Anatomic Pathology | Pathology Residency | Loyola Medicine

Anatomic Pathology

Subspecialized Pathology Training

The department of Pathology comprises faculty with subspecialty fellowship training in all pathology subspecialites, providing state of the art and up to date diagnostic evaluation, including integration of molecular pathology assessment. Dr. Ping Tang, Professor and Vice Chair of Anatomic Pathology discusses the importance of subspecialty pathology and a multi-disciplinary approach to diagnosis in this video clip.

Cytopathology

Cytopathology is the study of cell samples from various body sites for the detection of pathologic processes. In some organ systems, such as the cervix, exfoliative cytology is the screening technique used for the detection of cancer. For other sites ( e.g., breast, thyroid, lymph nodes, etc.) fine needle aspiration biopsy (FNAB) is the technique of choice for obtaining material. The role of a cytopathologist is that of manager, consultant to the clinicians, as well as teacher to other pathologists, medical students, residents, fellows, and cytotechnologists. At the Loyola University Medical Center, residents receive training in interpreting all types of cytologic material. These are correlated with clinical presentation and supplemented by ancillary studies including: immunohistochemistry, flow cytometry, image analysis, electron microscopy, and molecular pathology. The residents are also trained in quality assurance of cytologic diagnosis and correlating cytologic material with the corresponding histologic specimens. Several teaching conferences are integrated into the core of this rotation. Our department also offers fellowship training in cytopathology.

Dr. Güliz A. Barkan, Professor of Pathology and Urology, Cytopathology Fellowship Program Director and Director of Cytopathology explains her role as a cytopathologist and genitourinary-pathologist in this video:

Dermatopathology

Dermatopathology is a continuously evolving discipline of both Pathology and Dermatology. The pathology residents at the Loyola University Medical Center have the opportunity to study pathology of skin diseases on a daily basis as part of their Surgical Pathology rotation as well as an elective during their senior years. Our Residents work in close collaboration with our clinical dermatology and pathology faculty to provide a comprehensive, integrated learning experience.  Residents receive extensive and specialized training encompassing all aspects of skin diseases. The LUMC experience is exceptional in that it provides fellows a synergistic learning experience between clinical diagnosis and investigative dermatology. Residents hone their diagnostic skills serving Loyola's busy satellite ambulatory care patients, active inpatient infectious disease patients, and transplant and burn unit patients. There is emphasis on "low power" pattern recognition of the various inflammatory and neoplastic diseases of the skin. A criteria-based systematic approach to the differential diagnosis of common neoplastic and inflammatory entities is stressed, incorporating molecular studies, direct immunofluorescence, and electron microscopy.  Didactic lectures are offered weekly to review common and challenging dermatopathology cases.  Supplemental materials for self-study include access to an online digital dermatopathology library with quiz and annotation formats and an extensive glass slide library.  Additionally, residents have the opportunity to explore disease pathogenesis and new treatment modalities via collaboration with our active cutaneous research programs based in the Cardinal Bernadin Cancer Center.

Dr. Jodi Speiser, Director of Dermatopathology explains her role in patient care and the importance of clinco-pathologic correlation in this video:

Neuropathology

The section of Neuropathology has a board certified neuropathologist who serves both the Loyola University Medical Center and the Edward Hines, Jr. VA Hospital. In addition, the service receives muscle and nerve biopsies as well as autopsy brains from a number of regional hospitals for consultation. The laboratory is fully equipped to perform the numerous special techniques needed for diagnostic neuropathology including enzyme histochemistry, immunohistochemistry, computer morphometry, electron microscopy, and immunofluorescence. The section maintains a large teaching collection in all areas of neuropathology. The teaching material includes gross specimens in acrylic, Kodachrome, and microscopic slides as well as indexed material on laser disk contributed by Loyola to "The Slice of Life." Teaching is provided to Loyola medical students as well as residents in Pathology, Neurosurgery, Neurology, and Neuroradiology.

The major focus of the research program is the normal and abnormal aging process in the CNS. In 1992, The Loyola University / Hines Brain Bank was established for systematic collection of autopsy brains from normal aging as well as neurodegenerative diseases such as Alzheimer's disease. The material collected is used as a resource for neuroscientists from the university-wide Neuroscience and Aging Institute as well as regional institutions. The Brain Bank has been and will continue to be a resource for obtaining outside funding from agencies such as the National Institutes of Health, private foundations, and the pharmaceutical industry.

Pediatric Pathology at Lurie Childrens Hospital

Senior residents are required to complete a one month rotation at Ann & Robert H. Lurie Children's Hospital of Chicago. The main goal of this rotation is to familiarize the resident with the common diseases characteristically seen in infants and children.

The residents' responsibilities include:

  • Pediatric autopsies
  • Processing all pediatric surgical specimens
  • Presenting at Intra & Interdepartmental conferences (including Pediatric Tumor Board and Pediatric Surgical Pathology Conferences)

At the end of the rotation, the resident should be familiar with pathologic lesions such as perinatal lung disorders, congenital malformations, small cell tumors, neuroblastoma, and Wilm's tumor; be able to identify current key sources of information to solve diagnostic problems in pediatric pathology; become aware of the multi-disciplinary approach to pediatric pathology problems for which light microscopy is not sufficient. The latter includes evaluation of metabolic or storage diseases, ploidy, oncogenes in childhood tumors, and molecular pathology in the study of childhood lymphomas and leukemias.

Orthopedic Pathology

   

Senior residents can take an elective in orthopedic and podiatric pathology to see a wide range of musculoskeletal cases. Residents will learn to correlate radiological imaging with bone and soft tissue pathology. Residents also can rotate through the orthopedic surgery department to observe surgical procedures and participate in orthopedic tumor boards. 

Take a look at the amazing resource on Orthopedic and Pediatric Pathology developed by Dr. Dariusz Borysz by clicking below:

Surgical Pathology

The section of Surgical Pathology is responsible for the diagnosis of specimens obtained from the Loyola University Medical Center and Edward Hines, Jr. VA Hospital. The total volume is approximately 35,000 specimens: 30,000 at Loyola and 5,000 at Edward J. Hines VAH. Many cases are seen in consultation from outside hospitals and clinics. The section of Surgical Pathology at Loyola supports the clinical activities of a 561-bed hospital of adult and pediatric medical/surgical activities. Edward Hines, Jr. VA Hospital is a 495-bed medical/surgical facility. The residency training in Surgical Pathology, supervised by the faculty, includes gross examination, microscopic description, frozen section techniques, and the use of special stains and imaging as well as other ancillary studies. Specialized areas of Surgical Pathology are also available such as Neuropathology and Renal Pathology.  Special facilities in the Surgical Pathology division are available to assure the best diagnosis for patients. These include electron microscopy, molecular biology lab, immunofluorescence, immunohistochemistry, and DNA analysis of solid tumors. A regular schedule of interdepartmental conferences is maintained for presentation of interesting cases, providing an ideal forum for clinicopathologic correlation.

At the end of the Surgical Pathology rotation, the residents are competent in handling all surgical specimens, integrating light microscopy with special stains, cytology, electron microscopy, immunohistochemistry, and molecular pathology as indicated.

Dr. Maria Picken discusses her role as a multifaceted surgical pathologist and the evolution of personalized diagnostics in this video:

Transplant Pathology

Transplant Pathology cases can be seen during HNT and GI rotations, however, an elective rotation focused on Transplant Pathology can be arranged for senior residents at Loyola University Medical Center. Loyola's cardiac transplantation program is one of the most active in the country with more than 500 heart transplant cases performed to date. A very active lung transplant service is also well established -- the third largest in the country -- with more than 300 single-lung, double-lung, and heart-lungs transplants performed. The resident exposed to this material learns to interpret cardiac (7/week) and lung (4/week) biopsies and aids in the study of explanted hearts and lungs, congenital heart defects, ischemic and dilated cardiomyopathies, myocarditis, chronic restrictive lung diseases, and cystic fibrosis cases. Major research opportunities in this area include the study of acute and chronic rejection and complications of transplantation (e.g., opportunistic infections and post-transplant lymphoproliferative disorders).

Autopsy/Forensic Pathology

The autopsy rotation is designed to provide a comprehensive exposure to all aspects of clinical and anatomic pathology. The main purpose is to make the resident proficient in the various techniques for performing an adequate medical autopsy in order to:

  1. Discover or confirm the cause of death
  2. educate the residents in gross and microscopic pathology
  3. provide clinical and pathologic correlations

Approximately 100 autopsies are performed in our program annually between the Loyola University Health System and Edward Hines, Jr. VA Hospital. By performing a careful, thorough autopsy, the pathologist provides a useful service for clinicians as well as for patients' families. The autopsy is presently the best quality control available for the practice of medicine and is utilized as part of the hospital's quality assurance program. 

The Medical Examiner's Office of Cook County offers a rotation of one month to the pathology residents of the Loyola University Medical Center. This rotation provides pathology residents with the basic knowledge in the area of medical-legal investigation. This office performs approximately 3,200 autopsies yearly. During this rotation, the resident learns how to handle medical-legal cases. The resident also accompanies the investigators to the death-scene investigation and to court. Lectures in Forensic Pathology are given on a weekly basis. The resident also attends the daily signing-out session.

Loyola’s Department of Pathology introduced its Digital Pathology Laboratory in 2013 with Dr. Dariusz Borys as the director of the laboratory. In the new lab, anatomical pathology slides are scanned to provide high-resolution digital histology images. Loyola pathologists are now working with clinicians and researchers in other medical departments to provide images that improve medical care and enhance tumor board presentations, research projects and publications. The new technology also enables the emerging practice of telepathology, with sharing and viewing of histological images at locations outside the hospital and a streamlined ability to consult experts at external sites. Furthermore, the department’s ever-increasing digital collection of slide images representing a wide range of pathological conditions will enhance fellow, resident and medical student teaching and training and create new opportunities for research.

Loyola’s pathology department is excited to be at the cutting edge of this new technology and feel it will play a significant role in the future of the field.