss WE, Monaco SE, Pantanowitz L. Solitary Tracheobronchial Papilloma: Cytomorphology and ancillary studies with histologic correlation. Cytojournal 2011;8:6.

Monaco SE, Shuai Y, Bansal M, Krasinskas AM, Dacic S. The diagnostic utility of P16 FISH and GLUT1 immunohistochemistry in mesothelial proliferations. Am J Clin Pathol 2011;135:619-627.

Jacobs BL, Blodgett TM, Monaco SE, Hrebinko RL, Jacobs SA. Adrenal Insufficiency as Presenting Feature of Non-Hodgkin Lymphoma. Canadian Journal of Urology 2010;17(5):5411-4.

Kastenbaum HA, Khalbuss WE, Felgar RA, Stoller S, Monaco SE. The Spectrum of Coincident Entities with Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CLL/SLL) Diagnosed by Cytology. Cytojournal 2010;7:20.

Monaco SE, Schuchert MJ, Khalbuss WE. Diagnostic Difficulties and Pitfalls in Rapid On-site Evaluation of Endobronchial Ultrasound (EBUS) Guided Fine Needle Aspiration. Cytojournal 2010;7:9.

Cai G, Parwani AV, Khalbuss WE, Yu J, Monaco SE, Jukic DM, Teot LA. Cytological Evaluation of Image-Guided Fine Needle Aspiration Biopsies via Robotic Microscopy: A Validation Study. Journal of Pathology Informatics 2010;26;I.pii:4.

Al-Maghraby HQ, Khalbuss WE, Rao UNM, Cieply K, Dacic S, Monaco SE. Fine needle aspiration biopsy diagnosis of dedifferentiated liposarcoma: Cytomorphology and MDM2 amplification by FISH. Cytojournal 2010;7:5.

Seethala S, Jain S, Ohori NP, Monaco S, Lacomis J, Crock F, Nemec J. Focal monomorphic ventricular tachycardia as the first manifestation of amyloid cardiomyopathy. Indian Pacing and Electrophysiology Journal 2010;10(3):143-147.

Khalbuss WE, Teot LA, Monaco SE. Diagnostic accuracy and limitations of fine needle aspiration cytology of bone and soft tissue lesions: A review of 1114 cases with cytological-histological correlation. Cancer Cytopathology 2010;118 (1):24-32.

Monaco SE, Nikiforova MN, Cieply K, Teot LA, Khalbuss WE, Dacic S. A Comparison of EGFR and KRAS Status in Primary Lung Carcinoma and Matched Metastases. Human Pathology 2010 Jan;41(1):94-102.

Monaco SE, Teot LA, Felgar R, Surti U, Cai G. Fluorescence In-situ Hybridization (FISH) Studies on Direct Smears: An Approach to Enhance the Fine Needle Aspiration Biopsy Diagnosis of B-cell Non-Hodgkin Lymphomas. Cancer Cytopathology 2009 Oct 25;117(5):338-48.

Monaco SE, Navolotskaia O, Cai G. Fine Needle Aspiration Biopsy Diagnosis of Prostate Carcinoma Metastatic to the Breast. Diagn Cytopathol. 2009 May;37(5):388-90.

Monaco SE, Dabbs D, Kanbour-Shakir A. Pleomorphic Lobular Carcinoma in Pleural Fluid: Diagnostic Pitfall for Atypical Mesothelial Cells. Diagn Cytopathol. 2008; 36 (9):657-661.

Schneider LF, Monaco SE, Warren MP. Elevated ghrelin level in women of normal weight with amenorrhea is related to disordered eating. Fertility & Sterility 2008; 90 (1): 121-128.

Monaco SE, Angelastro JM, Szabolcs M, Greene LA. The transcription factor ATF5 is widely expressed in carcinomas, and interference with its function selectively kills neoplastic, but not non-transformed breast cell lines. International Journal of Cancer 2007 May; 120(9): 1883-90.

Puder JJ, Monaco SE, Gupta SS, Wang J, Mayer L, Ferin M, Warren MP. Estrogen and exercise may be related to body fat distribution and leptin in young women. Fertility & Sterility 2006; 86 (3): 694-699.

Monaco S, Tsao L, Oesterheld J, Bhagat G, Alobeid B. Pediatric ALK+ anaplastic large cell lymphoma with t(3;8)(q26.2;q24) translocation and c-myc rearrangement terminated in a leukemic phase. Am J Hematol. 2006;82(1):59-64.

Tong G, Hamele-Bena D, Borczuk A, Monaco S, Khosh MM, Greenbaum E. Fine Needle Aspiration Biopsy of Epithelioid Hemangioendothelioma of the Oral Cavity: Report of One Case and Review of Literature. Diagnostic Cytopathology 2006 March; 34(3): 218-223.

Tay SHK, Nordli DR, Bonilla E, Null E, Monaco S, Hirano M, DiMauro S. Aortic Rupture in Mitochondrial Encephalopathy, Lactic Acidosis, and Stroke-Like Episodes. Arch Neurol 2006 Feb;63: 281-283.

McClelland S, Garcia RE, Monaco SE, Goldman JE, Olson TJ, Kim GH, Petrylak DP, Goodman RR. Carcinomatous meningitis from urachal carcinoma: the first reported case. J Neurooncol 2006 Jan; 76(2):171-4.

Monaco SE, Davis M, Huang AC, Bhagat G, Baergen RN, Lorenz JM, Chung WK, Thaker HM. A Case of Alpha-Thalassemia Major Presenting In A Term Neonate Without Hydrops. Pediatr Dev Pathol 2005 Nov-Dec; 8(6): 706-9.