The

Laboratory Report Spring 2013

A Publication of the Department of Pathology and Genomic Medicine

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Dr. Dina Mody to Present at International Congress of Cytology

Dr. Suzanne Powell Helps Build Training Infrastructure Abroad

Dr. Pulin Kothari Joins Department Faculty

New Diagnostic Test Offerings

In Focus: The Clinical Microbiology Team

Department Hosts International Symposium

Sugar Land Lab Staff Lead Continuing Education Effort

Trainee Spotlight

2013 Residency Match

Table of Contents

Dr. Alberto Ayala Receives Highest Honor From Academy

D r. Alberto Ayala, deputy chief of

pathology for the Department,

has received the Distinguished

Pathologist Award from the United States

and Canadian Academy of Pathology

(USCAP), the highest honor bestowed by

the Academy. He was presented with the

award in a ceremony at the Arthur Purdy

Stout Society of Surgical Pathologists

Meeting during the 102nd annual meeting

of the USCAP in Baltimore, Maryland on

March 3rd.

“Alberto is a living legend in pathol-

ogy,” said Dr. James Musser, chair of the

Department of Pathology and Genomic

Medicine for the Hospital System. “The

Department, the System, and our patients

are very fortunate to have him here at

Methodist.”

The Distinguished Pathologist Award

was established by the Council of the

USCAP for recognition of distinguished

service in the development of the disci-

pline of pathology. This award is pre-

sented to an individual who is recognized

as making major contributions to pathol-

ogy over the years.

Dr. Ayala received his M.D. degree

from the University of Nuevo Leon

School of Medicine in Monterrey, Mexico

in 1960. He completed pathology resi-

dency at The University of Texas Medical

Branch at Galveston, and a fellowship at

MD Anderson where he joined the fac-

ulty in 1968. Dr. Ayala served as the dep-

uty chairman and ad-interim chairman of

the department there before joining

Methodist in 2004.

For more information on Dr. Ayala,

visit methodisthealth.com/Ayala. For more

information on the USCAP, visit

uscap.org.

Alberto G. Ayala, M.D.

Register now at houstonpathologists.org.

To register or submit an abstract, visit cap.org. Abstract deadline is April 1st.

The

LABORATORY REPORT

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Dr. Suzanne Powell Helps Build Training Infrastructure Abroad

D r. Suzanne Powell, vice chair of

education for the Department,

recently visited several institu-

tions in Singapore as part of a group of

specialty-specific site visitors from the

Accreditation Council for Graduate

Medical Education International

(ACGME-I).

“Singapore is a wonderful country with

some great graduate medical education

programs,” said Dr. Powell. “The

ACGME-I can assist with efforts to estab-

lish more uniform standards across pro-

grams in Singapore, and the rest of the

international community.”

The ACGME-I is a non-governmental

organization that accredits graduate

medical education programs outside of

the United States. Its mission is to im-

prove health care by assessing and

advancing the quality of resident physi-

cian education through accreditation to

benefit the public, protect the interests of

residents, and improve the quality of

teaching, learning, research, and profes-

sional practice.

In addition to her leadership roles in the

residency programs at Methodist, Dr.

Powell is the immediate past chair of the

Residency Program Directors of Pathol-

ogy (PRODS) Council and the Residency

Review Committee for Pathology of the

ACGME, where she has also served on

the Executive Council of Review Com-

mittee Chairs as the representative of

hospital-based specialties.

D r. Dina Mody, medical director

of cytopathology and director

of the Cytopathology Fellow-

ship Program for the Department, will

chair two seminars at the 18th Interna-

tional Congress of Cytology on May 27th,

in Paris, France.

“I am genuinely grateful just to be

asked,” said Dr. Mody. “This is an in-

credible occasion to meet with the great

cytopathologists of our time, and share

our immense wealth of knowledge and

expertise with each other, and the

younger doctors in attendance.”

The International Congress of Cytology

is held every three years by the Interna-

tional Academy of Cytology and a host

country academy partner. The Congress

offers a comprehensive overview of

Dr. Dina Mody to Present at International Congress of Cytology

current practices and future develop-

ments in the field of clinical cytology,

covering morphology, molecular testing,

newly targeted therapy strategies, and

up-to-date Codes of Good Practices.

Dr. Mody received her M.D. degree in

1979 from the Seth G.S. Medical College

at Bombay University. She completed

her pathology residency at the Baylor

College of Medicine. Dr. Mody was the

recipient of the Lifetime Achievement

Award from the College of American

Pathologists in 2009.

For more information on Dr. Mody,

visit methodisthealth.com/Mody. For more

information on the International Con-

gress of Cytology in Paris, visit cytology-

paris2013.com. Dina R. Mody, M.D.

For more information on Dr. Powell,

visit methodisthealth.com/Powell. For

more information on the ACGME-I,

visit acgme-i.org.

The

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Dr. Pulin Kothari Joins Department Faculty

D r. Pulin Kothari has joined the

Department faculty as of

March 1st. He comes to Meth-

odist from Christus St. Catherine Hospi-

tal in Katy, where he was chief of pathol-

ogy and laboratory medical director.

“Dr. Kothari has a remarkable breadth

of experience in pathology and labora-

tory management,” said Dr. James

Musser, chair of the Department of Pa-

thology and Genomic Medicine for the

System. “His services are much needed

at many of our outlying system hospitals

where community growth continues at a

rapid pace. We are glad to have him with

us.”

West Nile Virus PCR Test

West Nile virus (WNV) is transmitted

to humans by infected mosquitos and

causes seasonal epidemics in the summer

through autumn. The CDC reports that

more than 30,000 people have become

sick from WNV since it was first identi-

fied in the US in 1999. Last year, nearly

half of all US cases occurred in Texas.

Approximately 80% of infected people

remain asymptomatic; however, a subset

of patients develops overt clinical dis-

ease. Immunocompromised, elderly,

and pregnant individuals are particularly

susceptible to severe infections. Most

commonly, patients develop West Nile

fever, which is characterized by fever,

headache, rash, and malaise. Less than

New Diagnostic Test Offerings:

1% of patients will develop a potentially

life threatening neuroinvasive disease,

such as encephalitis, meningitis, or polio-

myelitis. Early diagnosis and treatment

is crucial for best outcomes.

In March 2013, the Molecular Diagnos-

tics Laboratory at TMH validated a real-

time reverse transcriptase PCR-based

assay to detect West Nile virus. The test

is run daily and can be performed on

peripheral blood or cerebrospinal fluid.

For more information, please contact

Dr. Randall Olsen at rjolsen@tmhs.org or

Ms. Heather Hendrickson at hlhendrick-

son@tmhs.org.

Common Intraocular Pathogen Assay

Ocular pathology poses many chal-

lenges, most notably, the very small

quantity of specimen available for diag-

nostic evaluation. In cases of suspected

infectious anterior or posterior uveitis, all

laboratory testing must be performed

using only a few hundred microliters of

vitreous fluid or aqueous humor. To

maximize our testing capacity, the Mo-

lecular Diagnostics Laboratory at TMH

has validated a multiplex real-time PCR

assay to detect the five most common

intraocular pathogens. Schema of Common Intraocular Pathogen Assay.

Dr. Kothari will serve at Methodist

West Houston Hospital, Methodist

Willowbrook, and Methodist Sugar Land

Hospitals.

Dr. Kothari received his medical degree

from the medical school at The Univer-

sity of Texas Health Science Center at

San Antonio. He completed his pathol-

ogy residency at The University of Texas

Health Science Center at Houston, and

fellowships in surgical pathology and

cytopathology at the Baylor College of

Medicine.

For more information on Dr. Kothari,

visit methodisthealth.com/Kothari.

Pulin S. Kothari, M.D.

The test panel includes cytomegalovi-

rus (CMV), herpes simplex virus 1 and 2

(HSV1 and HSV2), Toxoplasma gondii,

and varicella-zoster virus (VZV). This

novel multiplex strategy further

strengthens our existing expertise in

ophthalmic and infectious disease

pathology at TMH.

The validation study was supported,

in part, by a department microgrant.

The new molecular diagnostic panel

will be introduced in-house in April.

For more information, please contact

Dr. Randall Olsen at rjolsen@tmhs.org,

Dr. Patricia Chevez-Barrios at pchevez-

barrios@tmhs.org, or Ms. Heather Hen-

drickson at hlhendrickson@tmhs.org.

The

LABORATORY REPORT

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In Focus: The Clinical Microbiology Team

C linical microbiology, or medical

microbiology, is both a field of

medicine and a branch of micro-

biology. It involves the study of microor-

ganisms, including bacteria, viruses,

fungi, and parasites, that have medical

importance because they can cause infec-

tions in humans.

The Department of Pathology and Ge-

nomic Medicine has a team of three clini-

cians with specialty training and exper-

tise in clinical microbiology. This team

James R. Davis, Ph.D.

Medical Director, Clinical Microbiology

Dr. Davis received his Ph.D. in microbi-

ology from the University of Houston in

1965. He has held faculty appointments at

The University of Texas Dental Branch in

Houston and the Baylor College of Medi-

cine. Dr. Davis is particularly interested

in the training of the next generation of

clinical microbiologists. His research

aims to improve patient care by reducing

test turnaround time while maintaining

accuracy.

In addition to being the medical direc-

tor of clinical microbiology, he is also the

associate director of all clinical laborato-

ries in the Department of Pathology and

Genomic Medicine.

For more information on Dr. Davis,

visit methodisthealth.com/Davis.

Geoffrey A. Land, Ph.D., D(ABB)

Co-Director, Clinical Microbiology

Dr. Land received his Ph.D. in microbi-

ology from the Tulane University Medi-

cal Center in New Orleans, Louisiana in

1973. He completed an NIH-sponsored

research fellowship in microbiology at

the Duke University Medical Center in

Durham, North Carolina, before holding

faculty appointments at several institu-

tions, including The University of Texas

Southwestern Medical Center and Baylor

College of Medicine.

Dr. Land is an active laboratory inspec-

tor and has served on the American Soci-

ety for Histocompatibility and Immuno-

genetics (ASHI) Accreditation Review

Board as commissioner, co-chair, pro-

gram director, and as president of the

society.

For more information on Dr. Land, visit

methodisthealth.com/Land.

provides invaluable sup-

port to the entire medical

staff throughout The

Methodist Hospital Sys-

tem, and at institutions

served by Methodist Di-

agnostic Laboratories.

The clinical microbiology team: from left, Drs. Randall Olsen, James Davis, and Geoffrey Land.

Randall J. Olsen, M.D., Ph.D.

Associate Medical Director, Clinical Microbiology

Dr. Olsen received his M.D. and Ph.D.

(pathology and microbiology) degrees

from the University of Nebraska in 2003.

He completed clinical pathology resi-

dency training at the Baylor College of

Medicine and a hematopathology fellow-

ship at The Methodist Hospital.

Dr. Olsen’s research focuses on the mo-

lecular pathogenesis of severe invasive

group A Streptococcus infections, such as

is seen with necrotizing fasciitis or “flesh

eating disease.”

For more information on Dr. Olsen,

visit methodisthealth.com/Olsen.

For more information on the clinical

microbiology service at Methodist, please

contact Pat Cernoch at 713-441-0333.

Dr. Davis (right) mentoring PGY1 resident, Dr. Eric Salazar. Dr. Olsen inspecting a mass spectrometry target with Laboratory Manager Pat Cernoch.

The

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Trainee Spotlight:

Sergio Piña Oviedo, M.D. PGY3 Resident

D r. Sergio Piña Oviedo, PGY3 pathology resident, has published a first-author paper

in Modern Pathology, the premiere journal of the United States and Canadian

Academy of Pathology and a Nature Publishing Group periodical. The paper, enti-

tled, “Flat pattern of nephrogenic adenoma: previously unrecognized pattern unveiled using

PAX2 and PAX8 immunohistochemistry,” was published online in January and identifies a

previously undescribed benign flat pattern adenoma, and highlights the importance of the

differential diagnosis from flat neoplastic lesion, particularly urothelial carcinoma in-situ.

Dr. Piña Oviedo received his M.D. degree in 2003 from the Universidad Panamericana

School of Medicine in Mexico City. He conducted neuroscience research at Temple Univer-

sity in Philadelphia before joining the residency program at Methodist in 2010. Sergio Piña Oviedo, M.D.

Sugar Land Lab Staff Lead Continuing Education Effort

D onna Hermis, M.H.A.,

MT(ASCP), the labora-

tory director at Meth-

odist Sugar Land Hospital, and

two of her staff, have developed

continuing education modules

for the American Society for

Clinical Pathology (ASCP).

These modules are part of the

ASCP LabQ program to earn

credits towards the maintenance

of ASCP certification.

“ASCP certification is very

important in the clinical pathol-

ogy laboratory,” said Ms. Hermis.

“The designation indicates a high

level of professional training and con-

tinuing education.”

The three learning modules cover im-

portant laboratory topics, such as how to

ensure accurate handling and testing of

patient specimens, how phlebotomists

can improve patient satisfaction among

the modules. “These continuing

education modules and certifica-

tions help keep us at this high

level of performance.”

Outpatient Phlebotomist Cath-

erine Mingino also authored one

of the modules which focused

on achieving a positive patient

experience.

The ASCP LabQ program

modules focus on technical

problems in the clinical pathol-

ogy laboratory and provide

CME and CMLE credits in areas

that include transfusion medicine,

clinical chemistry, clinical immu-

nology, hematology, microbiology, and

phlebotomy.

For more information on the ASCP

LabQ program, visit ascp.org/LabQ. For

more information on Methodist Sugar

Land Hospital, visit methodisthealth.com/

SugarLand.

From left, Sugar Land Laboratory Director Donna Hermis, Phlebotomist Catherine Mingino, and Laboratory

Manager Rosalie Thornblom.

patients with special needs, and how to

prepare for laboratory accreditation in-

spections.

“Our laboratory runs very accurately

and efficiently,” said Rosalie Thornblom,

BS, MT(ASCP), manager of the Sugar

Land laboratory and an author of one of

Department Hosts International Symposium

E arlier this month (March 4-5), Dr. James Musser and The

Methodist Hospital hosted the third Nordic-North

American Symposium on Antimicrobial Resistance and

Molecular Epidemiology. Investigators from Denmark, Finland,

Norway, Canada, Iceland, and the United States participated in the

2-day event.

Antimicrobial resistance has been a serious medical and public

health concern for over a decade, especially with regards to resis-

tant strains of tuberculosis, Staphylococcus aureus, and Klebsiella

pneumoniae. According to the World Health Organization, approxi-

mately 440,000 new cases of multidrug-resistant tuberculosis

emerge annually, resulting in more than 150,000 deaths.

The

LABORATORY REPORT

Bingham BA, Hatef DA, Chevez-Barrios P, Blackmon SH, Kim MP. Increased FDG Activity in a Dermatofibroma in Esophageal Can-

cer Patient. Clin Nucl Med. 2013 Mar;38(3):e140-2.

Brown AF, Sirohi D, Fukuoka J, Cagle P, Policarpio-Nicolas M, Tacha D, Jagirdar J. Tissue-Preserving Antibody Cocktails to Differen-

tiate Primary Squamous Cell Carcinoma, Adenocarcinoma, and Small Cell Carcinoma of Lung. Arch Pathol Lab Med. 2013 Jan 4. [Epub

ahead of print]

Cagle PT. Evolving frontlines in the diagnosis and treatment of pulmonary diseases. Arch Pathol Lab Med. 2012 Dec;136(12):1476-7.

Cagle PT, Allen TC. Lung cancer genotype-based therapy and predictive biomarkers: present and future. Arch Pathol Lab Med. 2012

Dec;136(12):1482-91.

Cagle PT, Olsen RJ. Verifying the Role of Surgical Pathologists in the Precision Medicine of Lung Cancer. Arch Pathol Lab Med. 2012

Dec 31. [Epub ahead of print]

Cerny J, Yu H, Ramanathan M, Raffel GD, Walsh WV, Fortier N, Shanahan L, O'Rourke E, Bednarik J, Barton B, Kroll-Desrosiers A,

Hao S, Woda B, Hutchinson L, Evens AM, Rosmarin AG, Nath R. Expression of CD25 independently predicts early treatment failure

of acute myeloid leukaemia (AML). Br J Haematol. 2013 Jan;160(2):262-6.

Chandler WL. Microparticle counts in platelet-rich and platelet-free plasma, effect of centrifugation and sample-processing protocols.

Blood Coagul Fibrinolysis. 2013 Mar;24(2):125-32.

Chen AC, Paulino AC, Schwartz MR, Rodriguez AA, Bass BL, Chang JC, Teh BS. Prognostic Markers for Invasive Micropapillary

Carcinoma of the Breast: A Population-Based Analysis. Clin Breast Cancer. 2012 Dec 12. Epub

Crookston KP, Sibbitt WL Jr, Chandler WL, Qualls CR, Roldan CA. Circulating microparticles in neuropsychiatric systemic lupus

erythematosus. Int J Rheum Dis. 2013 Feb;16(1):72-80.

Crothers BA, Jones BA, Cahill LA, Moriarty AT, Mody DR, Tench WD, Souers RJ. Quality Improvement Opportunities in Gyneco-

logic Cytologic-Histologic Correlations: Findings From the College of American Pathologists Gynecologic Cytopathology Quality

Consensus Conference Working Group 4. Arch Pathol Lab Med. 2013 Feb;137(2):199-213.

Darragh TM, Colgan TJ, Cox JT, Heller DS, Henry MR, Luff RD, McCalmont T, Nayar R, Palefsky JM, Stoler MH, Wilkinson EJ, Zaino

RJ, Wilbur DC; Members of LAST Project Work Groups, including Schwartz MR. The Lower Squamous Terminology Standardization

Project for HPV-Associated Lesions: Background and Consensus Recommendations from the College of American Pathologists and

the American Society for Colposcopy and Cervical Pathology. J Low Genit Tract Dis. 2012 Jul;16(3):205-42.

Darragh TM, Colgan TJ, Cox JT, Heller DS, Henry MR, Luff RD, McCalmont T, Nayar R, Palefsky JM, Stoler MH, Wilkinson EJ, Zaino

RJ, Wilbur DC; Members of LAST Project Work Groups, including Schwartz MR. The Lower Squamous Terminology Standardization

Project for HPV-Associated Lesions: Background and Consensus Recommendations from the College of American Pathologists and

the American Society for Colposcopy and Cervical Pathology. Arch Pathol Lab Med. 2012 Oct;136(10:1266-97

Divatia M, Kim SA, Ro JY. IgG4-Related Sclerosing Disease, an Emerging Entity: A Review of a Multi-System Disease. Yonsei Med J.

2012;53(1):15-34.

Escalante P, McKean-Cowdin R, Ramaswamy SV, Williams-Bouyer N, Teeter LD, Jones B, Graviss EA. Can mycobacterial katG ge-

netic changes in isoniazid-resistant tuberculosis influence human disease features? Int J Tuberc Lung Dis. 2013 Mar 1. [Epub ahead of

print]

Continued page 7

RECENT PUBLICATIONS

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T he results from the 2013 National Resident Matching

Program were posted on March 15, and the

following medical school graduates will be PGY1

residents in the Department starting in July:

2013 Residency Match David A. Cohen, M.D.

University of Miami Leonard M. Miller School of Medicine

Brandon R. Driver, M.D.

The University of Texas Medical Branch at Galveston

Nicola E. Dundas, M.D.

The University of Texas Medical School at Houston

Katherine H. Lohmann, M.D.

Tulane University School of Medicine

The

LABORATORY REPORT

Ping Wang, Ph.D. Claudia P. Molina, M.D.

Seema Mullick, M.D.

Thu Ngo, M.D.

Steven Shen, M.D., Ph.D.

Paul Sumby, Ph.D.

The Laboratory Report is a publication

of The Methodist Hospital System

Department of Pathology and

Genomic Medicine.

Gao L, Wang Z, Li F, Hammoudi AA, Thrall MJ, Cagle PT, Wong ST. Differential diagnosis of lung carcinoma with coherent anti-

Stokes Raman scattering imaging. Arch Pathol Lab Med. 2012 Dec;136(12):1502-10.

Guo CC, Shen SS, Si Q, Dancer J, Stanton ML, Tamboli P, Ro JY, Czerniak BA Necrosis assessment in renal carcinoma-reply. Hum

Pathol. 2012;43(1):151-2.

Guo M, Gong Y, Wang J, Dawlett M, Patel S, Liu P, Bevers TB, Sneige N. The role of human papillomavirus type 16/18 genotyping in

predicting high-grade cervical/vaginal intraepithelial neoplasm in women with mildly abnormal Papanicolaou results. Cancer Cytopa-

thol. 2013 Feb;121(2):79-85.

Jung G, Hwang HS, Jang SJ, Ro JY. Are elastic stain and specialty sign out necessary to evaluate pleural invasion in lung cancers? Ann

Diagn Pathol. 2012;16(4):250-4

Kibe R, Zhang S, Guo D, Marrero L, Tsien F, Rodriguez P, Khan S, Zieske A, Huang J, Li W, Durum SK, Iwakuma T, Cui Y. IL-7Rα

deficiency in p53null mice exacerbates thymocyte telomere erosion and lymphomagenesis. Cell Death Differ. 2012 Jul;19(7):1139-51.

Long SW, Williams D, Valson C, Cantu CC, Cernoch P, Musser JM, Olsen RJ. A Genomic Day In The Life of a Clinical Microbiology

Laboratory. J Clin Microbiol. 2013 Jan 23. [Epub ahead of print]

Musser JM. S. Burt Wolbach, Rocky Mountain Spotted Fever, and Blood-sucking Arthropods: Triumph of an Early Investigative Pa-

thologist. Am J Pathol. 2013 Feb;182(2):291-3.

Nguyen DT, Nguyen HQ, Beasley RP, Ford CE, Hwang LY, Graviss EA. Performance of Clinical Algorithms for Smear-Negative Tu-

berculosis in HIV-Infected Persons in Ho Chi Minh City, Vietnam. Tuberc Res Treat. 2012;2012:360852.

Oh SY, Maier H, Schroeder J, Richter GS, Elli D, Musser JM, Quenee LE, Missiakas DM, Schneewind O. Vaccine Protection against

Bacillus cereus-Mediated Respiratory Anthrax-Like Disease in Mice. Infect Immun. 2013 Mar;81(3):1008-17.

Ozcan A, de la Roza G, Ro JY, Shen SS, Truong LD. PAX2 and PAX8 expression in primary and metastatic renal tumors: a compre-

hensive comparison. Arch Pathol Lab Med. 2012 Dec;136(12):1541-51.

Piña-Oviedo S, Shen SS, Truong LD, Ayala AG, Ro JY. Flat pattern of nephrogenic adenoma: previously unrecognized pattern un-

veiled using PAX2 and PAX8 immunohistochemistry. Mod Pathol. 2013 Jan 18. [Epub ahead of print]

Quiroga-Garza G, Zhou H, Mody DR, Schwartz MR, Ge Y. Unexpected High Prevalence of HPV 90 Infection in an Underserved

Population: Is It Really a Low-Risk Genotype? Arch Pathol Lab Med. 2013 Feb 20. [Epub ahead of print]

Ramkumar C, Kong Y, Cui H, Hao S, Jones SN, Gerstein RM, Zhang H. Smurf2 regulates the senescence response and suppresses

tumorigenesis in mice. Cancer Res. 2012 Jun 1;72(11):2714-9.

Song Y, Zhang Y, Bernard PE, Reuben JM, Ueno NT, Arlinghaus RB, Zu Y, Qin L. Multiplexed volumetric bar-chart chip for point-of-

care diagnostics. Nat Commun. 2012;3:1283.

Stamatakis L, Cheng PJ, Ho PL, Thrall MJ, Mayer WA, Miles BJ, Link RE. A 60-year-old woman with an incidentally discovered right

renal mass. Urology. 2012 Dec;80(6):1183-6.

Wang M, Tang D, Shu B, Wang B, Jin H, Hao S, Dresser KA, Shen J, Im HJ, Sampson ER, Rubery PT, Zuscik MJ, Schwarz EM, O'Keefe

RJ, Wang Y, Chen D. Conditional activation of b- catenin signaling in mice leads to severe defects of intervertibral disc tissue. Arthritis

Rheum. 2012 Aug;64(8):2611-23.

Wu X, Amrikachi M, Shah SK. Embedding topic discovery in conditional random fields model for segmenting nuclei using multis-

pectral data. IEEE Trans Biomed Eng. 2012 Jun;59(6):1539-49.

RECENT PUBLICATIONS continued

7

Editor-in-Chief

April A. Ewton, M.D.

The Laboratory Report

Editorial Committee

Hazel L. Awalt, M.D.

Christopher Leveque, M.D.

The Methodist Hospital

Clare Rose, M.B.A.

Manuel Hinojosa, M.H.A. Editorial Coordinator

Philip Randall

Department Chair

James M. Musser, M.D., Ph.D.