1
|
Mata DA, Lee JK, Shanmugam V, Marcus CB, Schrock AB, Williams EA, Ritterhouse LL, Hickman RA, Janovitz T, Patel NR, Kroger BR, Ross JS, Mirza KM, Oxnard GR, Vergilio JA, Elvin JA, Benhamida JK, Decker B, Xu ML. Liquid biopsy-based circulating tumour (ct)DNA analysis of a spectrum of myeloid and lymphoid malignancies yields clinically actionable results. Histopathology 2024; 84:1224-1237. [PMID: 38422618 DOI: 10.1111/his.15168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 02/14/2024] [Accepted: 02/15/2024] [Indexed: 03/02/2024]
Abstract
AIMS Liquid biopsy (LBx)-based next-generation sequencing (NGS) of circulating tumour DNA (ctDNA) can facilitate molecular profiling of haematopoietic neoplasms (HNs), particularly when tissue-based NGS is infeasible. METHODS AND RESULTS We studied HN LBx samples tested with FoundationOne Liquid CDx, FoundationOne Liquid, or FoundationACT between July 2016 and March 2022. We identified 271 samples: 89 non-Hodgkin lymphoma (NHL), 43 plasma-cell neoplasm (PCN), 41 histiocytoses, 27 myelodysplastic syndrome (MDS), 25 diffuse large B-cell lymphoma (DLBCL), 22 myeloproliferative neoplasm (MPN), 14 Hodgkin lymphoma (HL), and 10 acute myeloid leukaemia (AML). Among 73.4% with detectable pathogenic alterations, median maximum somatic allele frequency (MSAF) was 16.6%, with AML (36.2%), MDS (19.7%), and MPN (44.5%) having higher MSAFs than DLBCL (3.9%), NHL (8.4%), HL (1.5%), PCN (2.8%), and histiocytoses (1.8%) (P = 0.001). LBx detected characteristic alterations across HNs, including in TP53, KRAS, MYD88, and BTK in NHLs; TP53, KRAS, NRAS, and BRAF in PCNs; IGH in DLBCL; TP53, ATM, and PDCD1LG2 in HL; BRAF and MAP2K1 in histiocytoses; TP53, SF3B1, DNMT3A, TET2, and ASXL1 in MDS; JAK2 in MPNs; and FLT3, IDH2, and NPM1 in AML. Among 24 samples, the positive percent agreement by LBx was 75.7% for variants present in paired buffy coat, marrow, or tissues. Also, 75.0% of pairs exhibited alterations only present on LBx. These were predominantly subclonal (clonal fraction of 3.8%), reflecting the analytical sensitivity of LBx. CONCLUSION These data demonstrate that LBx can detect relevant genomic alterations across HNs, including at low clonal fractions, suggesting a potential clinical utility for identifying residual or emerging therapy-resistant clones that may be undetectable in site-specific tissue biopsies.
Collapse
Affiliation(s)
| | | | - Vignesh Shanmugam
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Cancer Program, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | | | | | - Erik A Williams
- Foundation Medicine, Inc., Cambridge, MA, USA
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | | | | | | | | | - Benjamin R Kroger
- Division of Hematology/Oncology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jeffrey S Ross
- Foundation Medicine, Inc., Cambridge, MA, USA
- Departments of Pathology, Urology, and Medicine (Oncology), State University of New York Upstate Medical University, Syracuse, New York, USA
| | - Kamran M Mirza
- Department of Pathology, Michigan Medicine, Ann Arbor, MI, USA
| | | | | | | | - Jamal K Benhamida
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Mina L Xu
- Department of Pathology, Yale New-Haven Hospital, Yale School of Medicine, New Haven, CT, USA
| |
Collapse
|
2
|
Cima L, Bussola N, Hassell LA, Kiehl TR, Schukow C, Zerbe N, Munari E, Torresani E, Barbareschi M, Cecchini MJ, Cirielli V, Pagliuca F, Ahsan M, Mohanty SK, Arbitrio E, Hughes G, Mirza KM. Evolving educational landscape in pathology: a comprehensive bibliometric and visual analysis including digital teaching and learning resources. J Clin Pathol 2024; 77:87-95. [PMID: 38123966 DOI: 10.1136/jcp-2023-209203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/01/2023] [Indexed: 12/23/2023]
Abstract
AIMS Pathology education is a core component of medical training, and its literature is critical for refining educational modalities. We performed a cross-sectional bibliometric analysis to explore publications on pathology education, focusing on new medical education technologies. METHODS The analysis identified 64 pathology journals and 53 keywords. Relevant articles were collected using a web application, PaperScraper, developed to accelerate literature search. Citation data were collected from multiple sources. Descriptive statistics, with time period analysis, were performed using Microsoft Excel and visualised with Flourish Studio. Two article groups were further investigated with a bibliometric software, VOSViewer, to establish co-authorship and keyword relationships. RESULTS 8946 citations were retrieved from 905 selected articles. Most articles were published in the last decade (447, 49.4%). The top journals were Archives of Pathology & Laboratory Medicine (184), Human Pathology (122) and the American Journal of Clinical Pathology (117). The highest number of citations was found for Human Pathology (2120), followed by Archives of Pathology & Laboratory Medicine (2098) and American Journal of Clinical Pathology (1142). Authors with different backgrounds had the greatest number of articles and citations. 12 co-authorship, 3 keyword and 8 co-citation clusters were found for the social media/online resources group, 8 co-authorship, 4 keyword and 7 co-citation clusters for the digital pathology/virtual microscopy/mobile technologies group. CONCLUSIONS The analysis revealed a significant increase in publications over time. The emergence of digital teaching and learning resources played a major role in this growth. Overall, these findings underscore the transformative potential of technology in pathology education.
Collapse
Affiliation(s)
- Luca Cima
- Department of Laboratory Medicine, Pathology Unit, Santa Chiara University Hospital, APSS, Trento, Italy
| | - Nicole Bussola
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Lewis A Hassell
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Tim-Rasmus Kiehl
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Pathology, Berlin, Germany
| | - Casey Schukow
- Department of Pathology, Corewell Health's Beaumont Hospital, Royal Oak, Michigan, USA
| | - Norman Zerbe
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Pathology, Berlin, Germany
| | - Enrico Munari
- Department of Molecular and Translational Medicine, Pathology Unit, University of Brescia, Brescia, Italy
| | - Evelin Torresani
- Department of Laboratory Medicine, Pathology Unit, Santa Chiara University Hospital, APSS, Trento, Italy
| | - Mattia Barbareschi
- Department of Laboratory Medicine, Pathology Unit, Santa Chiara University Hospital, APSS, Trento, Italy
- CISMED, Centro Interdipartimentale di Scienze Mediche, University of Trento, Trento, Italy
| | - Matthew J Cecchini
- Department of Pathology and Laboratory Medicine, University of Western Ontario, London, Ontario, Canada
| | - Vito Cirielli
- Department of Prevention, Legal Medicine Unit, Azienda ULSS 8 Berica, Vicenza, Italy
| | - Francesca Pagliuca
- Department of Mental and Physical Health and Preventive Medicine, Pathology Unit, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Muhammad Ahsan
- Histopathology Department, Chughtai Institute of Pathology, Lahore, Pakistan
| | - Sambit K Mohanty
- Department of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, Delhi, India
| | | | - Griffin Hughes
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Kamran M Mirza
- Department of Pathology and Laboratory Medicine, Loyola University Chicago Stritch School of Medicine, Maywood, Illinois, USA
| |
Collapse
|
3
|
Ulin L, Bernstein SA, Nunes JC, Gu A, Hammoud MM, Gold JA, Mirza KM. Improving Transparency in the Residency Application Process: Survey Study. JMIR Form Res 2023; 7:e45919. [PMID: 38145482 PMCID: PMC10775039 DOI: 10.2196/45919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 08/15/2023] [Accepted: 11/20/2023] [Indexed: 12/26/2023] Open
Abstract
BACKGROUND Increasing numbers of residency applications create challenges for applicants and residency programs to assess if they are a good fit during the residency application and match process. Applicants face limited or conflicting information as they assess programs, leading to overapplying. A holistic review of residency applications is considered a gold standard for programs, but the current volumes and associated time constraints leave programs relying on numerical filters, which do not predict success in residency. Applicants could benefit from increased transparency in the residency application process. OBJECTIVE This study aims to determine the information applicants find most beneficial from residency programs when deciding where to apply, by type of medical school education background. METHODS Match 2023 applicants voluntarily completed an anonymous survey through the Twitter and Instagram social media platforms. We asked the respondents to select 3 top factors from a multiple-choice list of what information they would like from residency programs to help determine if the characteristics of their application align with program values. We examined differences in helpful factors selected by medical school backgrounds using ANOVA. RESULTS There were 4649 survey respondents. When responses were analyzed by United States-allopathic (US-MD), doctor of osteopathic medicine (DO), and international medical graduate (IMG) educational backgrounds, respondents chose different factors as most helpful: minimum United States Medical Licensing Examination (USMLE) or Comprehensive Osteopathic Medical Licensing Examination (COMLEX) Step 2 scores (565/3042, 18.57% US-MD; 485/3042, 15.9% DO; and 1992/3042, 65.48% IMG; P<.001), resident hometown region (281/1132, 24.82% US-MD; 189/1132, 16.7% DO; and 662/1132, 58.48% IMG; P=.02), resident medical school region (476/2179, 22% US-MD; 250/2179, 11.5% DO; and 1453/2179, 66.7% IMG; P=.002), and percent of residents or attendings underrepresented in medicine (417/1815, 22.98% US-MD; 158/1815, 8.71% DO; and 1240/1815, 68.32% IMG; P<.001). CONCLUSIONS When applying to residency programs, this study found that the factors that respondents consider most helpful from programs in deciding where to apply differ by educational background. Across all educational groups, respondents want transparency around standardized exam scores, geography, and the racial or ethnic backgrounds of residents and attendings.
Collapse
Affiliation(s)
- Lindsey Ulin
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, United States
| | - Simone A Bernstein
- Department of Psychiatry, Washington University in St Louis, St Louis, MO, United States
| | - Julio C Nunes
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
| | - Alex Gu
- Department of Orthopaedic Surgery, George Washington University School of Medicine, Washington, DC, United States
| | - Maya M Hammoud
- Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, MI, United States
| | - Jessica A Gold
- Department of Psychiatry, Washington University in St Louis, St Louis, MO, United States
| | - Kamran M Mirza
- Department of Pathology and Clinical Laboratories, University of Michigan Medicine, Ann Arbor, MI, United States
| |
Collapse
|
4
|
Stone M, Lilley CM, Tang G, Loghavi S, Mirza KM. Phenotypic clues that predict underlying cytogenetic/genetic abnormalities in myeloid malignancies: A contemporary review. Cytopathology 2023; 34:530-541. [PMID: 37522274 DOI: 10.1111/cyt.13280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/13/2023] [Accepted: 07/14/2023] [Indexed: 08/01/2023]
Abstract
Precise subclassification of myeloid malignancies per the World Health Organization (WHO) classification system and the International Consensus Classification of Myeloid Neoplasms and Acute Leukaemias (ICC) requires investigation and documentation of the presence of cytogenetic and/or molecular genetic changes. These ancillary studies not only help in diagnosis, but also the prognosis of disease; however, they take time to be completed. In contrast, morphological evaluation of material from the blood and bone marrow specimens of cases where myeloid malignancies are suspected is usually completed quickly. Cytomorphological assessment may predict genetic changes and can be helpful in triaging acuity. This is especially true in haematological emergencies such as acute promyelocytic leukaemia (APL), where prompt APL-specific therapy can be life changing. Similarly, some morphological clues may help identify core binding factor leukaemias where a diagnosis of acute myeloid leukaemia (AML) could be rendered without reaching the 20% blast cutoff with immediate treatment-decision implications, or even a subset of cases of AML with FLT3 ITD/NPM1 mutation(s) which show characteristic features. Even though FISH/cytogenetics and/or PCR are still required for establishing the final diagnosis, evaluation for the presence of specific cytomorphological features that help predict genetic changes can be a useful tool to help guide early therapy.
Collapse
Affiliation(s)
- Michael Stone
- Department of Pathology, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Cullen M Lilley
- Department of Pathology and Laboratory Medicine, Loyola University Chicago Stritch School of Medicine, Maywood, Illinois, USA
| | - Guilin Tang
- Department of Hematopathology, MD Anderson Cancer Center, Houston, Texas, USA
| | - Sanam Loghavi
- Department of Hematopathology, MD Anderson Cancer Center, Houston, Texas, USA
| | - Kamran M Mirza
- Department of Pathology and Laboratory Medicine, Loyola University Chicago Stritch School of Medicine, Maywood, Illinois, USA
| |
Collapse
|
5
|
Lilley CM, Arnold CA, Arnold MA, Booth AL, Gardner JM, Jiang XS, Loghavi S, Mirza KM. Virtual Pathology Elective, Real Education: The PathElective.com Experience as a Model for Novel Pathology Pedagogy and a Primer for Curricular Evolution. Arch Pathol Lab Med 2023:495410. [PMID: 37638521 DOI: 10.5858/arpa.2022-0259-oa] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2023] [Indexed: 08/29/2023]
Abstract
CONTEXT.— PathElective.com was created in response to the pandemic's restrictions on interactions with trainees, and since has been incorporated into many training programs worldwide, serving as a unique means of delivering high-quality pathology and laboratory medical education at multiple levels of training. OBJECTIVE.— To analyze student usage, performance, and satisfaction to provide insight into the effectiveness of virtual education to guide curricular evolution. DESIGN.— Squarespace (Squarespace, Inc) was used for website development and to collect website analytics. Students were assessed before and after course participation using a dual-form crossover quiz design. Quiz data were anonymous and analyzed with a paired t test to account for varying student background. A novel analysis was performed aimed at examining the attrition rate of students across multiple modules. RESULTS.— Over the study period (May 1, 2020 to October 31, 2021), PathElective.com received 577 483 page views, 126 180 visits, 59 928 unique visitors, and 10 278 registered users who earned 15 305 certificates. A total of 7338 premodule and postmodule quiz pairs were analyzed. The overall average increase in score was 13.83% (P = .02). All but 5 of the 56 courses experienced a statistically significant increase in score. All courses received median scores of Very Satisfied/Satisfied in all 6 assessment domains. Aggregate attrition data revealed a unique, negative polynomial relationship (R2 = 0.656). CONCLUSIONS.— PathElective.com is a free, effective means of enhancing anatomic/clinical pathology training in medical education. These analyses offer a unique perspective on the online user experience and could guide the development of future online medical education resources.
Collapse
Affiliation(s)
- Cullen M Lilley
- From Loyola University Stritch School of Medicine, Maywood, Illinois (Lilley, Mirza)
| | - Christina A Arnold
- Department of Pathology, University of Colorado, Anschutz Medical Campus, Aurora (C. A. Arnold, M. A. Arnold)
| | - Michael A Arnold
- Department of Pathology, University of Colorado, Anschutz Medical Campus, Aurora (C. A. Arnold, M. A. Arnold)
- Pathology Department, Children's Hospital Colorado, Aurora (M. A. Arnold)
| | - Adam L Booth
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (Booth)
| | - Jerad M Gardner
- Departments of Pathology and Dermatology, Geisinger Medical Center, Danville, Pennsylvania (Gardner)
| | - Xiaoyin Sara Jiang
- Department of Pathology, Duke University School of Medicine, Durham, North Carolina (Jiang)
| | - Sanam Loghavi
- Department of Hematopathology, MD Anderson Cancer Center, Houston, Texas (Loghavi)
| | - Kamran M Mirza
- From Loyola University Stritch School of Medicine, Maywood, Illinois (Lilley, Mirza)
- Department of Pathology and Laboratory Medicine, Loyola University Health System, Maywood, Illinois (Mirza)
| |
Collapse
|
6
|
Bronson AS, Lilley CM, Zleczewski M, Mirza KM. Polyamine catabolism is concentrated in tumor-associated histiocytes in diffuse large B-cell lymphoma and classic Hodgkin lymphoma. Pathol Res Pract 2023; 248:154627. [PMID: 37343378 DOI: 10.1016/j.prp.2023.154627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 06/13/2023] [Accepted: 06/16/2023] [Indexed: 06/23/2023]
Abstract
Polyamines are cationic molecules necessary for cell survival, growth, and replication [1-5]. Polyamines come in a variety of structural forms and are principally regulated by two enzymes, spermine/spermidine acetyltransferase-1 (SAT1) and ornithine decarboxylase-1 (ODC1). SAT1 targets the polyamines spermidine and spermine for degradation via acetylation, while ODC1 is involved in converting the polyamine precursor molecule to more complex polyamines [6-8]. Polyamines and their regulatory enzymes have been implicated in tumor metastasis [9,10] and in crosstalk between oncogenes [11-13] in numerous types of cancer, but their role has never been evaluated in B-cell malignancies. In this study, we examine the expression of SAT1 in diffuse large B-cell lymphoma (DLBCL) and classic Hodgkin lymphoma (HL). We found that SAT1 is expressed in all examined cases of DLBCL (n = 15) and HL (n = 5), though the levels of expression across cases vary. We also note that SAT1 expression appears to be concentrated in tumor-associated histiocytes, rather than tumor cells in both DLBCL and HL. We propose that these findings indicate that the polyamine catabolic enzyme, SAT1, plays an unappreciated role in the pathogenesis of B-cell neoplasms.
Collapse
Affiliation(s)
- Adam S Bronson
- Loyola University Chicago Stritch School of Medicine, 2160 S 1st Ave, Maywood, IL 60153, USA
| | - Cullen M Lilley
- Loyola University Chicago Stritch School of Medicine, 2160 S 1st Ave, Maywood, IL 60153, USA
| | - Mathew Zleczewski
- Loyola University Medical Center Department of Pathology and Laboratory Medicine, 2160 S 1st Ave, Maywood, IL 60153, USA
| | - Kamran M Mirza
- Loyola University Chicago Stritch School of Medicine, 2160 S 1st Ave, Maywood, IL 60153, USA; Loyola University Medical Center Department of Pathology and Laboratory Medicine, 2160 S 1st Ave, Maywood, IL 60153, USA.
| |
Collapse
|
7
|
Hassell LA, Absar SF, Chauhan C, Dintzis S, Farver CF, Fathima S, Glassy EF, Goldstein JA, Gullapalli R, Ho J, Koch LK, Madory JE, Mirza KM, Nguyen PN, Pantanowitz L, Parwani A, Rojansky R, Seifert RP, Singh R, ElGabry EA, Bui M. Pathology Education Powered by Virtual and Digital Transformation: Now and the Future. Arch Pathol Lab Med 2023; 147:474-491. [PMID: 35878400 DOI: 10.5858/arpa.2021-0473-ra] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2022] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Myriad forces are changing teaching and learning strategies throughout all stages and types of pathology education. Pathology educators and learners face the challenge of adapting to and adopting new methods and tools. The digital pathology transformation and the associated educational ecosystem are major factors in this setting of change. OBJECTIVE.— To identify and collect resources, tools, and examples of educational innovations involving digital pathology that are valuable to pathology learners and teachers at each phase of professional development. DATA SOURCES.— Sources were a literature review and the personal experience of authors and educators. CONCLUSIONS.— High-quality digital pathology tools and resources have permeated all the major niches within anatomic pathology and are increasingly well applied to clinical pathology for learners at all levels. Coupled with other virtual tools, the training landscape in pathology is highly enriched and much more accessible than in the past. Digital pathology is well suited to the demands of peer-to-peer education, such as in the introduction of new testing, grading, or other standardized practices. We found that digital pathology was well adapted to apply our current understanding of optimal teaching strategies and was effective at the undergraduate, graduate, postgraduate, and peer-to-peer levels. We curated and tabulated many existing resources within some segments of pathology. We identified several best practices for each training or educational stage based on current materials and proposed high-priority areas for potential future development.
Collapse
Affiliation(s)
- Lewis A Hassell
- From the Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City (Hassell)
| | - Syeda Fatima Absar
- The Department of Pathology, Geisinger Medical Center, Danville, Pennsylvania (Absar)
| | - Chhavi Chauhan
- The American Society for Investigative Pathology, Cary, North Carolina (Chauhan)
| | - Suzanne Dintzis
- The Department of Laboratory Medicine and Pathology, University of Washington, Seattle (Dintzis, Koch)
| | - Carol F Farver
- The Department of Pathology (Farver), University of Michigan, Ann Arbor
| | - Samreen Fathima
- The Department of Pathology, Baylor University Medical Center, Dallas, Texas (Fathima)
| | - Eric F Glassy
- Affiliated Pathologists Medical Group, Palos Verdes Estates, California (Glassy)
| | - Jeffery A Goldstein
- the Department of Pathology, Northwestern University, Chicago, Illinois (Goldstein)
| | - Rama Gullapalli
- the Department of Pathology, University of New Mexico, Albuquerque (Gullapalli)
| | - Jonhan Ho
- The Department of Dermatopathology, University of Pittsburgh Medical Center, Washington, Pennsylvania (Ho)
| | - Lisa K Koch
- The Department of Laboratory Medicine and Pathology, University of Washington, Seattle (Dintzis, Koch)
| | - James E Madory
- The Department of Pathology, Medical University of South Carolina, Charleston (Madory)
| | - Kamran M Mirza
- The Department of Pathology and Laboratory Medicine, Loyola University Chicago Stritch School of Medicine, River Forest, Illinois (Mirza)
| | - Phuong Nhat Nguyen
- The Forensic Medicine Center of Ho Chi Minh City, Ho Chi Minh City, Vietnam (Nguyen)
| | - Liron Pantanowitz
- The Department of Pathology and Clinical Labs (Pantanowitz), University of Michigan, Ann Arbor
| | - Anil Parwani
- The Department of Anatomic Pathology, The Ohio State University, Columbus (Parwani)
| | - Rebecca Rojansky
- The Department of Pathology, Stanford University Hospital and Clinics, Stanford, California (Rojansky)
| | - Robert P Seifert
- The Department of Pathology, University of Florida, Gainesville (Seifert)
| | - Rajendra Singh
- The Department of Pathology, Norwell Health, Montville, New Jersey (Singh)
| | - Ehab A ElGabry
- the Department of Companion Diagnostics, Roche Tissue Diagnostics, Oro Valley, Arizona (ElGabry)
| | - Marilyn Bui
- and the Department of Interdisciplinary Oncology-Anatomic Pathology, Moffitt Cancer Center, Tampa, Florida (Bui)
- ElGabry and Bui are co-senior authors
| |
Collapse
|
8
|
Lilley CM, Mirza KM. Critical role of pathology and laboratory medicine in the conversation surrounding access to healthcare. J Med Ethics 2023; 49:148-152. [PMID: 33863832 DOI: 10.1136/medethics-2021-107251] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 03/09/2021] [Accepted: 03/21/2021] [Indexed: 06/12/2023]
Abstract
Pathology and laboratory medicine are a key component of a patient's healthcare. From academic care centres, community hospitals, to clinics across the country, pathology data are a crucial component of patient care. But for much of the modern era, pathology and laboratory medicine have been absent from health policy conversations. Though select members in the field have advocated for an enhanced presence of these specialists in policy conversations, little work has been done to thoroughly evaluate the moral and ethical obligations of the pathologist and the role they play in healthcare justice and access to care. In order to make any substantive improvements in access to care, pathology and laboratory medicine must have a seat at the table. Specifically, pathologists and laboratorians can assist in bringing about change through improving clinician test choice, continuing laboratory improvement programmes, promoting just advanced diagnostic distribution, triage testing and be good stewards of healthcare dollars, and recruiting a more robust laboratory workforce. In order to get to that point, much work has to be done in pathology education and the laboratory personnel training pipeline but there also needs to be adjustments at the system level to better involve this invaluable group of specialists in these policy conversations.
Collapse
Affiliation(s)
- Cullen M Lilley
- Department of Pathology and Laboratory Medicine, Loyola University Chicago Stritch School of Medicine, Maywood, Illinois, USA
| | - Kamran M Mirza
- Department of Pathology and Laboratory Medicine, Loyola University Chicago Stritch School of Medicine, Maywood, Illinois, USA
- Department of Pathology and Laboratory Medicine, Loyola University Medical Center, Maywood, Illinois, USA
| |
Collapse
|
9
|
Schukow CP, Booth AL, Mirza KM, Jajosky RP. #PathTwitter: A Positive Platform Where Medical Students Can Engage the Pathology Community. Arch Pathol Lab Med 2023; 147:135-136. [PMID: 36453869 DOI: 10.5858/arpa.2022-0282-ed] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2022] [Indexed: 12/02/2022]
Affiliation(s)
- Casey P Schukow
- From the Department of Graduate Medical Education, ProMedica Monroe Regional Hospital, Monroe, Michigan (Schukow)
| | - Adam L Booth
- From the Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (Booth)
| | - Kamran M Mirza
- From the Department of Pathology and Laboratory Medicine, Loyola University Chicago Stritch School of Medicine, Maywood, Illinois (Mirza)
| | - Ryan Philip Jajosky
- From the Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (Jajosky)
| |
Collapse
|
10
|
Lilley CM, Quintanilla-Arteaga A, Mirza KM, Ware AD, White MJ. The Role of Web-Based Platforms as a Novel Approach to Tackling Diversity, Equity, and Inclusion in Pathology Education - The PathElective.com Experience. Am J Clin Pathol 2022. [DOI: 10.1093/ajcp/aqac126.202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Introduction/Objective
Since its creation, PathElective.com has reached approximately 60,000 individuals. This web-based clinical experience has demonstrated itself to be a powerful and accessible educational tool for medical students and residents across the world. However, there is currently limited data on the inclusion and equity impact of pathology education resources. Here, we assess responses from website users to better understand our audience and how this resource impacts equity.
Methods/Case Report
We composed and administered a brief, anonymous survey to assess website user educational, ethnic, gender expression, age, and socioeconomic backgrounds. The one-time user limit survey was composed of multiple-choice, choose-all-that-apply, and short answer questions. The survey was distributed via email to users and was also available via website pop-up and banner.
Results (if a Case Study enter NA)
650 users responded to the survey. 78.9% of respondents used PathElective for <1 year with a plurality (28.2%) of respondents being users for <6 months. 94% of respondents disclosed an ethnicity, and in toto, 29 of the 37 ethnicities provided were represented. 62.9% of respondents identified as female, 35.4% as male, and 0.3% as genderqueer. When asked about sexual orientation, 83.1% responded as straight, 3.5% as bisexual, 3.1% as gay/lesbian, and 1.8% in another category. Importantly, 73.8% of respondents either agreed or strongly agreed that PathElective filled a previously unmet need and 74.4% either agreed or strongly agreed that PathElective was more accessible than other education adjuncts.
Conclusion
Data of a limited cross-section of PathElective.com users demonstrate the website provides accessible educational materials to a diverse group of pathology learners. Our users were more geographically, educationally, and sociodemographically diverse compared to the 2021 Pathology ERAS applicant pool. Moreover, the broader impact was demonstrated by learners responding that the materials filled a previously unmet need.
Collapse
Affiliation(s)
- C M Lilley
- Stritch School of Medicine, Loyola University Chicago , Chicago, Illinois , United States
| | - A Quintanilla-Arteaga
- Stritch School of Medicine, Loyola University Chicago , Chicago, Illinois , United States
| | - K M Mirza
- Stritch School of Medicine, Loyola University Chicago , Chicago, Illinois , United States
| | - A D Ware
- Department of Pathology, Johns Hopkins Hospital , Baltimore, Maryland , United States
| | - M J White
- Department of Pathology, Johns Hopkins Hospital , Baltimore, Maryland , United States
| |
Collapse
|
11
|
Dadrass F, Esmail F, Regmi A, Mudaliar K, Mirza KM, Kini AR, Kim W, Hagen P, Hossain NM. Isolated leukemia cutis as extramedullary relapse of acute myeloid leukemia. Clin Case Rep 2022; 10:e6009. [PMID: 35949412 PMCID: PMC9354096 DOI: 10.1002/ccr3.6009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 05/29/2022] [Accepted: 06/04/2022] [Indexed: 11/21/2022] Open
Abstract
Acute myeloid leukemia (AML) arises from clonal expansion of malignant hematopoietic precursor cells in the bone marrow. In rare instances, AML can recur with prominent extramedullary manifestations (i.e., leukemia cutis or myeloid sarcoma), either simultaneously or preceding marrow involvement, or as a sole site of primary disease relapse.
Collapse
Affiliation(s)
- Farinoosh Dadrass
- Loyola University Chicago Stritch School of Medicine Loyola University Medical Center Maywood Illinois USA
| | - Fatema Esmail
- Division of Hematology/Oncology, Department of Medicine Loyola University Medical Center Maywood Illinois USA
| | - Aayushma Regmi
- Department of Pathology and Laboratory Medicine Loyola University Medical Center Maywood Illinois USA
| | - Kumaran Mudaliar
- Department of Pathology and Laboratory Medicine Loyola University Medical Center Maywood Illinois USA
| | - Kamran M. Mirza
- Department of Pathology and Laboratory Medicine Loyola University Medical Center Maywood Illinois USA
| | - Ameet R. Kini
- Department of Pathology and Laboratory Medicine Loyola University Medical Center Maywood Illinois USA
| | - Wendy Kim
- Division of Dermatology, Department of Medicine Loyola University Medical Center Maywood Illinois USA
| | - Patrick Hagen
- Division of Hematology/Oncology, Department of Medicine Loyola University Medical Center Maywood Illinois USA
| | - Nasheed M. Hossain
- Division of Hematology/Oncology, Department of Medicine Loyola University Medical Center Maywood Illinois USA
| |
Collapse
|
12
|
Alcaraz-Mateos E, Mirza KM, Molina-Valverde S, Togkaridou M, Caballero-Alemán F, Poblet E. The utility of a gross dissection anatomical model for simulation-based learning in pathology. Rev Esp Patol 2022; 55:149-155. [PMID: 35779880 DOI: 10.1016/j.patol.2022.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/11/2022] [Accepted: 02/14/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The examination of morphological alterations in tissues is fundamental in Pathology. Traditional training in gross dissection has several limitations, including the risk of transmissible diseases, formaldehyde exposure and limited specimen availability. We describe a teaching method using anatomical simulators. METHODS Liquid silicone-based artisan neoplastic anatomical models were used in conjunction with clinical scenarios. Eighty-five medical students participated in a gross dissection experience and were asked to complete a feedback questionnaire. Additionally, a workshop was organized for students to compare three different teaching methods. The first one used still images (Group1-G1), the second a video explanation (Group2-G2), and the third directly observed a pathologist while grossing (Group3-G3). RESULTS The knowledge acquisition questionnaire showed an average value of 4.4 out of 5 (1-5) (range 3.4-4.7, σ0.89). The categories 'knowledge of resection margins' and 'macroscopic diagnosis' received the highest values (4.8, σ0.11 and 4.7, σ0.32, respectively), followed by 'understanding of handling and gross examination of the surgical specimen' (4.5, σ0.49), 'prognosis' (4.3, σ0.67) and 'understanding of a tumor resection' (3.9, σ0.96) (p<0.05). Regarding teaching methods, G3 spent less time than G2 and G1 with mean times of 15'39″ (σ2'12″), 16'50″ (σ3'45″), and 17'52″ (σ2'12″), respectively (p<0.05). Gross dissection marks (0-5) showed statistically significant differences (p<0.05). G2 obtained better results (3.7;σ0.54) than G3 (3.4;σ0.94) or G1 (3.1;σ0.8). CONCLUSIONS This preliminary study demonstrates that it is possible to implement a gross dissection simulation module at medical school and thus enable the acquisition of skills in a secure environment.
Collapse
Affiliation(s)
| | - Kamran M Mirza
- Department of Pathology and Laboratory Medicine, Loyola University, Chicago, USA
| | - Sara Molina-Valverde
- Internal Medicine Department, Virgen de la Arrixaca University Hospital, Murcia, Spain
| | | | | | - Enrique Poblet
- Department of Pathology, Reina Sofía University Hospital, Murcia, Spain; Faculty of Medicine, University of Murcia, Spain
| |
Collapse
|
13
|
Tushir A, Duy Nguyen T, Biehl C, Mirza KM. Challenges and Opportunities in Using Twitter as a Pedagogical Tool in Pathology and Laboratory Medicine Education. Am J Clin Pathol 2022; 157:836-843. [PMID: 35050345 DOI: 10.1093/ajcp/aqab219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 12/07/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Even though the benefits of using Twitter for teaching and information exchange within the pathology community are primarily undisputed, a fair number of users refrain from sharing educational content on this social media platform. The survey aims to identify challenges in using Twitter as a pedagogical tool and discuss ways of converting those challenges into opportunities. METHODS We performed a cross-sectional survey-based study involving 174 participants from the pathology community on Twitter. RESULTS The results demonstrated that procurement of content was the major challenge faced by 36.2% of the participants, with most participants being concerned or very concerned regarding institutional policies and Health Insurance Portability and Accountability Act issues. Content procurement concerns were followed by social media inertia, stated by 23% of the participants as an obstacle to posting educational content on Twitter. CONCLUSIONS The report helps elicit some common obstacles faced by the pathology and laboratory medicine community and allows us to recommend solutions to overcome these obstacles.
Collapse
Affiliation(s)
- Abhimanyu Tushir
- Biostatistics Certificate Candidate, UC San Diego Extension , San Diego, CA , USA
| | | | - Colton Biehl
- Nova Southeastern University , Boynton Beach, FL , USA
| | - Kamran M Mirza
- Department of Pathology and Laboratory Medicine, Loyola University Chicago Stritch School of Medicine, Maywood , IL , USA
| |
Collapse
|
14
|
Grech J, Lilley CM, Martinbianco EM, Ding X, Mirza KM, Chen X. Nodular Histiocytic/Mesothelial Hyperplasia Mimicking Mesenteric Metastasis. Cureus 2022; 14:e24971. [PMID: 35698687 PMCID: PMC9188811 DOI: 10.7759/cureus.24971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2022] [Indexed: 11/05/2022] Open
|
15
|
Martinbianco EM, Lilley CM, Grech J, Mirza KM, Chen X. Heterotopic Mesenteric Ossification With Trilineage Hematopoiesis. Cureus 2022; 14:e24620. [PMID: 35664416 PMCID: PMC9150764 DOI: 10.7759/cureus.24620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2022] [Indexed: 11/05/2022] Open
Abstract
Heterotopic ossification (HO) histologically refers to extraskeletal bone formation in non-ossifying tissues, most commonly noted in the extremities, buttocks, abdominal wall, and hip joints. HO developing in the mesentery (heterotopic mesenteric ossification, HMO) is very rare, with fewer than 100 cases reported in the literature. It usually occurs in adult male patients with a history of repeated abdominal trauma. So far, only two cases of HMO have been reported with the development of hematopoietic bone marrow. Here, we report the third case of HMO with true trilineage hematopoiesis in a 66-year-old female with suspicious mesenteric-retained foreign material from prior surgical procedures, including hysterectomy for endometrial adenocarcinoma and multiple repairs for incisional hernia.
Collapse
|
16
|
Saleh J, Regmi A, Speiser JJ, Mudaliar KM, Omman R, Velankar M, Mirza KM. A Case of Primary Myelofibrosis With Transformation to Leukemia Cutis. Am J Dermatopathol 2022; 44:58-61. [PMID: 34132659 DOI: 10.1097/dad.0000000000001999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT We report an extraordinary case of primary myelofibrosis with transformation to leukemia cutis. A 64-year-old Caucasian man with a history of JAK2-positive primary myelofibrosis presented with erythematous papulonodules on his right lower extremity. A punch biopsy revealed a normal epidermis with an underlying diffuse dermal infiltrate composed of medium-to-large-sized myeloid cells and leukocytes. Neoplastic cells were immunoreactive for LCA, CD34, CD61, CD117, and CD68 and negative for lysozyme, CD20, CD3, myeloperoxidase, and TdT. These findings were consistent with a diagnosis of leukemia cutis. A concurrent bone marrow biopsy demonstrated a markedly fibrotic, hypercellular marrow without a significant increase in blasts. With no morphologic evidence of bone marrow involvement by acute myeloid leukemia, our case suggests that the patient's primary myelofibrosis transformed to leukemia cutis. Our patient died 2 months after the onset of his skin nodules. Our case demonstrates that leukemia cutis should be included in the differential diagnosis for cutaneous nodular lesions in patients with a history of an advanced-stage hematological malignancy.
Collapse
Affiliation(s)
- Jasmine Saleh
- Department of Pathology and Laboratory Medicine, Loyola University Medical Center, Maywood, IL; and
| | - Aayushma Regmi
- Department of Pathology and Laboratory Medicine, Loyola University Medical Center, Maywood, IL; and
| | - Jodi J Speiser
- Department of Pathology and Laboratory Medicine, Loyola University Medical Center, Maywood, IL; and
| | - Kumaran M Mudaliar
- Department of Pathology and Laboratory Medicine, Loyola University Medical Center, Maywood, IL; and
| | - Reeba Omman
- Department of Pathology, University of Florida, Jacksonville, FL
| | - Milind Velankar
- Department of Pathology and Laboratory Medicine, Loyola University Medical Center, Maywood, IL; and
| | - Kamran M Mirza
- Department of Pathology and Laboratory Medicine, Loyola University Medical Center, Maywood, IL; and
| |
Collapse
|
17
|
Abstract
Objectives Due to the continued impact of coronovirus 2019 (COVID-19), residency
programs were advised to offer virtual interviews in place of traditional
in-person interviews for the 2021 match recruitment season. As a result,
many pathology residency programs offered preinterview virtual open-house
events to meet prospective applicants before the interview season. This
article aims to understand applicants’ perspective on those events
during the residency recruitment season of 2020 to 2021. Methods We performed a cross-sectional survey-based study involving 95 pathology
residency applicants. Results Our results demonstrated that applicants generally have a positive perception
of open house events; 91% found virtual open-house events beneficial, 63.2%
attended open-house events for programs they were not considering applying
to. Considering the high number of offered virtual open house events, 17% of
applicants felt overwhelmed by attendance and 30% felt obligated to attend.
Conclusions This brief report demonstrates the generally positive impact of these
events.
Collapse
Affiliation(s)
- Haneen T Salah
- College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia
| | - Kamran M Mirza
- Department of Pathology and Laboratory Medicine, Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA
| |
Collapse
|
18
|
Sweeney R, Esmail F, Mirza KM, Nand S. Hypercellular bone marrow in aplastic anemia: A case report of two patients. Clin Case Rep 2021; 9:e04845. [PMID: 34853682 PMCID: PMC8612008 DOI: 10.1002/ccr3.4845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/30/2021] [Accepted: 08/29/2021] [Indexed: 01/01/2023] Open
Abstract
Aplastic anemia is a disorder of bone marrow failure characterized by a hypocellular bone marrow. We report two cases with an initial hypercellular bone marrow at the time of presentation, suggesting a new phase in the pathogenesis of the disease.
Collapse
Affiliation(s)
- Ryan Sweeney
- Loyola University Chicago Stritch School of MedicineLoyola University Medical CenterMaywoodIllinoisUSA
| | - Fatema Esmail
- Division of Hematology/OncologyDepartment of Internal MedicineLoyola University Medical CenterMaywoodIllinoisUSA
| | - Kamran M. Mirza
- Department of Pathology and Laboratory MedicineLoyola University Medical CenterMaywoodIllinoisUSA
| | - Sucha Nand
- Division of Hematology/OncologyDepartment of Internal MedicineLoyola University Medical CenterMaywoodIllinoisUSA
| |
Collapse
|
19
|
Lilley CM, Marin MJ, Wiencek J, Fu L, Wolniak K, Kanakis CE, Hermelin D, Scordino T, Thomas C, Mirza KM, Demas C. The Utility of PathElective.com as a Curricular Adjunct in Laboratory Medicine Education. Am J Clin Pathol 2021. [PMCID: PMC8574499 DOI: 10.1093/ajcp/aqab191.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Introduction/Objective PathElective.com was founded as a means of combating stagnating resident and medical student education due to halting of in-person educational activities during the COVID-19 pandemic. The site has since grown to be included in medical student and resident training programs at numerous institutions across the world, serving as a unique means of delivering high-quality and trackable laboratory medicine education. Methods/Case Report The PathElective website was developed using Squarespace, video lectures were recorded by each professor or sourced from openly available web resources incorporating virtual slides, reading assignments, or relevant podcasts at the course director’s discretion. Monthly website traffic data were obtained through Squarespace analytics for the first 11 months of the website being available (May 1, 2020, to April 22, 2021). Geographic and source data were obtained through deidentified IP address analysis built-in to Squarespace analytics. Students who registered to take the online courses were assessed before and after interacting with the course materials using a dual form crossover quiz design to prevent memorization of questions and assess comprehension. Quiz data were all anonymous and improvement was determined using a paired t-test. Comparisons between courses were made via percentage improvements. Results (if a Case Study enter NA) Over the tracking period, PathElective.com received 352,012 page views, 73,550 visits, 33,225 unique visitors, and accrued 5,815 registered users. Most of the visitors (72.8%) arrived at the site via a direct URL input, 14.9% through a search engine, and 10.6% through social media. Most visitors were from the US (43.8%) or India (11.9%). With a total of 1598 test pairs being analyzed from all clinical pathology modules, the average increase in score was 14.4% (95%, CI=10.3-18.6, p=0.0052). All courses experienced a statistically significant increase in scores except for Clinical Chemistry lesson 3.2 (7%, -1.8-15.9% CI, p=0.12). Courses were well received with a median satisfaction score was very satisfied in all six assessment categories. Conclusion PathElective.com is a free and effective means of enhancing clinical pathology training in medical education. Students liked the online format, the quality of the lectures, and course faculty, and felt they could get help if needed. An area of improvement for this platform would be the interaction with students on social media.
Collapse
Affiliation(s)
- C M Lilley
- Stritch School of Medicine, Loyola University Chicago, Chicago, Illinois, UNITED STATES
| | - M J Marin
- Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, Florida, UNITED STATES
| | - J Wiencek
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, UNITED STATES
| | - L Fu
- Stritch School of Medicine, Loyola University Chicago, Chicago, Illinois, UNITED STATES
| | - K Wolniak
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, UNITED STATES
| | - C E Kanakis
- Department of Pathology and Laboratory Medicine, Loyola University Medical Center, Maywood, Illinois, UNITED STATES
| | - D Hermelin
- Department of Pathology, Anatomic & Clinical, Saint Louis University School of Medicine, St. Louis, Missouri, UNITED STATES
| | - T Scordino
- Department of Pathology, University of Oklahoma Medical Center, Oklahoma City, Oklahoma, UNITED STATES
| | - C Thomas
- Department of Pathology, University of Oklahoma Medical Center, Oklahoma City, Oklahoma, UNITED STATES
| | - K M Mirza
- Department of Pathology and Laboratory Medicine, Loyola University Medical Center, Maywood, Illinois, UNITED STATES
| | - C Demas
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, UNITED STATES
| |
Collapse
|
20
|
Hagen ES, Mirza KM, Anderson E, Cox B. An Examination of Non-Pathologist Physicians’ Experiences with and Perceptions of the Autopsy. Am J Clin Pathol 2021. [DOI: 10.1093/ajcp/aqab191.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction/Objective
The autopsy is an undervalued and underutilized resource in medicine. Many people believe autopsies are used solely in forensics while in fact much of what we know about human disease comes from examining the human body at autopsy. The decrease in requests for autopsy over the past several decades possibly results from medical professionals’ lack of exposure to and understanding of autopsy. We conducted a survey to explore non-pathologist physicians’ exposure to and understanding of the autopsy and discover challenges and barriers faced by non-pathologists when requesting an autopsy. Better understanding of non-pathologist physicians’ views and experiences can guide further inquiry or intervention to remove barriers to autopsy requests.
Methods/Case Report
We disseminated a Google Forms survey via Twitter, tweeting weekly between 10/26/20- 2/26/2021 to obtain a convenience sample. Mean differences in continuous variables were assessed using an independent samples T-test. Chi-squared analyses were employed to report proportional differences in categorical variables. Where appropriate, comparisons of Likert scores (percentages) were performed using ordinal regression methods and reported as odds ratios. Analyses were performed on SPSS statistical software (v.27). P-value was considered significant if <0.05.
Results (if a Case Study enter NA)
162 physicians responded to the survey. 29 responses were excluded (work outside US, practice pathology, or in residency), resulting in 133 surveys for analysis. Preliminary analysis suggests that Likert scores were generally favorable (>3) for questions that asked whether the autopsy was of benefit to the clinical team, public health, and family closure. Also, Likert scores revealed that physicians experience barriers surrounding the autopsy in terms of understanding and comfort with tasks related to the autopsy.
Conclusion
Our study reveals that physicians are often unsure about the cause of their patients’ death, highlighting the continued importance of the autopsy in patient care. Barriers to autopsy use may include limited understanding of the procedure, how it is financed, and how to request an autopsy. Physicians also express discomfort with discussing autopsy with families. Education and specific training on conversations about the autopsy may increase use.
Collapse
Affiliation(s)
- E S Hagen
- Medical School, Loyola University Chicago Stritch School of Medicine, Forest Park, Illinois, UNITED STATES
| | - K M Mirza
- Medical School, Loyola University Chicago Stritch School of Medicine, Forest Park, Illinois, UNITED STATES
| | - E Anderson
- Medical School, Loyola University Chicago Stritch School of Medicine, Forest Park, Illinois, UNITED STATES
| | - B Cox
- Pathology, Cedars-Sinai Medical Center, Los Angeles, California, UNITED STATES
| |
Collapse
|
21
|
Abstract
OBJECTIVES The goal is to describe the use of a virtual platform in the delivery of Virtual Pathology Grand Rounds (VPGR) and discuss the overall experience from the perspective of hosts, speakers, and participants. METHODS Zoom was a natural choice for an online format because virtual platforms had been increasingly used to conduct meetings and medical education. VPGR hosted 14 speakers on a variety of topics, including subspecialty anatomic pathology material, digital pathology, molecular pathology, and medical education. RESULTS There were 221 registrants and 114 participants for the first lecture, reaching a maximum of 1,268 registrants for the 12th lecture and the maximum limit of 300 participants during 3 lectures. Speakers stated that VPGR conveniently provided career-building opportunities through partnerships with host universities and remote attendance. Participants identified a lack of interpersonal communication and technical challenges as downsides. CONCLUSIONS VPGR serves as strong proof of concept for the feasibility and demand for high-quality, remote academic pathology talks.
Collapse
Affiliation(s)
- Kamran M Mirza
- Department of Pathology and Laboratory Medicine, Loyola University Health System, Maywood, IL, USA
| | - Raul S Gonzalez
- Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | | | - Elham Khanafshar
- Department of Pathology, University of California San Francisco, San Francisco, CA, USA
| | - Sara E Wobker
- Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| |
Collapse
|
22
|
Ahmed A, Mirza KM, Loghavi S. Elevating Twitter-Based Journal Club Discussions by Leveraging a Voice-Based Platform: #HemepathJC Meets Clubhouse. Curr Hematol Malig Rep 2021; 16:418-421. [PMID: 34586560 PMCID: PMC8480116 DOI: 10.1007/s11899-021-00644-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2021] [Indexed: 10/28/2022]
Abstract
PURPOSE OF REVIEW Social media-based scientific journal clubs provide an opportunity to promote published literature to a broader audience and allow robust multi-disciplinary and inter-professional discussion. Hematopathology Journal Club (#HemepathJC) on Twitter has successfully conducted monthly sessions since November 2019, covering topics related to lymphoma and leukemia. RECENT FINDINGS To enhance connectivity, multitasking, and productivity, we present our experience of leveraging the voice-based platform Clubhouse concurrent with Twitter. The Twitter and Clubhouse partnership for #hemepathJC holds the potential to increase dissemination of scientific knowledge and further promote journal club format discussion.
Collapse
Affiliation(s)
- Aadil Ahmed
- Department of Pathology & Laboratory Medicine, Rush University Medical Center, Chicago, IL, USA.
| | - Kamran M Mirza
- Department of Pathology & Laboratory Medicine, Loyola University Health System, Maywood, IL, USA
| | - Sanam Loghavi
- Department of Hematopathology, MD Anderson Cancer Center, Houston, TX, USA
| |
Collapse
|
23
|
Abstract
CONTEXT.— Hemophagocytic lymphohistiocytosis (HLH) is a rare, life-threatening disorder of immune regulation that can eventually result in end-organ damage and death. HLH is characterized by uncontrolled activation of cytotoxic T lymphocytes, natural killer cells, and macrophages that can lead to a cytokine storm. The diagnosis of HLH is often challenging due to the diverse clinical manifestations and the presence of several diagnostic mimics. The prognosis is generally poor, warranting rapid diagnosis and aggressive management. OBJECTIVE.— To provide a comprehensive review of the pathogenesis, clinical features, diagnosis, and management of HLH. DATA SOURCES.— Peer-reviewed literature. CONCLUSIONS.— HLH is a condition where a complete understanding of the pathogenesis, early diagnosis, and proper management has an important role in determining patient outcome. Genetic mutations causing impairment in the function of cytotoxic T lymphocytes and natural killer cells have been identified as the root cause of familial HLH; however, the specific pathogenesis of acquired HLH is unclear. The HLH-2004 protocol used in the diagnosis of HLH was originally developed for the pediatric population. The HLH-2004 protocol still forms the basis of the diagnosis of HLH in adults, although its use in adults has not been formally validated yet. Treatment of HLH is primarily based on the HLH-94 protocol, which involves suppressing the inflammatory response, but the treatment needs to be modified in adults depending on the underlying cause and comorbidities.
Collapse
Affiliation(s)
- Tanya Sajan Ponnatt
- From the Department of Pathology, Loyola University Chicago, Health Sciences Campus, Maywood, Illinois
| | - Cullen M Lilley
- From the Department of Pathology, Loyola University Chicago, Health Sciences Campus, Maywood, Illinois
| | - Kamran M Mirza
- From the Department of Pathology, Loyola University Chicago, Health Sciences Campus, Maywood, Illinois
| |
Collapse
|
24
|
Hernandez PV, Razzano D, Riddle ND, Fallon JT, Islam HK, Mirza KM, Pattarkine R, Platero T, Hermelin D, Adem PV, Booth AL, Nachinga EM, Reddy KS, Mares A, Lento PA. Measuring the Efficacy of Pathology Career Recruitment Strategies in US Medical Students. Arch Pathol Lab Med 2021; 146:494-500. [PMID: 34324631 DOI: 10.5858/arpa.2020-0834-oa] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2021] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Multiple articles and surveys in the literature suggest that medical students find a career in pathology undesirable and believe it is disproportionately focused primarily on the autopsy. OBJECTIVE.— To measure the effect of applied interventions on medical student attitudes about the field of pathology. DESIGN.— This prospective study involving medical students from first through fourth year was conducted as a pilot study in 2 medical schools in the United States. A 2-part anonymous survey regarding interest in pathology as a career and familiarity with the specialty using a 10-point scale was given to first- and second-year medical students before and after they listened to a 10-minute pathology career presentation. The same survey was given to third- and fourth-year medical students before and after a 4-week pathology elective. RESULTS.— A total of 121 and 83 students responded to the survey before and after the intervention, respectively. Of the 121 students who responded to the survey before the intervention, 106 (87.6%) had not spent significant time in a pathology laboratory before the intervention. The majority of responses in interest in career, job responsibilities, and features of pathologists before and after the intervention demonstrated a statistically significant difference (P < .001). We compared survey scores of presentation versus 4-week rotation groups before and after the intervention. Students who experienced the presentation did not differ from students who experienced the rotation in the majority of questions related to interest in career, job responsibilities, and features of pathologists. CONCLUSIONS.— Our study suggests that pathology exposure strategies can have a beneficial effect on student perceptions of the field and consideration of a career in pathology. Overall, the presentation intervention on the first- and second-year students seemed to have the greatest effect.
Collapse
Affiliation(s)
- Patricia V Hernandez
- From the Hadlock Laboratory, Institute for Systems Biology, Seattle, Washington (Hernandez).,Hernandez and Razzano contributed equally to this article
| | - Dana Razzano
- Hernandez and Razzano contributed equally to this article.,The Department of Pathology and Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut (Razzano)
| | - Nicole D Riddle
- The Department of Pathology, University of South Florida, Tampa (Riddle)
| | - John T Fallon
- The Department of Pathology and Laboratory Medicine, Brody School of Medicine at East Carolina University, Greenville, North Carolina (Fallon)
| | - Humayun K Islam
- The Department of Pathology, Microbiology, and Immunology, New York Medical College at Westchester Medical Center, Valhalla, New York (Islam, Pattarkine, Mares, Lento)
| | - Kamran M Mirza
- The Department of Pathology and Laboratory Medicine, Loyola University Chicago Stritch School of Medicine, Maywood, Illinois (Mirza)
| | - Rugved Pattarkine
- The Department of Pathology, Microbiology, and Immunology, New York Medical College at Westchester Medical Center, Valhalla, New York (Islam, Pattarkine, Mares, Lento)
| | - Tania Platero
- The University of El Salvador School of Medicine, San Salvador, El Salvador (Platero)
| | - Daniela Hermelin
- The Department of Pathology, SSM Health Saint Louis University Hospital, St Louis, Missouri (Hermelin)
| | - Patricia V Adem
- The Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York (Adem)
| | - Adam L Booth
- the Department of Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts (Booth)
| | - Eunice Mbela Nachinga
- the Department of Family Medicine, Kaiser Permanente, Seattle, Washington (Nachinga)
| | - Kalpana S Reddy
- the Department of Pathology and Laboratory Medicine, Hofstra North Shore-LIJ School of Medicine at Hofstra University, Hempstead, New York (Reddy)
| | - Angelica Mares
- The Department of Pathology, Microbiology, and Immunology, New York Medical College at Westchester Medical Center, Valhalla, New York (Islam, Pattarkine, Mares, Lento)
| | - Patrick A Lento
- The Department of Pathology, Microbiology, and Immunology, New York Medical College at Westchester Medical Center, Valhalla, New York (Islam, Pattarkine, Mares, Lento)
| |
Collapse
|
25
|
Mirza KM, Lilley CM, Upton MP. Is It Time for a Broader Call to Learn the Language of Pathology and Laboratory Medicine? Lab Med 2021; 52:415-419. [PMID: 34125194 DOI: 10.1093/labmed/lmab017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Kamran M Mirza
- Department of Pathology and Laboratory Medicine, Loyola University Chicago Stritch School of Medicine, Maywood, Illinois
| | - Cullen M Lilley
- Department of Pathology and Laboratory Medicine, Loyola University Chicago Stritch School of Medicine, Maywood, Illinois
| | - Melissa P Upton
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington
| |
Collapse
|
26
|
Lilley CM, Arnold CA, Arnold M, Booth AL, Gardner JM, Jiang XS, Loghavi S, Mirza KM. The Implementation and Effectiveness of PathElective.com. Acad Pathol 2021; 8:23742895211006829. [PMID: 33884295 PMCID: PMC8040569 DOI: 10.1177/23742895211006829] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 01/03/2021] [Accepted: 02/14/2021] [Indexed: 12/04/2022] Open
Abstract
The COVID-19 pandemic put most in-person pathology electives on-hold as departments adapted to changes in education and patient care. To address the subsequent void in pathology education, we created a free, virtual, modular, and high-quality pathology elective website. Website traffic from June 1, 2020, to October 1, 2020, was monitored using the built-in analyses on Squarespace. Twitter engagement was analyzed using Twitter analytics and the Symplur Social Graph Score. A voluntary satisfaction survey was sent to all PathElective users and results were analyzed. During this time, the site saw 25 467 unique visitors, over 34 988 visits, 181 302 page views, and 4449 subscriptions from 99 countries. Countries with the highest traffic are the United States (14 682), India (5210), and the Philippines (2195). PathElective’s Twitter social graph score increased from 63.59 to 89.3 with the addition of 1637 followers. Data from surveyed users (n = 177) show most to be pathology residents (41%). Most subscribers (89%) are committed to a career in pathology. The majority heard of the website via Twitter (55%). Almost half of those surveyed engaged with the PathTwitter community on Twitter and of those who participated, 99% found that interaction useful. In all survey questions surrounding satisfaction and usefulness, a large majority of the users were either satisfied or very satisfied. PathElective is a novel pathology elective that offers a unique opportunity to educate medical students and residents from around the globe and demonstrates high effectiveness and satisfaction among users.
Collapse
Affiliation(s)
- Cullen M Lilley
- Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA
| | - Christina A Arnold
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Michael Arnold
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Department of Pathology and Laboratory Medicine, Children's Hospital Colorado, Aurora, CO, USA
| | - Adam L Booth
- Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Jerad M Gardner
- Department of Laboratory Medicine, Geisinger Medical Center, Danville, PA, USA
| | | | - Sanam Loghavi
- Department of Hematopathology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Kamran M Mirza
- Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA.,Department of Pathology and Laboratory Medicine, Loyola University Medical Center, Maywood, IL, USA
| |
Collapse
|
27
|
Whaley RD, Booth AL, Mirza KM. Changes in USMLE Step 1 Result Reporting: A Pass or Fail for Pathology Programs? Acad Pathol 2021; 8:2374289521998029. [PMID: 33796640 PMCID: PMC7983407 DOI: 10.1177/2374289521998029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 01/17/2021] [Accepted: 01/22/2021] [Indexed: 11/16/2022] Open
Affiliation(s)
- Rumeal D Whaley
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Adam L Booth
- Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Kamran M Mirza
- Department(s) of Pathology and Laboratory Medicine, and Medical Education, Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA
| |
Collapse
|
28
|
Abstract
This review describes how Twitter is currently used by laboratory professionals for education, research, and networking. This platform has a global audience. It enables users to post information publicly, easily, rapidly, and free of charge. The absence of hierarchies enables interactions that may not be feasible offline. Laboratory professionals teach thousands of people using text, images, polls, and videos. Academic discussion flourishes without paywalls. Published research is shared faster than ever before, articles are discussed in online journal clubs, and research collaborations are facilitated. Pathologists network globally and make new friends within and beyond their specialty. Pathology departments and residency programs showcase trainees and faculty and celebrate graduations. As users in one time zone go to bed, others who are just waking up begin to read and tweet, creating a 24/7/365 live global online conference. We encourage others to plug into the power of Twitter, the network that never sleeps.
Collapse
Affiliation(s)
- Sanjay Mukhopadhyay
- Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio
| | - Constantine Kanakis
- Department of Pathology and Laboratory Medicine, Loyola University Health System, Maywood, Illinois
| | - Kathryn Golab
- Wisconsin Diagnostic Laboratories, Milwaukee, Wisconsin
| | - Daniela Hermelin
- Department of Pathology, St. Louis University Hospital, St. Louis, Missouri
| | - Genevieve M Crane
- Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio
| | - Kamran M Mirza
- Department of Pathology and Laboratory Medicine, Loyola University Health System, Maywood, Illinois
| |
Collapse
|
29
|
Hamnvåg HM, McHenry A, Ahmed A, Trabzonlu L, Arnold CA, Mirza KM. #TwitterHomework During Pathology Electives: Transforming Pathology Pedagogy. Arch Pathol Lab Med 2021; 145:1438-1447. [PMID: 33571353 DOI: 10.5858/arpa.2020-0391-oa] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2020] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Twitter has become a popular platform for pathologists, where they share cases and educational content, arrange journal club meetings, network, and collaborate. OBJECTIVE.— To determine if composing original tweets or retweeting existing content can be used as an educational and networking tool for medical students during pathology electives. DESIGN.— In this retrospective study, a survey was sent to assess if medical students who used Twitter during their pathology electives found the platform useful for the attainment of medical knowledge, and for networking and professional development. A similar survey was sent to rotating students who did not use Twitter, asking if they thought using the platform could be beneficial. Additionally, we used Twitter analytical software (Symplur Signals) to determine the potential for networking by analyzing the number of retweets and impressions. RESULTS.— Most respondents who used Twitter described using the platform as helpful in increasing their medical knowledge and useful for networking and professional development. From August 1, 2017, to January 2, 2019, thirty-seven elective medical students composed a total of 527 original tweets. The tweets were retweeted a total of 3399 times by 810 nonstudent users, and this engagement resulted in 6 360 731 impressions. Most of the retweeting was done by pathologists and pathology residents. CONCLUSIONS.— The responses from the survey suggest that Twitter can be an educational tool during pathology electives and be useful for networking purposes. The number of retweets and impressions, and the demographics of the users who retweeted the students confirm the networking potential of Twitter.
Collapse
Affiliation(s)
- Hans Magne Hamnvåg
- From the Department of Pathology and Laboratory Medicine, Loyola University Chicago, Maywood, Illinois (Hamnvåg, McHenry, Ahmed, Trabzonlu, Mirza)
| | - Austin McHenry
- From the Department of Pathology and Laboratory Medicine, Loyola University Chicago, Maywood, Illinois (Hamnvåg, McHenry, Ahmed, Trabzonlu, Mirza).,McHenry is currently in the Department of Pathology at Yale School of Medicine in New Haven, Connecticut
| | - Aadil Ahmed
- From the Department of Pathology and Laboratory Medicine, Loyola University Chicago, Maywood, Illinois (Hamnvåg, McHenry, Ahmed, Trabzonlu, Mirza).,Ahmed is currently in the Department of Pathology at University of Arkansas for Medical Sciences in City
| | - Levent Trabzonlu
- From the Department of Pathology and Laboratory Medicine, Loyola University Chicago, Maywood, Illinois (Hamnvåg, McHenry, Ahmed, Trabzonlu, Mirza)
| | - Christina A Arnold
- and the Department of Pathology, Ohio State University, Columbus (Arnold).,Arnold is currently in the Department of Pathology at the University of Colorado Denver - Anschutz Medical Campus in Aurora
| | - Kamran M Mirza
- From the Department of Pathology and Laboratory Medicine, Loyola University Chicago, Maywood, Illinois (Hamnvåg, McHenry, Ahmed, Trabzonlu, Mirza)
| |
Collapse
|
30
|
El Hussein S, Khoury JD, Lyapichev KA, Tashakori M, Khanlari M, Miranda RN, Kanagal-Shamanna R, Wang SA, Ahmed A, Mirza KM, Crane GM, Medeiros LJ, Loghavi S. Next-Generation Scholarship: Rebranding Hematopathology Using Twitter: The MD Anderson Experience. Mod Pathol 2021; 34:854-861. [PMID: 33219298 PMCID: PMC7678590 DOI: 10.1038/s41379-020-00715-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/18/2020] [Accepted: 10/19/2020] [Indexed: 12/30/2022]
Abstract
Hematopathologists are witnessing very exciting times, as a new era of unsurpassed technological advances is unfolding exponentially, enhancing our understanding of diseases at the genomic and molecular levels. In the evolving field of precision medicine, our contributions as hematopathologists to medical practice are of paramount importance. Social media platforms such as Twitter have helped facilitate and enrich our professional interactions and collaborations with others in our field and in other medical disciplines leading to a more holistic approach to patient care. These platforms also have created a novel means for instantaneous dissemination of new findings and recent publications, and are proving to be increasingly useful tools that can be harnessed to expand our knowledge and amplify our presence in the medical community. In this Editorial, we share our experience as hematopathologists with Twitter, and how we leveraged this platform to boost scholarly activities within and beyond our subspecialty, and as a powerful medium for worldwide dissemination of educational material and to promote our remote teaching activities during the COVID-19 pandemic.
Collapse
Affiliation(s)
- Siba El Hussein
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Joseph D. Khoury
- grid.240145.60000 0001 2291 4776Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Kirill A. Lyapichev
- grid.240145.60000 0001 2291 4776Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Mehrnoosh Tashakori
- grid.240145.60000 0001 2291 4776Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Mahsa Khanlari
- grid.240145.60000 0001 2291 4776Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Roberto N. Miranda
- grid.240145.60000 0001 2291 4776Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Rashmi Kanagal-Shamanna
- grid.240145.60000 0001 2291 4776Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Sa A. Wang
- grid.240145.60000 0001 2291 4776Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Aadil Ahmed
- grid.241054.60000 0004 4687 1637Department of Pathology and Laboratory Medicine, The University of Arkansas for Medical Sciences, Little Rock, AR USA
| | - Kamran M. Mirza
- grid.470420.50000 0004 0443 7488Department of Pathology and Laboratory Medicine, Loyola University Health System, Maywood, IL USA
| | - Genevieve M. Crane
- grid.239578.20000 0001 0675 4725Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH USA
| | - L. Jeffrey Medeiros
- grid.240145.60000 0001 2291 4776Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Sanam Loghavi
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| |
Collapse
|
31
|
Abstract
Introduction/Objective Grand Rounds seminars are a cornerstone of scholarship in all academic departments. They provide education, stimulate discussion, and build faculty reputation. The COVID-19 pandemic led to cancellations in teaching conferences and lost opportunities for all of the above starting in March 2020. The social medial hashtag #VirtualPathGR and @VirtualPathGR Twitter (San Francisco, CA) accounts (VPGR) were created to address a need for continued engagement in academic pathology, during and after periods of physical distancing. Methods #VirtualPathGR was first used on March 21, 2020 to assess interest in a VPGR format. Six pathologists organized a social-media based platform, utilizing video conferencing. Zoom (San Jose, CA) was selected because it is free and easy to use. A committee developed criteria for inviting hosts and speakers, developed a logo and template for announcements and promoted VPGR. Potential speakers were selected initially via self-nomination and subsequently by selections from the VPGR board. Free pre-registration was required to minimize risk of disruption by malicious actors. Academic institutions served as “hosts” similar to traditional GR, and the speaker was introduced by one of the VPGR board members. Evaluations were sent to participants via the chat function in Zoom. Lectures were recorded and archived via YouTube (San Bruno, CA). Results As of May 1, #VirtualPathGR has 2.6 million impressions and the Twitter account has 808 followers. From April 2 to May 1, five VPGR were held with 1,720 registrations (average 344 per event) and 829 Zoom attendees overall (average 165 per event). 4 separate academic host institutions were involved and speakers included Assistant to Full Professors. Participants from 16 different countries attended the live sessions. The archived talks have been viewed 954 times via YouTube. VPGR received support from the American Society for Clinical Pathology (Chicago, IL), leading to a partnership to provide CME credit. Conclusion VPGR serves as strong proof of concept of the ability and demand for high quality academic pathology talks to be given remotely. VPGR promotes academic engagement and provides career-building opportunities by partnering with host universities. While remote learning comes with challenges, VPGR shows that the pathology community can harness the power of remote technologies to enhance learning across the world, now and in the future.
Collapse
Affiliation(s)
- S E Wobker
- Pathology and Laboratory Medicine, UNC Chapel Hill, Chapel Hill, North Carolina, UNITED STATES
| | - K M Mirza
- Pathology, Loyola University, Chicago, Illinois, UNITED STATES
| | - X Jiang
- Pathology, Duke University, Durham, North Carolina, UNITED STATES
| | - R Gonzalez
- Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, UNITED STATES
| |
Collapse
|
32
|
Mukhopadhyay S, Booth AL, Calkins SM, Doxtader EE, Fine SW, Gardner JM, Gonzalez RS, Mirza KM, Jiang XS. Leveraging Technology for Remote Learning in the Era of COVID-19 and Social Distancing. Arch Pathol Lab Med 2020; 144:1027-1036. [PMID: 32364793 DOI: 10.5858/arpa.2020-0201-ed] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2020] [Indexed: 11/06/2022]
Abstract
The ongoing global pandemic of coronavirus disease 2019 (COVID-19) has rapidly disrupted traditional modes of operation in health care and education. In March 2020, institutions in the United States began to implement a range of policies to discourage direct contact and encourage social distancing. These measures have placed us in an unprecedented position where education can no longer occur at close quarters-most notably, around a multiheaded microscope-but must instead continue at a distance. This guide is intended to be a resource for pathologists and pathologists-in-training who wish to leverage technology to continue collaboration, teaching, and education in this era. The article is focused mainly on anatomic pathology; however, the technologies easily lend themselves to clinical pathology education as well. Our aim is to provide curated lists of various online resources that can be used for virtual learning in pathology, provide tips and tricks, and share our personal experience with these technologies. The lists include videoconferencing platforms; pathology Web sites; free online educational resources, including social media; and whole slide imaging collections. We are currently living through a unique situation without a precedent or guidebook, and we hope that this guide will enable the community of pathology educators worldwide to embrace the opportunities that 21st century technology provides.
Collapse
Affiliation(s)
- Sanjay Mukhopadhyay
- Department of Pathology, Cleveland Clinic, Cleveland, Ohio (Mukhopadhyay, Doxtader)
| | - Adam L Booth
- Department of Pathology, University of Texas Medical Branch, Galveston (Booth)
| | - Sarah M Calkins
- Department of Pathology, University of California, San Francisco (Calkins)
| | - Erika E Doxtader
- Department of Pathology, Cleveland Clinic, Cleveland, Ohio (Mukhopadhyay, Doxtader)
| | - Samson W Fine
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York (Fine)
| | - Jerad M Gardner
- Departments of Pathology and Dermatology, University of Arkansas for Medical Sciences, Little Rock (Gardner)
| | - Raul S Gonzalez
- Department of Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts (Gonzalez)
| | - Kamran M Mirza
- Department of Pathology and Laboratory Medicine, Loyola University Health System, Maywood, Illinois (Mirza)
| | - Xiaoyin Sara Jiang
- Department of Pathology, Duke University Medical Center, Durham, North Carolina (Jiang)
| |
Collapse
|
33
|
Ziemba YC, Razzano D, Allen TC, Booth AL, Anderson SR, Champeaux A, Feldman MD, Fitzhugh V, Gittens S, Grider M, Gupta M, Hanos C, Kelly K, Kothari T, Laudadio J, Lin AY, Mirza KM, Montone KT, Prieto VG, Remick DG, Riddle ND, Schubert M, Suskie K, Zafar N, Robboy SJ, Markwood PS. Social Media Engagement at Academic Conferences: Report of the Association of Pathology Chairs 2018 and 2019 Annual Meeting Social Media Committee. Acad Pathol 2020; 7:2374289520934019. [PMID: 32733989 PMCID: PMC7370333 DOI: 10.1177/2374289520934019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 04/08/2020] [Accepted: 05/03/2020] [Indexed: 12/16/2022] Open
Abstract
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 social media committee reviews the strategies that were employed and the resultant outcome data. In addition, we categorize tweets by topic to identify the topics of greatest interest to meeting participants, and we discuss the differences between Twitter and other social media platforms. Lastly, we review the existing literature on this topic from 23 medical specialties and health care fields.
Collapse
Affiliation(s)
- Yonah C Ziemba
- Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Dana Razzano
- Westchester Medical Center, New York Medical College, Valhalla, NY, USA
| | | | - Adam L Booth
- University of Texas Medical Branch, Galveston, TX, USA
| | | | - Anne Champeaux
- Ruffolo, Hooper, and Associates; University of South Florida Morsani College of Medicine, Tampa, FL, USA
| | | | | | - Simone Gittens
- Westchester Medical Center, New York Medical College, Valhalla, NY, USA
| | | | - Mary Gupta
- University of Tennessee Health Science Center, Memphis, TN, USA
| | | | - Karen Kelly
- SUNY Upstate Medical University, Syracuse, NY, USA
| | - Tarush Kothari
- Westchester Medical Center, New York Medical College, Valhalla, NY, USA
| | | | - Amy Y Lin
- University of Illinois at Chicago, IL, USA
| | | | | | - Victor G Prieto
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Nicole D Riddle
- Ruffolo, Hooper, and Associates; University of South Florida Morsani College of Medicine, Tampa, FL, USA
| | | | | | | | | | | |
Collapse
|
34
|
Felicelli C, Lopez-Hisijos N, Omman R, Shepherd D, Ananthanarayanan V, Kini AR, Ketterling RP, Maleszewski JJ, Jaffe ES, Nand S, Newman J, Haryani A, Liebo M, Mirza KM. Anaplastic large-cell lymphoma (ALK-negative)-related heart failure and recurrence after heart transplantation. J Heart Lung Transplant 2020; 39:1156-1158. [PMID: 32711931 DOI: 10.1016/j.healun.2020.06.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/25/2020] [Accepted: 06/25/2020] [Indexed: 11/26/2022] Open
Affiliation(s)
- Christopher Felicelli
- Department of Pathology and Laboratory Medicine, Loyola University Medical Center, Maywood, Illinois
| | - Nicolas Lopez-Hisijos
- Department of Pathology and Laboratory Medicine, Loyola University Medical Center, Maywood, Illinois
| | - Reeba Omman
- Department of Pathology and Laboratory Medicine, Loyola University Medical Center, Maywood, Illinois
| | - Daniel Shepherd
- Department of Pathology and Laboratory Medicine, Loyola University Medical Center, Maywood, Illinois
| | | | - Ameet R Kini
- Department of Pathology and Laboratory Medicine, Loyola University Medical Center, Maywood, Illinois
| | - Rhett P Ketterling
- Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Joseph J Maleszewski
- Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Elaine S Jaffe
- Section of Hematopathology, NIH (National Cancer Institute), Bethesda, Maryland
| | - Sucha Nand
- Divisions of Hematology/Oncology, Loyola University Medical Center, Maywood, Illinois
| | - Joshua Newman
- Cardiology, Department of Medicine, Loyola University Medical Center, Maywood, Illinois
| | - Ashish Haryani
- Cardiology, Department of Medicine, Loyola University Medical Center, Maywood, Illinois
| | - Max Liebo
- Cardiology, Department of Medicine, Loyola University Medical Center, Maywood, Illinois
| | - Kamran M Mirza
- Department of Pathology and Laboratory Medicine, Loyola University Medical Center, Maywood, Illinois
| |
Collapse
|
35
|
Ahmed A, Wojcik EM, Ananthanarayanan V, Mulder L, Mirza KM. Learning Styles in Pathology: A Comparative Analysis and Implications for Learner-Centered Education. Acad Pathol 2019; 6:2374289519852315. [PMID: 31218251 PMCID: PMC6560795 DOI: 10.1177/2374289519852315] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 04/22/2019] [Accepted: 04/29/2019] [Indexed: 12/02/2022] Open
Abstract
Initiatives like “American Medical Association (AMA)-Reimagining Residency” and
“Accreditation Council for Graduate Medical Education (ACGME)-Next Accreditation System”
are examples of a paradigm shift toward learner-centered pedagogy in resident education.
Such interventions require an understanding of the basics of the learning process itself.
This study aimed to identify preferred learning styles in pathology with the intent to use
specialty-specific pattern data, if any, to improve pathology training modalities. Kolb’s
learning tool questionnaire was sent to pathology-inclined medical students, pathology
residents, fellows, and faculty in 5 academic programs. Data from 84 respondents (6
students, 37 residents, 12 fellows, 29 attendings) were analyzed. There was remarkable
similarity in learning styles of fellows and faculty, revealing a dominance of
observational learning styles (“assimilating” and “diverging”) that was consistent with
pathology being a visual field. In contrast, residents showed dominance of “learn by
doing” styles (“converging” and “accommodating”). Residents’ stratification by training
year showed a scattered distribution with an upward trend toward “learn by doing”
behavior. While the difference in styles between residents and faculty/fellows may be due
to a generational gap, transition from medical school, or acquisition of technical skills
required for grossing specimens, this is an opportunity for adopting blended learning
models and active learning processes to cater to residents’ different styles and to allow
for flexibility to use all styles as and when needed. Based on these findings, we
hypothesize that partnering juniors and seniors with similar styles has a potential for
successful mentorship and exploration of other psychometrics is recommended for further
understanding and improvement of pathology training.
Collapse
Affiliation(s)
- Aadil Ahmed
- Department of Pathology and Laboratory Medicine, Loyola University Medical Center, Maywood, IL, USA
| | - Eva M Wojcik
- Department of Pathology and Laboratory Medicine, Loyola University Medical Center, Maywood, IL, USA
| | | | - Lotte Mulder
- Harvard Graduate School of Education, Cambridge, MA, USA
| | - Kamran M Mirza
- Department of Pathology and Laboratory Medicine, Loyola University Medical Center, Maywood, IL, USA
| |
Collapse
|
36
|
Abstract
This unique narrative offers a moving story about the power of pathology and the joys of the pathologist.
Collapse
Affiliation(s)
- Kamran M Mirza
- Department of Pathology and Laboratory Medicine, Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA
| |
Collapse
|
37
|
Omman R, Kwong C, Shepherd D, Molnar JA, Velankar MM, Mirza KM. Revisiting Howell-Jolly Body-Like Cytoplasmic Inclusions in Neutrophils: A Report of Two Cases and Confirmation of Nuclear Origin. J Hematol 2017; 6:101-104. [PMID: 32300402 PMCID: PMC7155841 DOI: 10.14740/jh334w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Accepted: 07/26/2017] [Indexed: 11/30/2022] Open
Abstract
Howell-Jolly body-like inclusions in neutrophils have been reported in a handful of reports; however, their nuclear origin has never been confirmed to date. We report the presence of these cytoplasmic inclusions in two cases and confirm their DNA-based origin by fluorescent nuclear staining. Peripheral blood smears were manually reviewed by light microscopy and after 4',6-diamidino-2-phenylindole (DAPI) fluorescent staining via confocal microscopy. Methanol fixed peripheral blood smears were incubated with DAPI (Sigma Aldrich, St. Loius, MO, USA) and coverslipped with mounting media. DAPI-stained cells were imaged with a Leica SPE confocal microscope using a 405 nm excitation laser and a 63×/1.3 NA oil immersion objective. Optical sections spanning the entire cell thickness were acquired and maximum intensity projections were produced in ImageJ. Both cases described herein had Howell-Jolly body-like inclusions similar to those reported in the literature. Testing for relevant infectious etiologies was negative. Positive staining on fluorescence microscopy confirmed DNA-based origin of this cytoplasmic inclusion material. These DNA-based inclusions occur in the immunosuppressed patient and mimic infectious inclusions. While morphologically worrisome, recognition of these inclusions may prevent unnecessary treatment and testing in clinically appropriate patients.
Collapse
Affiliation(s)
- Reeba Omman
- Department of Pathology, Loyola University Medical Center, Maywood, IL 60153, USA
| | - Christina Kwong
- Department of Pathology, Loyola University Medical Center, Maywood, IL 60153, USA
| | - Daniel Shepherd
- Department of Pathology, Loyola University Medical Center, Maywood, IL 60153, USA
| | - Jo A Molnar
- Department of Pathology, Loyola University Medical Center, Maywood, IL 60153, USA
| | - Milind M Velankar
- Department of Pathology, Loyola University Medical Center, Maywood, IL 60153, USA
| | - Kamran M Mirza
- Department of Pathology, Loyola University Medical Center, Maywood, IL 60153, USA
| |
Collapse
|
38
|
Husain AN, Mirza KM, Fedson SE. Routine C4d immunohistochemistry in cardiac allografts: Long-term outcomes. J Heart Lung Transplant 2017; 36:1329-1335. [PMID: 28988608 DOI: 10.1016/j.healun.2017.09.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 08/30/2017] [Accepted: 09/11/2017] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND In the past decade, C4d has emerged as a potential marker for antibody-mediated rejection (AMR); however, evidence on its use as a prognostic tool has been controversial. Although the International Society for Heart and Lung Transplantation guideline recommends early routine surveillance of C4d in heart transplantation, there is no consensus on its value in the pathologic assessment of AMR. Herein we present a correlation analysis of C4d immunoreactivity in endomyocardial biopsies with clinical cardiac dysfunction, cellular rejection, human leukocyte antigen (HLA) status, cardiac allograft vasculopathy (CAV) and death. METHODS A total of 5,840 endomyocardial biopsies from 296 heart transplant recipients (January 2004 to December 2014) were stained prospectively for C4d. Strong, diffuse endothelial staining was considered positive. All patients had at least 1 year of follow-up. Positive C4d staining was present in 53 biopsies from 28 patients. Sixteen of 28 patients had clinically significant cardiac dysfunction at the time of positive biopsy. In C4d-positive patients, the mean panel-reactive antibody (PRA) level was 33%. Ten patients demonstrated a first C4d positivity within the first year post-transplant, whereas 18 patients had C4d positivity after 1 year post-transplant. At autopsy, all 11 C4d-positive patients examined demonstrated cardiac allograft vasculopathy (CAV) as the underlying cause of death. In contrast, only 2 of 8 (25%) C4d-negative patients had CAV at autopsy. In the surviving cohort, there was an angiographic diagnosis of higher-than-moderate CAV in 10 patients (3.8%). RESULTS C4d-positive patients contributed to 67% of the overall institutional mortality in heart transplant recipients. Late C4d positivity (>1 year post-transplant) demonstrated an even higher risk for developing CAV and poor prognosis than early C4d positivity (within 1 year). In the C4d-negative group with postmortem examination, 75% (6 of 8) deaths were due to non-cardiac causes. CONCLUSIONS Our findings show a positive association of C4d with CAV and death. We identified a prognostic role for C4d in heart transplantation warranting routine long-term detection of this marker in the pathologic evaluation of cardiac AMR.
Collapse
Affiliation(s)
- Aliya N Husain
- Department of Pathology, The University of Chicago Medicine, Chicago, Illinois, USA.
| | - Kamran M Mirza
- Department of Pathology, The University of Chicago Medicine, Chicago, Illinois, USA
| | - Savitri E Fedson
- Department of Medicine, The University of Chicago Medicine, Chicago, Illinois, USA
| |
Collapse
|
39
|
Mirza KM, Taxy JB, Antic T. Radical Nephrectomy for Renal Cell Carcinoma: Its Contemporary Role Related to Histologic Type, Tumor Size, and Nodal Status: A Retrospective Study. Am J Clin Pathol 2016; 145:837-42. [PMID: 27124952 DOI: 10.1093/ajcp/aqw059] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Staging for renal cell carcinoma (RCC) depends on tumor size and the status of the regional lymph nodes. Although lymph node involvement by tumor yields the most accurate staging and prognostic information in patients with carcinomas of various genitourinary organs, the role of lymph node sampling (LNS) in patients with RCC to definitively establish nodal metastases remains unsettled. METHODS In this retrospective study of 399 patients with RCC treated by total nephrectomy, 115 cases were subjected to lymph node dissection. RESULTS The corresponding primary tumors averaged larger than 8 cm. Twenty-nine showed positive lymph nodes (25%). The present review confirms that primary tumor size is a key indicator of nodal involvement. Clear cell and papillary tumors larger than 4 cm involve lymph nodes more commonly than other types of RCC. Sarcomatoid differentiation occurred in all major cell types and existed in numbers too few to predict the likelihood of nodal metastases. CONCLUSIONS LNS in RCC for staging purposes may be warranted based on tumor size (>4 cm) as determined by imaging as well as histologic cell type, the latter suggesting a selective role for preoperative fine needle aspiration or core biopsy.
Collapse
Affiliation(s)
- Kamran M Mirza
- Department of Pathology, the University of Chicago Medicine, Chicago, IL
| | - Jerome B Taxy
- Department of Pathology, the University of Chicago Medicine, Chicago, IL
| | - Tatjana Antic
- Department of Pathology, the University of Chicago Medicine, Chicago, IL.
| |
Collapse
|
40
|
Sukhanova M, Mirza KM, Li Z, Stolzel F, Onel K, Sasaki MM, Reddy P, Joseph L, Raca G. Clinical Utility of the Detection of Genomic Aberrations in Formalin-Fixed Paraffin-Embedded Myeloid Sarcoma Samples. Cancer Genet 2013. [DOI: 10.1016/j.cancergen.2013.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|