Anatomic Pathology; Clinical Pathology
My interest in pathology dates back to my Medical school years. However it was not until I had spent some time in Internal Medicine and clinical Hematology / oncology that I realized that I wanted to pursue a career in pathology. As a pathologist my interest and training is broad based in both clinical and anatomic pathology, however my fellowship in Oncologic surgical pathology from Roswell Park Cancer Institute steered me towards that path. Ever since I started working in Veterans Affairs Medical Center in Buffalo New York, I noticed the increasing incidence of HPV related head and neck squamous cell carcinomas and that sparked a curiosity to understand the mechanism of disease and why HPV is slowly replacing smoking as the predominant causative agent in the pathogenesis of squamous cell carcinoma especially in the Head and Neck region and what are the prognostic implications of its prevalence to the disease. This has thus become my research interest. In addition to oncologic surgical pathology, I am also interested in Hematology. Fortunately working at VAMC provides me with ample opportunity to continue to polish and improve my skills in diagnostic Hematology and also acquire additional skills in the form of flow cytometric evaluation and diagnostic molecular pathology, with the support of my colleagues who have unique expertise in these fields. The kind of clinical material that we evaluate here every day is also very challenging and the opportunity for growth provided, very gratifying.
Anatomic Pathology; Blood Banking/Transfusion Medicine; Clinical Pathology; Cytopathology; Dermatopathology - Anatomic Pathology; Autopsy
My clinical interests have been in diagnostic anatomic pathology with a focus on non- small cell lung cancer and other thoracic malignancies, soft tissue sarcoma, and all aspects of dermatopathology including inflammatory dermatoses, melanoma and non-melanoma skin cancer and the cytologic evaluation of fine needle aspiration biopsy material. Participation as a panel member in the NCCN‘s development of empirically based guidelines for clinical care of cancer patients with thoracic malignancies and non melanoma skin cancer was a major focus during the previous decade. My career focus has evolved over time such that currently mentoring of faculty and participation in the development of innovative approaches to medical education occupies the vast majority of my effort.
Anatomic Pathology; Clinical Pathology; Cytopathology
I am board certified in Cytopathology, Anatomical Pathology and Clinical Pathology. I have special interests in detecting malignant cells in all body sites using light microscopy and immunohistochemistry. I am interested in GYN cytology, Non-GYN cytology and Find Needle Aspirate (FNA) cytology, in including making rapid adequacy assessment and diagnosis in Endoscopic Ultrasound FNA (EUS-FNA) of pancreas and intra-abdominal mass, and Endobronchial Ultrasound FNA (EBUS-FNA) of lung cancer diagnosis and staging. I also have a broad interest in surgical pathology, including biopsy and frozen sections.
Anatomic Pathology; Clinical Pathology; Pediatric Pathology
I spend most of the time at Women and Children’s Hospital of Buffalo taking care of routine Surgical Pathology, and Frozen sections. We cover a broad spectrum of cases which are received not only from children but also from adult patients. We have a very close relationship with Gastroenterology Group. All endoscopic biopsies are reviewed every week in a joint conference attended by Physicians, Fellows, Residents and Medical students. Pathology Residents from SUNY program rotate through this hospital for Pediatric Pathology training. I serve as Site Director for this training. Neonatal and Pediatric autopsies are performed here and they are later discussed with a group of pediatricians, surgeons, radiologists and OB/GYN, whoever is involved in that particular case. I am and Assistant Director for the Clinical Laboratories of Women’s and Children’s Hospital and also Assistant Director of Blood Bank at Buffalo General Hospital. I am responsible for all hemoglobin electrophoresis performed at the specialty lab of Women’s and Children’s Hospital and, on rotation basis, cover Immunofluorescence at Kaleida Health Lab at Flint Road. I represent Roswell Park Cancer Institute as Principal Investigator of Pathology at National Children Oncology Group (COG) and as an Investigator for NIH- Cancer Therapy Evaluation Program. We discuss all malignancies at Tumor Board. The Tumor Board is held every week at Women’s and Children’s Hospital with video link to Roswell Park Cancer Institute.
Anatomic Pathology; Blood Banking/Transfusion Medicine; Clinical Pathology; Cytopathology; Hematology - Clinical Pathology; Immunopathology; Surgical Pathology; Toxicology; Transfusion Medicine; Bioinformatics; Microbiology; Virology
I serve the Department of Pathology and Anatomic Sciences as a general pathologist in anatomic and clinical pathology. My primary areas for service work include surgical pathology and cytopathology as an attending pathologist rotating among the Kaleida hospital sites and clinical pathology activities in clinical chemistry, transfusion medicine, microbiology and hematology. I serve as the laboratory medical director for the clinical laboratories at the Women and Children‘s Hospital of Buffalo and the Center for Laboratory Medicine, Williamsville (Flint). I also provide more specialized medical support for the forensic toxicology laboratory at the Women and Children‘s Hospital, the fetal defect screening program at the Center for Laboratory Medicine in Williamsville, the Virology laboratory at Women and Children‘s Hospital and the Therapeutic Plasmapheresis program at the Buffalo General Medical Center. I have developed an interest in Clinical Informatics and regularly employ those skills to retrieve and analyze data from Kaleida and elsewhere to support clinical decision making, research activities, EHR development and business development. Within the department, I am the pathologist overseeing the Transfusion Service across Kaleida and also provide pathology direction to the Kaleida Clinical Chemistry and Microbiology programs. In addition, I support the leadership of Kaleida in their Utilization Program, the Gainsharing Program, Peer Review and as Chair of the Site specific Transfusion Committees. Since January 2013 I have also served as the laboratory director of the Erie County Public Health Laboratory. Previously I have served as the laboratory director at the Center for Laboratory Medicine, Amherst (Suburban), Buffalo General Hospital and as an assistant laboratory director at Gates Circle. Each of these positions has been valuable to me in learning how different groups work together and how different groups of clinicians see and set expectations for a pathology department. Outside of Kaleida, I serve the region as representative to the Erie County Medical Society Legislative Committee and the Economic Affairs Committee. I have also served as president of the Western New York Society of Pathologists (1999-2000) and as Delegate to the College of American Pathologists House of Delegates (2005 - present). The overall theme of these activities is to leverage the skills cultivated by any practicing pathologist to recognize patterns. Those patterns recognized are then directed to purposes that can be quite diverse, ranging from diagnosis to data integrity. Data retrieved from multiple sources are used to provide an unbiased review for departmental and hospital leaders to troubleshoot, drive test menus or to review patterns of practice. Good data can drive good decisions, but only to the degree that the data can be recognized and understood. My professional time is divided in four parts, with anatomic pathology service work comprising about one quarter of my time, clinical pathology service work a second quarter, administrative activities a third quarter and clinical informatics the last quarter (plus or minus 5%), but with the added bonus that on any one day, these duties can shift dramatically to address the needs of the department and hospital. One of the most rewarding parts of my career has been the opportunity do all of these to the best of my ability and to support the efforts of the excellent professionals around me. The variety of responsibilities I have translate into a job that is never dull. I have used my own situation as a model for the pathology residents I train to provide a live demonstration that the field of Pathology is big enough to have something of interest for any interested person.
Anatomic Pathology; Clinical Pathology; Molecular Genetic Pathology - Clinical Biochemical; Surgical Pathology
Professional Summary: As a pathologist, I help cover the clinical duties for the Kaleida Health system’s anatomical pathologist needs at the Buffalo General Medical Center, Suburban Hospital and DeGraff Hospital. I am Board certified in Anatomic and Clinical Pathology with an interest in oncologic pathology and approaches related to precision medicine. The majority of my time is allocated for clinical service work, which includes general surgical pathology, some clinical pathology coverage, and the teaching of pathology residents. Additional clinical duties include overseeing the laboratory’s immunohistochemistry section and involvement in the build-up of the CTRC’s biobank. For resident education, one major emphasis currently being undertaken is the deciphering of the technical and bioinformatic bridges that separate pathologists from those involved in the field of genomic sequencing. Dedicated research time has allowed me to be involved in investigations centered on improvements in sample procurement and biomarker studies for antibody-drug conjugate (ADC) characterization. Current work on the former is centered on the development of an automated prototype for the processing of cells recovered from washed core needle biopsies, but with utility for any ‘wet’ type biopsy or sample (e.g., cytology specimens). This prototype is intended to enable unfixed cells to travel through a microfluidic platform that will allow for their quantitative evaluation and assessment of their cytologic features for diagnostic purposes, and their recovery for downstream molecular studies. Because of their unfixed nature, we are assessing the utility of the DNA extracted from these cells for long read sequencing technologies, believing these devices will ultimately replace both multi-panel, next generation tests and FISH assays for the elucidation of molecular abnormalities at both the single nucleotide and structural variation level. This approach will preserve the original core needle biopsy tissue for further tissue-based testing that requires morphologic evaluation, in particular, the profiling of tumor tissue to guide treatment with the aforementioned ADC currently being tested in clinical trials. The underlying effort is to maximize the amount of informative data derived from diminutive biospecimens and prevent the current problems associated with tissue exhaustion.
Anatomic Pathology; Clinical Pathology; Surgical Pathology
I spend my professional time working in anatomic pathology service work, clinical pathology service, administrative activities and teaching pathology residents from SUNY Pathology residency program. I serve as the medical director for the clinical laboratories at DeGraff Memorial Hospital, director of Outreach Services at Kaleida Health and as assistant director to the Center for Laboratory Medicine, Williamsville (Flint). I had also served as the laboratory director of the Erie County Public Health Laboratory STD clinic. I serve the Department of Pathology and Anatomic Sciences at Kaleida Health as a general pathologist in anatomic and clinical pathology. My primary areas for service work include surgical pathology and cytopathology as an attending pathologist rotating among the Kaleida hospital sites. Each of these positions has been valuable to me in learning how different groups work together and how different groups of clinicians see and set expectations for a pathology department.
Anatomic Pathology; Autopsy; Clinical Pathology; Cytopathology; Dermatopathology - Anatomic Pathology; Immunopathology; Medical Microbiology; Surgical Pathology; Bioinformatics; Microbiology
I pursued undergraduate and graduate education in biomedical engineering because of my interest in the application of basic science to solve real world problems. My studies included biomaterials and medical imaging. An interest specifically in medical science led me to medical school and eventually into pathology. After close to four years practicing community pathology, a desire to reestablish connections with UB pathologists initiated during my Roswell Park fellowship brought me back to Buffalo as a UB pathologist. My clinical responsibilities include surgical pathology, cytopathology, autopsy pathology and clinical pathology. I routinely work with pathology residents during their surgical pathology, cytology and autopsy rotations. I have particular interest in dermatopathology and gastrointestinal pathology. Image processing and analysis and bioinformatics also intrigue me. I am currently searching for new opportunities to collaborate with faculty in the anatomical sciences half of our department.
Anatomic Pathology; Clinical Pathology
I am a board-certified pathologist. I‘m serving the Kaleida Health laboratories primarily in the fields of hematology/hematopathology and transfusion medicine. My research experiences includes both basic immunology and translational research involving antibody engineering, lymphoma and solid tumor immunotherapy, lymphoma characterization, leukemic bone marrow microenvironment studies, as well as general clinical pathology research. My previous research was focused on using different antibody-based strategies to generate novel reagents for cancer immunotherapy. For example, based on the observation that the induction of apoptosis in lymphoma cells requires proper presentation of anti-CD20, we have generated a novel Rituximab Polymer that induces apoptosis in non-Hodgkin’s lymphoma cells. Bio-distribution study has shown that this polymer targeted Burritt’s lymphoma cells in mouse xenograft model. Immunotherapeutic study has demonstrated that systemic delivery of this polymer successfully induced tumor regression in vivo. Moreover, we found that some anti-HLA-DR monoclonal antibody and its humanized form are also potent apoptosis inducers on lymphoma cells. We also showed that tumor targeting antibodies fused with T-cell co-stimulators presented increased tumor uptake. Systemic administration of this combination induced tumor regression significantly and prolonged the survival of treated mice. Currently, my research focuses on the characterization of follicular lymphoma with marginal zone differentiation. Follicular lymphoma (FL) with marginal zone differentiation is a relatively rare morphologic variant of FL. We tried to characterize the clinicopathologic features as well as survival studies. We found that this morphology correlates with complex cytogenetic abnormalities and associated with worse clinical outcome compared with follicular lymphoma without marginal zone differentiation. Recognizing this variant is important in patient treatment and prognosis. Another focus of my currently ongoing studies is about the bone marrow microenvironment in leukemic and aleukemic acute myeloid leukemia (AML). Aleukemic AML differs from leukemic AML in that the peripheral blood show high blast counts. Little is understood why in certain AML, the bone marrow releases high number of blasts into the peripheral blood. Our hypothesis is that there is a bone marrow-sinusoids gate that controls the release of hematopoietic cells into peripheral blood, including the immature precursor cells. This gate can be affected by the changes in bone marrow microenvironment including aberrant expression of certain adhesion molecules and a variety of depositions in the stroma by AML. This hypothesis is supported by the fact that in many previous studies, only high blast counts in the peripheral blood correlates with worse prognosis in AML. I believe further exploration along this direction will gain us more valuable information about AML pathophysiology. I have also been actively involved in undergraduate student, medical student, and junior resident teaching and training during all these years of my career development. I enjoyed sharing my thoughts and experiences with them and often times, I learn a lot from these interactions.