Thoracic Pathology Center of Excellence
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Faculty
Mission Statement
The Thoracic Center of Excellence is based at UPMC Presbyterian and has a broad agenda focused
on achieving excellence in clinical service, resident/fellow education, and translational research.
The Center of Excellence supports diagnostic services at both Presbyterian and Shadyside Hospitals,
offering skilled interpretation in the surgical pathology of thoracic, mediastinal, and
cardiovascular diseases. This mission supports the focused efforts in thoracic oncology and
interstitial lung disease of the Divisions of Thoracic Surgery and Pulmonary Medicine at the UPMCHS.
The Thoracic Center of Excellence is active in housestaff education, with much of the educational
efforts focused on training of residents through case analysis and discussion. A wealth of internal
material is supplemented by an active consultation service, an extensive slide teaching collection and
study sets in the pathology of lung transplantation. Housestaff officers are trained in the
applications of histochemistry, immunohistochemistry, and molecular biological techniques in the
evaluation of clinical and pathologic diagnostic problems as well as in the interpretation of
radiologic images and functional studies. Our research focus is largely oriented toward utilizing our
own and the resources of the
Molecular Anatomic Pathology section of the Division of Anatomic Pathology
for assessing the relationship of surgical pathology to molecular pathology to clinical outcome. Major
focuses have been on clonality in unusual pulmonary proliferations, the relationship of molecular
changes in non-small cell carcinoma to clinical outcome, and the utilization of histology and
immunohistology in predicting acute and chronic rejection of lung allografts.
Clinical Services
Thoracic Pathology is a comprehensive area including all organs within the thoracic cavity including lungs,
thymus, and heart. Four pathologists are committed to this Center of Excellence: Samuel A. Yousem, MD,
Sanja Dacic, MD, PhD, Frank Schneider, MD, and N. Paul Ohori, MD. On this diagnostic bench, we handle
all pulmonary specimens including all of the material from University of Pittsburgh Cancer Institute.
This material however is supplemented by a huge volume of inflammatory lung disease derived from a very
active interstitial lung disease program, from the world’s largest thoracic transplantation program,
a brisk consultation service, and a very active cardiovascular group. Signout on the thoracic bench
includes daily reviews of all biopsy and large resection specimens including over 150 native lungs.
The wide array of materials that include neoplasms, inflammatory lung disease, thymic neoplasia,
allograft lung biopsies, and cardiovascular pathology is a unique experience. Signout is associated with frozen section
responsibilities although in the afternoons, housestaff
officers are allowed protected time for both grossing specimens and reviewing glass slides of their cases.
Research Activities
Within the Thoracic Pathology Center of Excellence are diverse investigative efforts that
reflect our focus on inflammatory lung disease and thoracic neoplasia. Working with the Simmons
Center for Interstitial Lung Disease, Drs. Yousem and Schneider have focused on describing and analyzing
new models and forms of interstitial lung disease, particularly focused on rheumatologic conditions.
Such an interest in inflammation readily extends to our analysis of allograft lungs and the pathology of
lung transplantation where we are actively involved in studying antibody mediated rejection as it applies
to lung allografts. Perhaps our greatest interest and international recognition is in thoracic oncology
in an area lead by Sanja Dacic, MD, PhD. In this area we have utilized fluorescence in situ hybridization
techniques and molecular techniques, in close collaborations with Yuri Nikiforov, MD, PhD and Marina
Nikiforova, MD in the Molecular Anatomic Pathology Laboratory, to establish ourselves as the premiere
clinical, diagnostic, and research thoracic pathology group in the country. Routine cases are typically
submitted for molecular analysis and the results incorporated into our diagnostic surgical pathology
reports. This work is the basis for very active collaborative discussions between our molecular analysis
pathology division, our FISH group, and our diagnostic pathologists. Truly, there is no section of
pathology in the world that is equivalent to this experience in pulmonary pathology.
Teaching Activities
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In addition to participating in the general department–wide teaching activities including a weekly
research conference, anatomic pathology grand rounds, and multiheaded slide conference, the thoracic
pathology Center of Excellence is involved in several clinicopathologic conferences each week:
the thoracic oncology conference on Tuesday morning, a general pulmonary medicine conference with
pulmonary medicine fellows and faculty at 11:00 AM on Tuesday, a consultation practice slide review
conference at 11:00 AM on Wednesday, and the interstitial lung disease/rheumatology conference at 8:00
AM on Thursday. This core group of weekly conferences is supplemented by at least five other
monthly conferences that encompass the entire vast array of pulmonary pathology including research
conferences on pulmonary fibrosis, pulmonary vascular disease, and Lung SPORE meetings with Jill
Siegfried, PhD focused on hormonal and tyrosine kinase receptor studies and lung carcinogenesis.
Training Activities
The Thoracic Pathology Center of Excellence has a fellowship in Pulmonary Pathology.
This training program can be one or two years in length, with the first year largely devoted to
developing clinical expertise in Thoracic Pathology, and an optional second year focused on translational
research in pulmonary disease, either inflammatory interstitial lung disease or thoracic neoplasia.
