Members of the University of Rochester Medical Center’s Department of Pathology & Laboratory Medicine will join thousands of pathologists from across the globe to present abstracts at the 2018 meeting of the United States and Canadian Academy of Pathology (USCAP).
The meeting, which is the largest of its kind in the world, will be held March 17-23 in Vancouver, BC, Canada. Below is a schedule of events that include URMC faculty and residents. In addition to presenting research, we are pleased to again host a cocktail reception for alumni and friends at the conference on Monday, March 19 (details below). All are welcome!
For general USCAP meeting information, please visit their website.
PP – Pan Pacific Vancouver
FW – Fairmont Waterfront
FPR – Fairmont Pacific Rim
PH – Pinnacle Hotel Harbourfront
SUNDAY, MARCH 18, 2018
University of Rochester Fellowship Fair
5:30 - 7:30 PM
Table #4, VCC West Ballroom D
MONDAY, MARCH 19, 2018
8:00 AM - 12:00 PM
Real Time Cytopathology Feedback (RTCF) versus traditional Rapid On-Site Evaluation (ROSE) for Endobronchial Ultrasound Guided Fine-Needle Aspiration (EBUS-FNA) of mediastinal lymph nodes (MLN). Alexandra Danakas, Carolyn E Jones, John Plavnicky, Christian G Peyre, Sierra Kovar, Joseph J Wizorek, Mary Beth Kearns, Donna Russell, Shawn Evans, Luis De Las Casas.
HIV Enteropathy: Real or Myth? A Histologic Review. ILKe Nalbantoglu1, Raul S Gonzalez.
Poster Session I
9:30 AM - 12:00 PM
74 Significance of Clinicopathologic Parameters, Including Margin Distance and Tumor Budding, on Local Disease Recurrence Following Esophageal Endoscopic Mucosal Resection. Phoenix Bell, ILKe Nalbantoglu, Justin Cates, Raul S Gonzalez.
85 Perineal Carcinoma Cuniculatum: Histology Review of 38 Cases. Dongwei Zhang, Raul S Gonzalez, Michael Feely, Hwajeong Lee, Kavita Umrau, Daniela Allende, Dipti Karamchandani, Michael P Zaleski, Jingmei Lin, Maria Westerhoff, Xuchen Zhang, Lindsay Alpert, Jinping Lai, Xiuli Liu.
171 NKX3.1 Expression in Salivary Gland Neoplasms: A Marker for Mucinous Differentiation and a Potential Diagnostic Pitfall. Anna-Karoline Israel, Abberly Lott Limbach.
273 Extent of Lesional Cell Spread in Hepatic Epithelioid Hemangioendothelioma: Implications for the Diagnosis in Minimal Samples. Diana Agostini-Vulaj, Burcin Pehlivanoglu, Sharon Weiss, Alyssa Krasinskas, Michael Feely, Jason L Hornick5, Justin Cates, N. Volkan Adsay, Raul S Gonzalez.
1:00 PM - 3:00 PM
Moderators:Timothy D'Alfonso and Megan Troxell
Room: VCC West 211
A Novel Detection Methodology for HER2 Protein Quantitation in Clinical Samples: Correlation with Pathologic Response to Trastuzumab-Based Neoadjuvant Therapy. Bradley M. Turner, Brandon Buscaglia, Hideki Goda, Loralee Mcmahon, Takako Natori, Hisatake Okada, Armen Soukiazian, Yasushi Nakano, David Hicks.
Moderators:Tracy George and Annette Kim
Room: VCC West 208 - 209
Microarray CGH-SNP Analysis Detects Frequent Chromosomal Abnormalities Indicating Clonal Cytopenia(s) in Patients With Indeterminate Bone Marrow Dysplasia - An Institutional Study Of 94 Cases. Nisha Patel, Michelle Pitch, Andrew G Evans, M. Anwar Iqbal.
Moderators: Dhanpat Jain and Lei Zhao
Room: VCC West 224
Does ASS1 Immunohistochemistry Predict an Increased Risk of Hemorrhage in Hepatocellular Adenomas? Heidi Lehrke, Taofic Mounajjed, Raul S Gonzalez, Riyam T Zreik, Laura J Denham, Rory Smoot, Daniela Allende, Bita V Naini, Roger K Moreira, Rondell Graham.
Poster Session II
1:00 PM - 4:30 PM
123 Immunohistochemistry of Androgen Receptor and Related Signaling Pathways in Bladder Cancer as Prognosticators. Satoshi Inoue, Taichi Mizushima, Hiroki Ide, Takashi Kawahara, Guiyang Jiang, George J Netto, Hiroshi Miyamoto.
191 Acinic Cell Carcinoma of Salivary Gland Expresses Low Levels of PD-L1 with Retained MMR Proteins: A Potential Biomarker for Therapy. Abberly Lott Limbach.
How to Get Started and Succeed in Academics: Mistakes We Made and What We Wish We’d Known on Day One
Room: VCC WEST 302-304
- Raul S. Gonzalez, MD, University of Rochester Medical Center, Rochester, NY
- Rondell P. Graham, MBBS, Mayo Clinic, Rochester, MN
- Laura W. Lamps, MD, University of Michigan Hospitals, Ann Arbor, MI
- Rhonda K. Yantiss, MD, Weill Cornell Medical College, New York, NY
Description: Making the leap from training to a career in academic medicine is daunting for many pathology residents and fellows. As there are few resources specifically devoted to transitioning from pathology training to academic practice, this Special Course would offer trainees and new academic attendings an in-depth look at the first 1-5 years of academic practice. Through the experience of the faculty, participants will hear about mistakes made along the way, lessons learned in areas where there is little formal training, and strategies that have led to successes. The program will discuss useful approaches to securing an academic position, tips, and pitfalls for the first year, and positioning oneself for academic promotion. The program will also discuss how to develop an early career research program, balancing academic activity and clinical work, and avoiding burnout.
University of Rochester Medical Center Alumni Reception
5:30 - 7:30 PM
Room: Fairmont Waterfront, MacKenzie Rm. II
No RSVP required, all are welcome!
TUESDAY, MARCH 20
Poster Session III
9:30 AM - 12:00 PM
101 Should Ki67 Immunohistochemistry Be Performed on All Lesions in Multifocal Small Intestinal Neuroendocrine Tumors? Numbereye Numbere, Aaron Huber, Chanjuan Shi, Justin Cates, Raul S Gonzalez
104 Mesenteric Tumor Deposits Arising from Small Intestinal Neuroendocrine Tumors are Frequently Associated with Sclerosis and IgG4-Expressing Plasma Cells. Jordan Andrew Roberts, Raul S Gonzalez, Frank Revetta, Chanjuan Shi.
117 Clinical Outcome of Perineal Carcinoma Cuniculatum in a Cohort of 38 Cases. Dongwei Zhang, Raul S Gonzalez, Michael Feely, Kavita Umrau, Hwajeong Lee, Daniela Allende, Dipti Karamchandani, Michael P Zaleski, Jingmei Lin, Maria Westerhoff, Xuchen Zhang, Lindsay Alpert, Jinping Lai, Xiuli Liu.
154 Liver Histology in Septic Patients: Is It All About Ductular Cholestasis? Caroline Bsirini, Raul S Gonzalez.
1:00 PM - 2:45 PM
Moderators: Deepti Dhall and Laura Lamps
Room: Vancouver Convention Centre West 224
Mesenteric Tumor Deposit Number, But Not Size, Affects Prognosis of Patients with Small Intestinal Well- Differentiated Neuroendocrine Tumors. Raul S Gonzalez, Justin Cates, Chanjuan Shi.
Poster Session IV
1:00 PM - 4:30 PM
40 Quantitative Measurement of Human Epidermal Growth Factor Receptor-2 (HER2) Protein Expression in ‘Classical’ and ‘Non-Classical’ FISH Categories: A Comparative Study. Jian Shen, Brandon Buscaglia, Hideki Goda, Bradley M. Turner, Hisatake Okada, Loralee Mcmahon, Jill Henry, Yasushi Nakano, David Hicks.
102 Lymphocytic Esophagitis in Adult Crohn’s Disease is Characterized by Younger Age, Lower Incidence of Reflux Symptoms, and a CD4 Predominant Infiltrate. Elizabeth Yiru Wu, Deepa T Patil, Michael Drage, Amitabh Srivastava.
116 What Remains of Appendiceal Adenocarcinoma After LAMN and Goblet Cell Neoplasms are Excluded? Raul S Gonzalez, Joseph Misdraji, Rhonda Yantiss
132 Clinicopathologic Analysis of Benign Lipomatous Lesions of the Colon. Sam L Barron, Raul S Gonzalez
136 Interobserver agreement in the diagnosis of anal dysplasia. Sohaib Abu-Farsakh, Michael Drage, Aaron Huber, Bradley M. Turner, Sharlin Varghese, Xi Wang, Christa Whitney- Miller, Raul S Gonzalez.
150 Significance of Method of Lymph Node Involvement in Pancreatic Ductal Adenocarcinoma. Diana Agostini-Vulaj, Justin Cates, Richard Dunne, Raul S Gonzalez.
151 Low Union (Lower Insertion of Cystic Duct into Common Hepatic Duct) as a Major Etiologic Factor in the Development of Pancreatic, Distal Bile Duct and Ampullary Cancers: An analysis of 860 pancreatobiliary resections. Takashi Muraki, Michelle Reid, Raul S Gonzalez, Aarti Sekhar, Bahar Memis, Burcin Pehlivanoglu, Yue Xue, Pardeep Mittal, Juan M Sarmiento, David Kooby, Shishir Maithel, Ken Cardona, Bassel El-Rayes, Alyssa Krasinskas, Gwen Lomberk, Raul Urrutia, Kathleen K Christians, Susan Tsai, Douglas Evans, N. Volkan Adsay, Alpharetta.
162 Loss of ARID1A Expression Predicts Worse Overall Survival in Patients with Resected Pancreatic Adenocarcinoma and Is Associated with Inactivating Mutations of the ARID1A Gene. Annacarolina da Silva, Vicente Morales-Oyarvide, Douglas A Rubinson, Margaret M Kozak, Wenjia Wang, Diana Agostini-Vulaj, Aaron Huber, Daniel T Chang, Thomas E Clancy, Aram F Hezel, Shuji Ogino, Brian M Wolpin, Jonathan A Nowak.
202 Clinical Significance of Perivesical Lymph Node Metastasis in Radical Cystectomy for Bladder Cancer. Meenal Sharma, Jerome Jean-Gilles, Hiroshi Miyamoto.
261 AID-Generated Acquired IGH Glycosylation Sites but Not Somatic Hypermutation Rate Differentiate Low-grade versus High-grade Follicular Lymphoma. Chad Hudson, Janice Spence, Diana G Adlowitz, Richard Burack.
262 Increased AID-Generated Acquired Glycosylation Sites in Diffuse Large B-cell Lymphomas with IGH-BCL2 and CD10 Expression. Chad Hudson, Janice Spence, Diana G Adlowitz, Madalynn Bryant, Richard Burack.
277 Unexpectedly High Prevalence of Cystoisospora belli in Acalculous Gallbladders of Younger Patients. Mushal Noor, Christa Whitney-Miller, Laura W Lamps, Raul S Gonzalez, Aaron Huber, Jennifer J Findeis-Hosey, Zhongren (David) Zhou, Lawrence J Saubermann, Rebecca L Abell, Philip J Katzman, Michael Drage.
WEDNESDAY, MARCH 21
Poster Session V
9:30 AM - 12:00 PM
103 Relationships Among Histologic Characteristics, Molecular Phenotypes, and Patient Outcomes in Mucinous Colorectal Carcinoma. Raul S Gonzalez, Justin Cates, Mary Kay Washington.
149 Evaluation of Histologic Changes in the Livers of Patients With Early and Late Hepatic Artery Thrombosis. Michael J Lee, Raul S Gonzalez.
243 Autoimmune Disease and Lymphoma: A Method for Large Scale Search of the Electronic Medical Record Enables Correlation of Clinical Parameters with Type and Risk of Lymphoproliferative Disease. Genevieve M Crane, Amy Duffield.
265 Next Generation Sequencing-Assays Detect B-Lymphocyte Clonality in Formalin-Fixed Paraffin Embedded Specimens of Classical Hodgkin Lymphoma without Microdissection. Cynthia Reyes Barron, Andrew Campbell, Paul G Rothberg, Richard Burack, Yi Ding DING4 1University of Rochester Medical Center, Victor, NY, 2University of Rochester Medical Center, 3University of Rochester, Rochester, NY, 4University of Rochester Medical Center, Rochester, NY
350 Is the Rate of Frozen Section Discordance Affected by Subspecialty Sign Out? Joseph H Blitman, Brandon Buscaglia, Christa Whitney- Miller, David Hicks, Aaron Huber.
Poster Session VI
1:00 PM - 4:00 PM
162 MCM7 Expression Correlates With Tumor Size and Ki67 Index in Well-Differentiated Small Intestinal Neuroendocrine Tumors. Zhongren (David) Zhou, Numbereye Numbere, Aaron Huber, Chanjuan Shi, Raul S Gonzalez.
167 Expression of TIM3 (CD366) and LAG3 (CD223) in Colorectal Carcinoma-associated Inflammatory Infiltrate Suggest Novel Therapeutic Targets for Immune Checkpoint Blockade. Michael Drage, Max Klapholz, Ana C Anderson, Amitabh Srivastava.
280 L1 CAM – A Potential Biomarker for Recurrent and Aggressive Endometrial Carcinoma. Ioana Moisini, James R Richter, Tanya Pulver, Raphael Hellwegg, Boris Winterhoff, Molly Klein.
318 Lack of MUM1 Expression Characterizes B-Lymphoblastic Leukemia/Lymphoma. Chad Hudson, Roula Katerji, Richard Burack.
THURSDAY, MARCH 22
7:30 PM – 9:30 PM
Secrets from the Consult Files: Puzzling Cases Solved Piece by Piece
Room: VCC WEST 301-305
Moderator: Michael Torbenson, MD, Mayo Clinic, Rochester, MN
- Maria Westerhoff, MD, University of Michigan, Ann Arbor, MI
- Tom Smyrk, MD, Mayo Clinic Rochester, MN
- ILKe Nalbantoglu, MD, Yale University, New Haven, CT
- Raul Gonzalez, MD, University of Rochester Medical Center, Rochester, NY
- Oyedele (Dele) Adeyi, MD, University of Toronto, ON, Canada
We recently caught up with Dr. Brooke Koltz, a former Pathology resident at the University of Rochester (2008-2012) and Cytopathology fellow (2012-2013).
After training and working in Rochester, she and her family moved to the Philadelphia, PA area for a year and recently moved to Perrysburg, OH, near Toledo. This is a homecoming of sorts for Koltz, who grew up in nearby Whitehouse, OH.
She will start a new role this month at the University of Toledo Medical Center (where she also attended medical school). Her clinical responsibilities will include surgical pathology, cytopathology, and resident education. Here, she shares more about the experiences that led her to this moment in her career.
Tell us about your family.
I am married to Peter Koltz, who was also a resident at University of Rochester in Plastic and Reconstructive Surgery. We have four children, Eleanora (9), Henry (7), Cecilia (4), and Simon (2).
What first sparked your interest in pathology?
I went into medical school thinking I would become an emergency medicine physician, but I am so glad that I didn’t. I was one of those rare students that was fascinated by histology and pathology labs in the first and second year of medical school.
Even so, I was still set in pursuing clinical medicine until I took an elective pathology rotation on a whim late in my third year. In about a week, my whole outlook changed. As I sat across the multi-headed scope from the attendings and residents, I realized that what they did was ‘medicine’ to me. From then on I pursued a career in pathology. So far, I have no regrets.
When you look back on your time here, is there a particular person or experience that made a great impact on you professionally or personally?
The entire Cytopathology department had an impact on me both professionally and personally. Not only did the department educate me and prepare me for my future career, but I truly enjoyed being a small part of the talented team for a few years.
I often find myself repeating things that Dr. Giampoli, Dr. Zhou, and Dr. Yao taught me when I sit down with residents. The entire team of cytotechnologists, including Donna Russell, Mary Ann Rutkowski, and Michael Facik, accepted me into their offices, the occasional inside joke, and gave me the benefit of their years of experience and knowledge. I couldn’t have asked for a better fellowship.
Aside from the Cytopathology department, many of the surgical pathology attendings, especially Dr. Hicks and Dr. Whitney-Miller, encouraged me and gave me a solid experience to pursue my career goals. My co-residents were fun and supportive as well. There are too many people to name, but I appreciated my time in Rochester and felt that I received a positive educational and personal experience.
How do you like to spend your free time? Do you have any hobbies/interests?
Like most mothers, my free time is often spent chasing my kids around and getting them to their various activities. But I do love to read books, and I read often. I am happy to read almost anything: fiction, non-fiction, poetry. I also enjoy playing and watching sports, including soccer.
What’s next for you career wise?
I am looking forward to spending more time teaching residents, medical students, and student fellows in my new position. I have always enjoyed teaching, and am happy that I have found a position that puts a large emphasis on education.
What advice would you give up-and-coming pathology trainees looking to start their careers?
Because I am one half of a two physician household, I have had to change jobs frequently in the last four years as my husband’s training has taken him to various hospitals. While I haven’t always wanted to leave positions, the benefit has been that I have gained experience in a lot of different practice settings.
My advice would be to learn as much as you can from each place you end up, even if it isn’t necessarily your dream job. Seek to find what you can take away from each place or experience that will grow your knowledge. Each place (and person!) has something unique to teach you that will contribute to your success as a physician, a pathologist, and a person.
Mary Ann Rutkowski remembers the day she chose her future career – at the mall.
As a high-schooler, she was at a career day event when someone handed her a flier about the field of cytology. Intrigued, she read about microscopes and cancer detection, picturing herself behind a 'scope someday.
A native of the Utica region, she graduated from Upstate Medical Center and went on to complete a clinical semester at URMC to become a certified cytotechnologist.
It was the summer of 1978, and she was 20 years old when she was offered a job in the URMC Department of Pathology and Lab Medicine. She hasn't looked back since and on May 6, Rutkowski will retire from that same position after 38 years.
Here, she shares some reflections on her long and successful career.
Do you remember your teachers from your clinical semester at URMC?
Dr. Stanley F. Patten, Jr. wrote the textbooks. He laid the groundwork for how you not only diagnose cancer but the pre-cancerous conditions, which are so important. I have had so many wonderful mentors throughout my tenure here. Many were really pioneers in the field. Drs. Bonfiglio, Wilbur, Stoler are just a few that come to mind. Florence Patten also had a major influence on my formative years as a cytotech.
I still find it kind of frustrating when we get a case of cervical cancer which should be 100 percent preventable. It’s usually in people who may not have insurance, or something prevents them from getting annual screenings.
How has microscope technology changed since you started?
We used to look at a lot of conventional slides where you smear the material onto the slide, and it was very difficult to see. It was thick, not well stained, and air dried, so there were a lot of technical problems. It was challenging in a fun kind of way to decipher what was going on in these conventional smears.
Probably in the early 1990s, liquid-based technology really revolutionized cervical cancer screening and took that element of poor quality out of the picture. It was definitely a much needed advancement. That’s where we are today placing a pap sample in a solution and removing error the doctor may make in making the slides.
What has been your favorite part of the job overall?
The part I enjoy most is when we go out on our aspiration biopsy procedures because we get to see the patients and we’re reminded that it’s not just a piece of glass that we have on a microscope. We may see their family, friends – their support personnel – with them. Even though we can never get to know them personally because then you lose your objectivity, I’ve always enjoyed going out and playing an “active” role in obtaining diagnostic material. The first step for our patients towards treatment is getting the answer; that is the role we play.
Do you think some people choose this profession because it’s not patient-facing?
Perhaps. That’s what attracted me to it – it has some patient contact but not an extreme amount. I admire people who take care of people who are quite sick. It’s a tough job. We are the people who are behind the scenes.
In addition to patients, what has it been like to work with partnering agencies?
We have had some wonderful clinicians who get referrals from all over this part of the state. I think we take it for granted because we’ve worked with them for so long, but these people come from Buffalo and the Southern Tier because they don’t have access to people with the expertise to do endoscopies or the various invasive procedures. For me it’s rewarding that we’re on the same team. They’re trying to stick a needle in a target and we’re trying to interpret that material accurately to the best of our ability.
How do you plan to spend retirement?
Life’s a gift and when you’re around people who have a lot of health problems you’re reminded that if you have your health, you should enjoy it and not complain. I hope to travel and I enjoy photography (an amateur shutterbug). My husband and I have a little cabin on 30 acres in the middle of nowhere on the top of a mountain in Naples that we’ve nicknamed “the bungalow.” I suspect I will be there more often.
Rochester has been our home for 30 years … When you’re here this long, this becomes your home and we have friends here. We live right in the Highland Park area and love city living, being close to things, and that park is so unique. That was my goal: to be retired before the Lilac Festival (laughs).
It’s rare these days to hear about someone sticking with the same job for 38 years. What has kept you around so long?
I never really wanted to leave, (and) even now it’s bittersweet. I feel like I have friends here, not just coworkers. We’ve always worked as a team and that’s what has allowed us to survive, helping each other out. That’s what I think has kept me here as long as I have. It can be stressful some days but we help each other out. The days go by fast and the weeks go by even faster. And the years! I blinked and here I am 38 years later. I truly have had the time of my life here at the U of R.
Do you have any advice for young people starting their careers?
Make sure you set your goals and do something you enjoy doing. You may not stay as long in one place, but no matter what, make sure you enjoy it and appreciate what you have instead of looking at the glass as half-empty.