ModPath Chat
ModPath Chat is the official podcast of Modern Pathology, the journal of the US and Canadian Academy of Pathology. It features interviews with authors, opinion leaders, and experts discussing the latest science, technology, and developments in pathology. The monthly series is hosted by Dr. George J. Netto, Editor-in-Chief of Modern Pathology.
Episodes
Invasive Lobular Carcinoma (ILC): European Lobular Breast Cancer Consortium Recommendations. Anne Vincent-Salomon and Maxim De Schepper
This episode is a conversation with Professor Anne Vincent-Salomon from Institut Curie, Paris and
Dr. Maxim De Schepper from University Hospitals Leuven, Belgium. The topic is the European Lobular Breast Cancer
Consortium study aiming to harmonize the pathological diagnosis of ILC by comparing 5 commonly used E-cadherin
antibody clones (NCH-38, EP700Y, Clone 36, NCL-L-E-cad [Clon
Fumarate hydratase deficient renal cell carcinoma. Guido Martignoni and Anna Caliò
Drs. Guido Martignoni and Anna Caliò from the University of Verona in Italy discuss their recent study on primary and metastatic fumarate hydratase (FH)-deficient renal cell carcinomas. Six metastatic tumors were histologically documented with high frequency of involvement of lymph nodes, liver and peritoneal cavity. Metastases were morphologically heterogeneous often differing from corre
Intraductal oncocytic papillary neoplasm, Claudio Luchini and Gaetano Paolini
Dr. Claudio Luchini from the University of Verona and Dr. Gaetano Paolini from Brescia University Hospital in Italy discuss their systematic review article, published in Modern Pathology, on Intraductal oncocytic papillary neoplasm (IOPN) of the pancreas.
Gastrointestinal Langerhans cell histiocytosis: New insights. Shaomin Hu and Yue Xue
Our host discusses with Drs. Shaomin Hu from Cleveland Clinic and Yue Xue MD PhD, from Case Western
Reserve in Cleveland Ohio, their multi-institutional study on gastrointestinal (GI) tract involvement by Langerhans
cell histiocytosis (LCH). The authors highlight new insights from their large study showing that adult patients with
multisystem LCH exhibit similar clinicopathologic
Opening the Black Box: Spatial Transcriptomics and the Relevance of Artificial Intelligence–Detected Prognostic Regions in High-Grade Serous Carcinoma. Anna Ray Laury et al
Our host discusses with Dr. Anna Laury, from the Department of Pathology, University of Helsinki, Finland, her team's study on the utilization of AI-guided spatial transcriptomic analysis to allow for the biological interpretation of morphologic features detected by AI algorithms when applied to WSI of standard H&E sections.
The authors previously trained an AI model to identify HGSC
Pathologist-Driven Reflex Somatic Tumor DDR Testing in Localized Prostate Cancer. Susan Prendeville and Shamini Selvarajah
Our host discusses with Drs. Prendeville and Selvarajah, from the departments of Laboratory Medicine and Pathobiology at the University of Toronto, their recent study on Pathologist-Driven somatic testing for DNA Damage Repair (DDR) in prostate carcinoma (PCa).
516 FFPE samples from metastatic and localized high risk PCa cases including needle biopsies, TURP and RP specimens were tested u
Staging of Multiple NSCLC: Paradigm shift using molecular methods Natasha Rekhtman
Non-small cell lung carcinomas (NSCLCs) commonly present as 2 or more separate tumors. They encompass separate primary lung carcinomas (SPLCs), representing independently arising tumors, or intrapulmonary metastases (IPMs), representing intrapulmonary spread of a single tumor. In this episode, Dr. Natasha Rekhtman, from Memorial Sloan Kettering Cancer Ctr, NY provides an update on the gro
A Portrait of HER2- Low Invasive Lobular Carcinoma (ILC) of Breast. Lounes Djerroudi Anne Vincent-Salomon
Our host discusses with Drs. Djerroudi and Vincent-Salomon, from the Institut Curie in Paris France, their recent study comparing HER2-negative invasive breast cancer of no special type (IBC-NST), with HER2-negative ILC.
HER2-negative ILC had a higher frequency of HER2-zero cases (59.4% vs 53.7%) and a lower frequency of HER2-low (40.6% vs 46.3%). Clinicopathological features associated
Special Episode - Meet the Listeners
A most exciting conversation with some of the many engaged listeners of our podcast around the globe. Our host is joined by Dr. Zeeshan Ansar from Karachi, Pakistan; Dr. Emilian Olteanu, from Timisoara, Romania; Dr. Sanam Loghavi from Houston, USA and Dr. Sanjay Mukhopadhyay, from Clevland, USA.
Molecular Profiling of Sinonasal Olfactory Carcinoma with Lisa Rooper, MD
In this episode, our host and Dr. Lisa Rooper from Johns Hopkins University, on behalf of her group of esteemed coauthors, discuss their recent study on the molecular characteristics of “Olfactory Carcinoma.” Targeted molecular profiling of 23 cases of the rare sinonasal tumor was performed to help clarify their pathogenesis and classification. The authors found recurrent Wnt pathway and
Liver Pathology in the Molecular Era: A Conversation with the USCAP 2024 Long Course Codirectors
Integration of molecular analyses in routine diagnostics is the new practice paradigm of surgical pathology practice. The 2024 USCAP Long Course led by Dr. John Hart from the University of Chicago and Daniela Allende of Cleveland Clinic focuses on hepatic neoplasms and medical diseases where there are opportunities for ancillary molecular testing to refine the diagnosis and provide clinic
A Conversation with The Expert: Digital Transformation in Anatomic Pathology
Liron Pantanowitz MD
In this meet the expert episode, ModPath CHAT host Dr. George Netto discusses with Dr. Liron Pantanowitz, Chair of Pathology at UPMC and a pioneer leader in the field, his views on the current status and future direction of Digital Pathology. The conversation touches the various aspects of the digital transformation journey in AP, from infrastructure requirement to talent acquisition and
Automated Deep Learning-Based Diagnosis of AML Using Flow Cytometry with Olga Pozdnyakova and Joshua Lewis
Flow cytometric analysis of blood & bone marrow for diagnosis of acute myelogenous leukemia (AML) relies heavily on manual intervention in the processing & analysis steps. Attention-based multi-instance learning models (ABMILMs) are deep learning models that make accurate predictions & generate interpretable insights regarding the classification of a sample from individual events.The Drs.
WHO-HEM5 Updates in Myeloid Neoplasms, Dr. Sanam Loghavi
Modern Pathology is publishing a seminal series of review articles highlighting the recently completed fifth edition of the World Health Organization classification of hematolymphoid tumors (WHO-HEM5). In this episode of ModPath CHAT, Dr. Sanam Loghavi from The MD Anderson Cancer Center in Houston, discusses the major updates in the classification of myeloid neoplasms, providing a compari
Polymorphous Adenocarcinoma, Cribriform Subtype: Novel Fusions and Fusion Partners
Polymorphous adenocarcinoma (PAC) is a common, usually low-grade salivary gland carcinoma. While conventional PACs are most associated with PRKD1 p.E710D hotspot mutations, the cribriform subtype is often associated with gene fusions in PRKD1, PRKD2, or PRKD3. The guest, Dr. Justin Bishop from UT Southwestern Medical Center in Dallas, discusses his team’s recent study characterizing the f
Is there a Value for Anastomotic Biopsies in Crohn’s Disease?
Endoscopic evidence of disease is a critical predictor of relapse in patients with Crohn’s disease (CD). While histologic disease activity is evolving as a similarly important end point, classical morphologic features of CD may overlap with postoperative inflammatory changes, confounding the evaluation of anastomotic biopsies.In this episode, Dr, John Hart, Professor and Vice Chair of Ana
Meet the Expert: A Candid Conversation on Mentorship and Leadership Development with Dr. Laura Lamps
This episode features Dr. Laura Lamps , a leader in the field of gastrointestinal pathology. Dr. Lamps is the Godfrey D. Stobbe Professor and Director of Gastrointestinal Pathology and Assistant Chair for Faculty Development and Program Director of GI Pathology Fellowship at the Department of Pathology, Michigan Medicine, at the University of Michigan. The former President of US and Canad
Deep Learning for Predicting Prostate Cancer Molecular Subtype on H and E Images!
In this episode, Dr. Tamara Lotan from Johns Hopkins University discusses the potential of deep-learning (DL) algorithms trained on H and E-stained whole slide images (WSI) to screen for clinically relevant genomic alterations in prostate cancer (PCA).Dr. Lotan reviews her team’s recent publication in Modern Pathology, where they were able to create DL algorithms to identify PCA with unde
Melanocytic neoplasms with Protein Kinase C fusion genes
In this episode, Dr. Arnaud de la Fouchardiere, from the Universite Claude Bernard in Lyon France, discusses his multinational team’s recent study on the clinical and histologic presentation of 51 cutaneous melanocytic neoplasms with a PKC fusion gene.
Most tumors occurred in young adults (median age, 29.5 years) and some presented in newborns. Histologically, 42 tumors were class
ROS1 Alterations as a Potential Driver in Gliomas
ROS1 alterations are uncommon in gliomas and are primarily described in infants. In this episode, our host discusses with Dr. Xinyan Lu from the Feinberg School of Medicine in Chicago her team’s recent study on characterizing the clinicopathological features and molecular signatures of the full spectrum of ROS1 fusion–positive gliomas across all age groups. A multi-institutional cohort of
The Clinical and Biological Significance of ER “Low-Positive” Breast Cancer
Estrogen receptor (ER) status in breast cancer (BC) is determined using immunohistochemical nuclear expression. Currently, tumors with 1% or more positive cells are defined as ER-positive. BC, with 1%-9% expression (ER-low-positive), is a clinically and biologically unique subgroup. In this episode of Mod Path CHAT, Dr. Emad Rakha discusses his team’s study on the subject.
A large BC coho
A Practical Diagnostic Approach for Borderline Hepatocellular Adenomas
Borderline hepatocellular adenomas (BL-HCA) are characterized by focal architectural/cytologic atypia and reticulin loss, features that are insufficient for a definitive diagnosis of hepatocellular carcinoma (HCC). The diagnosis and management of BL-HCA are challenging as their biological behavior, especially in terms of malignant potential, is still debated.
Our guest, Dr. Nicola
Stimulated Raman Histology for Rapid Intraoperative Diagnosis of Central Nervous System Tumors
Stimulated Raman Histology for Rapid Intraoperative Diagnosis of Central Nervous System TumorsStimulated Raman histology (SRH) is an ex-vivo optical imaging method that enables the microscopic examination of fresh tissue intraoperatively. SRH imaging allows rapid microscopic imaging, avoids tissue loss, and enables remote telepathology review. Our guest, Dr. Matija Snuderl from New York U
An integrated approach to differentiate Grade 3 PanNET from PanNEC
Distinguishing grade 3 pancreatic neuroendocrine tumor (G3 PanNET) from neuroendocrine carcinoma (PanNEC) is a known diagnostic challenge, and accurate classification is critical because clinical behavior and therapies differ. Dr. Nancy Joseph from the University of California San Francisco discusses her group’s recent study on high-grade neoplasms originally diagnosed as pancreatic neuro
Digitally quantitated tumor cellularity as a prognostic factor in NSCLC
Dr. Matthew Cecchini from the University of Western Ontario discusses his team’s study on the prognostic role of digitally assessed cell density in non-small cell lung carcinoma (NSCLC). Recently, a revised reporting system for lung adenocarcinoma incorporates high-risk histologic patterns, which may have increased cellular density. Digital slides from The Cancer Genome Atlas (TCGA) lung
PTEN Deficiency in Tubo-Ovarian High-Grade Serous Carcinoma
In this episode, Dr. Brooke Howitt from Stanford University discusses her team’s recent study on PTEN expression in tubo-ovarian high-grade serous carcinoma (HGSCs). PTEN deficiency (complete or sub-clonal loss) as detected by immunohistochemistry was identified in 13 of the 62 HGSCs (21%) and was significantly correlated with reduced expression of estrogen receptor and worse first progre
Computer-Assisted Diagnosis of Lymph Node Metastases in Colorectal Cancers
Screening lymph nodes for metastases in colorectal cancer (CRC) can be a cumbersome task, but it is amenable to artificial intelligence (AI)-assisted diagnostic solutions. Prof. Inti Zlobec and Dr. Amjad Kahn from the Institute of Pathology in Bern, Switzerland discuss their newly proposed deep learning-based tool for the evaluation of CRC lymph node metastases in digitized whole-slide im
Fundic Gland Polyps in FAP and Sporadic Patients
Fundic gland polyps (FGPs) develop sporadically (frequently after proton pump inhibitor therapy) or in the setting of a hereditary polyposis syndrome, such as familial adenomatous polyposis (FAP). In the later setting, FGPs often demonstrate low-grade dysplasia and are frequently associated with APC mutations. Sporadic FGPs with dysplasia also demonstrate frequent APC mutations.Our guest,
SATB2 Rearrangement in Psammomatoid Ossifying Fibroma
Psammomatoid ossifying fibroma (PsOF) is a benign fibro-osseous neoplasm that predominantly affects frontal and ethmoid bones, with a preference for adolescents and young adults. The clinical and morphologic features of PsOF overlap with other fibro-osseous lesions, and additional molecular markers may help increase their diagnostic accuracy. Chromosomal breakpoints at bands Xq26 and 2q33
Genetic Profiling in Diffuse Large B-Cell Lymphoma
Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma. Over the previous two decades, tremendous progress has been made in our understanding of the molecular pathogenesis of DLBCL. Unfortunately, these advances have not yet been translated into improvements in targeted therapy. In this podcast, our guest, Dr. Daniel J. Hodson of Cambridge University, discus
SOX17: A Highly Sensitive and Specific Immunomarker for Ovarian and Endometrial Carcinomas
Currently, PAX8 is the most commonly used immunomarker for gynecologic carcinomas; however, it lacks specificity. By mining The Cancer Genome Atlas mRNA expression profile data, Drs. Ding and Liu’s team identified SOX17 as a potential specific marker for gynecologic tumors. The authors performed immunohistochemical staining on tissue microarrays from 416 ovarian and endometrial cancer cas
Ovarian Mucinous Neoplasms: How Reproducible are Current Diagnostic Categories?
Primary ovarian mucinous tumors represent a heterogeneous group of neoplasms that can be diagnostically challenging. Our guest, Dr. Pavel Dundr and his coauthors analyzed 124 tumors that were originally diagnosed as mucinous borderline tumors (MBTs) or mucinous carcinomas (MCs), with an emphasis on interobserver diagnostic agreement and assessment of the potential utility of molecular pro
Extranodal extension in HPV-positive oropharyngeal squamous cell carcinoma
Extranodal extension (ENE) is a significant prognostic factor for human papillomavirus (HPV)-negative head and neck squamous cell carcinoma. However, it remains controversial whether ENE is prognostically relevant in HPV-positive oropharyngeal squamous cell carcinoma (OPSCC). The host discusses with Dr. Nora Katabi from Memorial Sloan Kettering Cancer Center her team’s recent study on the
Detecting deficient mismatch repair in solid neoplasms
Immunohistochemistry (IHC) and microsatellite instability (MSI) testing constitute the two major test modalities currently in use for detecting deficient mismatch repair (dMMR). Each is associated with caveats and limitations that can be consequential. Most notably, the traditional approach of defining mismatch repair protein IHC abnormality by complete loss of staining in all tumor cells
Verruciform and Acanthotic Vulvar Precursor Lesions
The group of precursors that lead to HPV-independent, p53-wild-type squamous cell carcinoma is largely unexplored. Nonetheless, a subset of lesions with verruciform acanthosis and altered squamous maturation has been characterized using diverse nomenclature such as VAAD, vLSC, DEVIL, and VAM. These lesions are associated with invasive squamous cell carcinoma and verrucous carcinoma of the
Morphologic Feature Guiding Discovery of Driver Genetic Alteration in Rare Entity
Adenoid Ameloblastoma is a very rare benign odontogenic tumor characterized microscopically by epithelium resembling conventional ameloblastoma, with additional duct-like structures, epithelial whorls, and cribriform architecture. Dentinoid deposits, clusters of clear cells, and ghost-cell keratinization may also be present.These tumors do not harbor BRAF or KRAS mutations and their molec
Risk Stratification for SLNB in Melanoma
Although prophylactic lymph node dissections do not improve survival, the prognostic implications of a positive sentinel node and the benefits of removing nodal metastases for loco-regional disease control remain important. There is a strong interest in novel approaches that can improve patients’ selection for sentinel lymphnode biopsies(SLNB) given that 85% of these procedures are negati
Flat urothelial lesions of the urinary bladder: Who is in who is out?
Flat lesions of the urothelium with histologic features that falls short of the threshold for urothelial carcinoma in situ (CIS) remains a challenging problem in diagnostic surgical pathology. Among these are flat urothelial hyperplasia, urothelial dysplasia, and atypia of unknown significance; lesions that have struggled under evolving classifications, changing criteria, and limited clin
Radio-Resistant Prostate Carcinoma: "Cribriform" morphologies and DNA Damage Response and Repair defects
Locally recurrent prostate cancer from 53 patients that failed radiation therapy and underwent salvage radical prostatectomy was analyzed for clinicopathological and genomic characteristics. Most radiorecurrent tumors were enriched in cribriform morphologies (invasive cribrifom PCa and intraductal carcinoma with cribriform pattern) and demonstrated potentially targetable genomic alteratio
The Stanford Experience in Implementation of the Molecular Classification of Endometrial carcinomas (EC)
Establishing an efficient and standardized workflow for performing molecular classification on ECs, and reporting both the molecular and histologic findings in an integrative manner, is imperative. Dr. Brooke Howitt discusses with the host her institution’s effort to implement rapid and routine molecular classification on all ECs diagnosed at Stanford.
Expanding the clinico-pathological spectrum of SDH Deficient RCC
Most succinate dehydrogenase (SDH)-deficient RCCs demonstrate classic morphology characterized by bland eosinophilic cells with intracytoplasmic inclusions. Increasingly, "variant" morphologic features are recognized. Drs. Anthony Gill and Talia Fuchs discuss with the host their findings in a recent publication in Modern pathology where features such as high-grade nuclear features, necros
High Risk and Selected Benign Breast Lesions on Core Biopsy: Excision Vs Surveillance?
The vast majority of image-detected breast abnormalities are currently diagnosed by percutaneous core needle biopsy (CNB). While management of frankly malignant lesions diagnosed by CNB is now well-defined, there is less consensus on the optimal management of high-risk and selected benign lesions diagnosed by CNB. In this episode, Dr. Benjamin Calhoun from University of North Carolina in
Are ancillary studies of any utility in risk assessment of Barrett’s esophagus and dysplasia?
Modern Pathology have recently launched a new series of reviews addressing controversial issues in pathology. In this episode of ModPath CHAT, Dr. Elizabeth Montgomery, a world renowned expert in gastrointestinal pathology gives her point of view on the utility of ancillary testing for risk stratification of Barrett’s esophagus and dysplasia.
Ki-67 assessment in pancreatic neuroendocrine neoplasms manual vs. digital?
Ki-67 assessment is a key step in the diagnosis of neuroendocrine neoplasms (NENs) from all anatomic locations. The application of digital pathology coupled with machine learning has been shown to be highly accurate and reproducible for the evaluation of Ki-67 in NENs. The guest, Dr. Claudio Luchini from the University of Verona in Italy, discusses his recently published systematic review
Heterogeneity of molecular alterations in CRC with peritoneal carcinomatosis
In a subset of patients with metastatic colorectal cancer (mCRC), the peritoneum is the predominant site of dissemination. While cure can be achieved by cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), this procedure is associated with long-term morbidity and high relapse rates. In this episode of ModPath CHAT, Drs. Siesing and Jirstrom from Lund Universi
A Risk Stratification Model for Low Stage Uterine leiomyosarcoma
Uterine leiomyosarcoma is the most common uterine mesenchymal malignancy. The majority present at stage I with variable clinical outcome.In this episode of ModPath Chat, Dr. David Chapel discusses his recently published multi-institutional study proposing a novel risk stratification model (shown below) for low stage uterine leiomyosarcoma.Risk score = (coagulative necrosis)(1) + (mitoses
A promising role for methylome and copy number profiling in classifying bone and soft tissue tumors
In this episode the audience will enjoy a great discussion of the growing potential of methylome and copy number profiling, a technique well established for the classification of brain tumors, in bone and soft tissue tumors diagnosis.Nuclear overexpression of FOS and FOSB have emerged as a reliable surrogate markers to detect rearrangements of the transcription factors FOS and FOSB in ost
Pink sporadic RCCs associated with TSC/MTOR alterations
While AML and cysts are the most common renal manifestations in patients with inherited TSC syndromes, approximately 4% will develop renal cell carcinoma (RCC). These include RCC with clear cytoplasm, papillary architecture, and prominent smooth muscle stroma; RCC with granular eosinophilic cytoplasm and macrocystic architecture; and RCC resembling the eosinophilic variant of chromophobe
Spread through airspaces (STAS) on frozens: too much, too soon
The host discusses with Dr. Sanjay Mukhopadhyay and Dr. Monisha Sudarshan from Cleveland Clinic their recent Modern Pathology editorial on the findings by F. Zhou et al. (https://doi.org/10.1038/s41379-021-00875-x). The concept of tumor spread through air spaces (STAS) has been recently introduced and is gaining momentum. On permanent sections, STAS has been associated with an increased l
Image-based assessment of extracellular mucin in colorectal cancer
Dr. Inti Zlobec, professor of digital pathology at the Institute of Pathology in the University of Bern, discusses her team’s recent publication in Modern Pathology on the role of image analysis in assessing area of extracellular mucin and predicting consensus molecular subtypes (CMS) in colorectal carcinoma. The utilized deep learning algorithm had an excellent agreement with pathologist
Meet the Expert: A Conversation with Professor Reinhard Buttner
An informative discussion with Dr. Buttner on the significance of newly acquired genetic insights into pulmonary invasive mucinous adenocarcinoma (IMA). In the latest WHO classification, IMA is defined as a primary lung adenocarcinoma with tumor cells showing goblet cell- or columnar cell-morphology with abundant intracytoplasmic mucin. Due to its distinctive clinical features, i.e., peri
DP, WSI, AI, DL: The Alphabet Soup of the Third Revolution in Pathology
Traditional pathology have played an integral role in the delivery of diagnosis, semi-quantitative or qualitative assessment of protein expression, and classification of disease. Technological advances have recently paved the way for the development of digital pathology-based approaches for quantitative pathologic assessments, namely whole slide imaging (WSI) and artificial intelligence (
Atypical Uterine Polyps: A benign clinical course despite morphologic and molecular overlap with Adenosarcomas.
A subset of clinically benign uterine polyps shows atypical morphologic features worrisome for, but not diagnostic of, Mullerian adenosarcoma. The guest, Dr Marisa Nucci discusses her team’s finding in their recently published study in Modern Pathology. The authors propose the term "atypical uterine polyps" for these lesions, which show biologic overlap with early Mullerian adenosarc
Breast Implant Associated Lymphomas: EBV positivity pathogenic role?
Breast implant anaplastic large cell lymphoma (ALCL) is a T-cell neoplasm arising around textured breast implants. Our host discusses with Drs. Medeiros and Miranda their recent report on eight cases of Epstein–Barr virus (EBV)-positive large B-cell lymphoma associated with breast implants. Their data suggest a pathogenetic role for breast implants (as well as EBV) in the pathogenesis of
Molecular subtypes of Index Vs Metachronous Gastric cancers
Professor Gregory Lauwers from Moffitt Cancer Center discusses his team’s recent study comparing index and metachronous gastric cancers in 42 Korean patients. Gastric adenocarcinomas were classified into 5 subtypes: EBV-associated, MMR deficient (MMRD), E cadherin aberrant, p53-aberrant [p53(+)], and p53 non-aberrant [p53(neg)]. Although no significant difference in the frequency of most
Machine Learning facilitates assessment of shaved lumpectomy margins
Drs. Timothy D’Alfonso, David Ho, and Lee K.Tan from Memorial Sloan Kettering in NY discuss their recent Modern Pathology study describing a new machine learning algorithm that can help pathologists assess shaved margins from lumpectomy specimens. A uniquely developed Deep Multi-Magnification Network (DMMN) was utilized in Whole Slide Images (WSI) in the hope to triage negative margi
Meet the Expert: A Conversation with Professor Holger Moch
Professor Holger Moch shares with our audience his most inspiring career journey as a physician scientist and a luminary in the field of renal cancers. An enjoyable historical look back at the evolution of the field and the progress in renal tumor classifications.
2021 Year in Review
In this episode of ModPath CHAT, Dr. George J Netto reviews five of the highly cited manuscripts that were published in Modern Pathology in 2021.
NTRK Fusions
Identification of molecular alterations in NTRK 1-3 has become increasingly important with the emergence of histology-agnostic, US Food and Drug Administration-approved, effective inhibitors. The host discusses with Dr. Jaclyn Hechtman, director of clinical diagnostic development at Neogenomics, her practical insights on how testing for NTRK fusion can best be implemented and communicated
DICER1 Tumor Predisposition Syndrome: A chat with Pepper Dehner!
Dr. Dehner discusses his four decades journey with an entity that he first described in 1977. Since his initial description of Pleuropulmonary Blastoma (PPB), the neoplasm has become one of the defining entities of DICER1 Syndrome, a rare autosomal dominant familial tumor predisposition disorder with heterozygous DICER1 germline mutation. A fascinating historical perspective and most info
Re-evaluating tumors of purported specialized prostatic stromal origin: Distinct entities or Heterogenous mesenchymal neoplasms?
The host is joined by Dr. Andres Acosta from the Brigham and Women Hospital. Dr Acosta discusses, on behalf of a distinguished group of coauthors, their recent somewhat provocative modern pathology publication proposing that mesenchymal neoplasms of the prostate are morphologically and molecularly heterogeneous lesions that include neoplasms that harbor genetic aberrations seen in specifi
"AstroPath" Substituting cells for cosmic stars, the sky is the limit for digital and computational pathology!
In this special "Meet the Expert" episode, two distinguished guests from Johns Hopkins University discuss their pioneering approach of applying methodologies, initially developed for astronomy, to the assessment of biomarkers of tumor microenvironment (TME). The guests are Dr. Janis Taube, director of Dermatopathology at Hopkins, and a co-Director of the TME Core at the Bloomberg-Kimmel I
Counting Mitoses: SI(ze) matters!
In this episode, Dr. Ian Cree, Head of The WHO Tumour Classification discusses his team's recent open access publication in Modern Pathology. Historically, mitotic figures counting has been done by expressing the number of mitoses per n high power fields (HPFs), ignoring the fact that microscope fields may differ substantially, even at the same high power (×400) magnification. D
The Role of Genotyping in the Diagnosis and Prognostication of Gestational Trophoblastic Disease
In this episode of MODPATH CHAT, our guests Dr. Natalia Buza and Dr. Pei Hui from the department of Pathology at Yale University share their approach to the application of DNA genotyping to the diagnosis and prognostication of Hydatidiform moles and Gestational trophoblastic tumors. Genotyping is now the gold standard in the confirmation and subtyping of sporadic hydatidiform moles. DNA g
Regression predicts Sentinel Lymph Node (SLN) status
The prognostic significance of regression has long been a matter of debate. Our guest, Professor Richard Scolyer, co-director of the Melanoma Institute Australia discussed his team’s recent findings on the prognostic value of regression, and the presence of regression and/or tumor infiltrating lymphocytes (TIL) in primary cutaneous melanomas predicted sentinel lymph no
A Novel Prognostic Score for NSCLC following Neoadjuvant therapy
Dr. Sabina Berezowka, from the university of Lausanne Switzerland, discusses with our host her team’s recent study describing a novel "Prognostic Score" for assessing tumor regression following Neaodjuvant therapy in non-small cell lung cancer (NSCLC). The proposed combined prognostic score (PRSC) performed better than pTNM staging and previously published Major Pathologic Response (MPR)
DDIT3 Immunohistochemical expression as a diagnostic marker for Myxoid Liposarcoma
Dr. Jason Hornick discusses his team recent study finding that a monoclonal antibody directed against the N-terminus of DDIT3 is a highly sensitive and specific for high-grade MLPS. DDIT3 immunostains could replace molecular genetic testing in many cases, although limited labeling may be seen in a range of other tumor types. Study by Hornick et al, Nuclear expression of DDIT3 distinguishe
TRIM63 as a biomarker for MiT family RCC
In this episode Dr. Rohit Mehra of University of Michigan discusses the utility of TRIM63 as a diagnostic marker to distinguish MiTF-RCC from other renal tumor subtypes with overlapping morphology. In combination with TFE3/TFEB FISH, TRIM63 RNA-ISH assays can improve the accuracy and efficiency of MiTF-RCC diagnosis.Study by Mehra et al, TRIM63 is a sensitive and specific biomarker f
A MODPATH Chat with Dr. Victor Reuter: The Digital Transformation of Anatomic Pathology
Always a visionary, Dr. Reuter was one of the earliest Anatomic Pathologists to embrace and advance the genomic and more recently the digital transformation of our field.In this episode of Meet The Expert series, Dr. Reuter shares his perspective and vision on the current and future impact of digital pathology
Artificial intelligence for advance requesting of IHC in diagnostically uncertain prostate biopsies
Dr. Clare Verrill and Andrea Chatrian of Oxford University in England discuss their team’s study on AI for advance ordering of IHC in difficult prostate biopsy. Their elegant work shows that an AI tool making automated IHC request prior to the pathologist read of H&E could create leaner workflow and result in pathologist time savings and shorten overall Turnaround time from accession
Synchronous Endometrial and Ovarian Carcinomas: Clonal relationship and directionality of progression.
Dr. Britta Weigelt of MSKCC discusses her team’s study on synchronous endometrial (EC) and ovarian carcinomas (OC) in Lynch syndrome and constitutional Mismatch Repair Deficiency Syndrome (CMMRD). Contrary to sporadic synchronous ECs/OCs, which are almost invariably clonally related, ECs/OCs simultaneously involving the uterus and ovary in LS patients may represent two independent primary
Deciphering the Molecular Underpinning of Ulcerative Colitis Associated Colorectal Cancer
Dr. Daniela Hirsch, from the Institute of Pathology at the University of Heidelberg in Germany, discusses her findings on the molecular alterations associated with colorectal cancer in the setting of Ulcerative Colitis. Using aCGH, a 48 gene panel and MSI analysis and IHC for TP53, the author and her team revealed high rate of TP53 mutations and gains in chromosome 5p in these predom
Post Neo-adjuvant Chemotherapy Patterns of Residual Breast Cancer
Dr. Stuart Schnitt from Brigham and Women Hospital in Boston discusses his team'srecent findings of variable architectural and cytological patterns of residual disease in breast cancer patients with incomplete pathologic response. The relationship of pattern of residual disease to pre-treatment clinicopathologic parameters and the potential impact on management are discussed.Study by Past
"Rebranding" Hematopathology Using Twitter: The MD Anderson Experience
In this episode, our guests, Dr. Siba El Hussein and Dr. Sanam Loghavi from the department of hematopathology at MD Anderson Cancer Ctr, discuss their experience on the role of social media in the dissemination of knowledge in hematopathology and establishing networks of collaborators and followers. Editorial by El Hussein et al, Next-Generation Scholarship: Rebranding Hematopathology Usi
USCAP 2021 Long Course: Biomarkers of Response to Check Point Inhibitors - beyond PD-L1
In this fourth and final episode of our special series covering this year’s USCAP Long Course on lung disease, our guest, Dr. Lynette Sholl, chief of pulmonary pathology at the Brigham and Women Hospital discusses her presentation on "Biomarkers of Response to Checkpoint Inhibitors". Dr. Sholl touches upon the potential role of CD8+ T cell count, Multiplex IF based spatial profiling and n
USCAP 2021 Long Course: Neuroendocrine Tumors of Lung, a Decade of Change!
In this third of four special episodes highlighting the USCAP 2021 Long Course on Pulmonary Pathology, our host discusses with Dr. Natasha Rekhtman of Memorial Sloan Kettering Cancer Center (MSKCC) her presentation on Neuroendocrine tumors. Dr. Rekhtman offers her perspective on the current status of the classification of pulmonary NE tumors and the "grey zones" that remain to be tackled.
USCAP 2021 Long Course: "Pulmonary Pathology: Practical Problems and Solutions". HP, FHP, CTILD, UIP/IFP and more!
In this second of four special episodes highlighting the USCAP 2021 Long Course on Pulmonary Pathology, our host is joined by two distinguished faculty: Dr. Andrew Churg of the University of British Colombia and Dr. Maxwell Smith from the Mayo Clinic Arizona. The two international experts on interstitial lung disease (ILD) share their valuable perspective on "where we are and where we ne
USCAP 2021 Long Course: "Pulmonary Pathology: Practical Problems and Solutions". Meet the Directors!
In this special episode, Dr. Sanja Dacic and Dr. Mary Beth Beasley highlight the topics of the upcoming Long Course on Pulmonary Pathology, that will air on March 13th during the USCAP 2021 annual meeting. As international experts and thought leaders on thoracic tumors, they have been heavily involved with developing guidelines for molecular biomarkers of mesotheliomas and Lung cancers. T
MHC class I loss in endometrial carcinoma
MHC class I loss by tumor cells decreases tumor neoantigen presentation to the immune system and therefore represents a possible mechanism of immunotherapeutic resistance in cancers that otherwise could be good candidates for checkpoint inhibition (e.g. mismatch repair (MMR)-deficient and PD-L1-positive tumors). In this episode our guest, Dr. Anne Mills discusses her recent Modern Patholo
Predictors of metastases in non-seminomatous TGCT: The rationale for evolution of the pathologic staging system?
Pathological risk factors for metastatic disease in patients with testicular non-seminomatous germ cell tumors are debated. The tumor-node-metastasis (TNM) classification eighth edition for testicular cancers includes divergent versions, by the International Union Against Cancer (UICC) and by the American Joint Committee for Cancer (AJCC). In this episode we discuss with Dr. Daniel Berney
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1001 Classic Short Stories & Tales
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1001 Sherlock Holmes Stories & The Best of Sir Arthur Conan Doyle
