Friday, March 25, 2016

A list of neuropathologists who are departmental chairs

There is a disproportionate number of neuropathologists who are chairs of their departments. Some readers thought it would be interesting if a list of these chairs could be compiled. With the help of Mark Cohen, Bette Kleinschmidt-DeMasters, and Robert Mrak, a pretty comprehensive list has been assembled:


Douglas Anthony at Brown

Steven Carroll at Medical University of South Carolina

Robert Corona at SUNY Upstate

Jeffrey Golden at Brigham and Women's Hospital

Eyas Hattab at University of Louisville

Alex Judkins at Children's Hospital Los Angeles

David Louis at Massachusetts General Hospital

Jenny Libien at SUNY Downstate

Thomas Montine currently at University of Washington and soon to be at Stanford

Edwin Monuki at the University of California Irvine

Robert Mrak at the University of Toledo

Amyn Rojiani at Augusta University

Kevin Roth at Columbia

John Schweitzer at East Tennessee State University


Also of note:
William Hickey at Dartmouth (acting chair of pharmacology and toxicology, former pathology chair)

Best Post of December 2015 -- "I'm a neuropathologist with a glioblastoma": A guest post from Susan M. Staugaitis, MD, PhD

The next in our "Best of the Month" series comes from  December 11, 2015:

I’m a neuropathologist with a glioblastoma.  How ironic is that?  For 17 years, my skill in making this diagnosis has been a major part of my job.  I know more about the biology of my disease than most of the physicians involved in my care.  And suddenly, within two weeks, my life expectancy changed from 30+ years to 2-5.  My reality has changed.


Dr. Staugaitis wearing the Novocure Optune electric field generator as part of her treatment 

If I'm freaking you out, you are not alone.  I'm freaking everybody out.  I haven’t had such a good excuse to be so “frontal lobe” since I was a teenager.  In the past five months, I have become so accustomed to my diagnosis and disabilities that I blurt it out to store clerks when explaining why I’m seeking a particular good or service.  I know the song I want to hear over and over again as I cross to the other side.  Would you expect anything less from someone who looks a lot better than her scan?  

I cope by trying to stay realistic and in the moment.  I try to extract anything and everything that is positive from my experience today and defer to tomorrow all thoughts that won’t matter until then.  It’s not much different from the days when I lived in southern California, not worrying about the “big one” that could hit anytime, but keeping myself prepared nevertheless. 

Family and friends remark on the extraordinary strength and courage I display.  Honestly, hearing this can get to be too much.  I do need the people close to me to help me fortify and reinforce the strength I am finding in myself, but quixotic sentiments don’t provide much comfort.  I’m too honest and practical to expect a miracle, to dream the impossible dream.  I’ll be satisfied with the possibility of beating the odds.

But, any gambler will tell you that the odds depend on the game.  I think sports gambling is most relevant to me and my diagnosis.  In sports gambling, it is all in the point spread.  You can win when your team loses and lose when your team wins.

Neuropathologists have inside information in this respect.  We look at the location of the lesion, at the histology in the microscope, at the molecular profile, and the combination gives us a pretty good idea of how to place our bet.  No emotions or wishful thinking here; we’ve got data.  As scientists, we are obligated to describe the data accurately and analyze it objectively.  In fact, if we are to gain and maintain the respect of our peers, we cannot ignore any data, no matter how much we dislike it, no matter how much it conflicts with our view of how the world should be.  And as writers, we find the words that communicate our interpretations as definitively and positively as possible without being incorrect.

Then it is time to sit back and watch the game, wait for the final score.  Did my bet beat the spread? 

And regardless of the game’s outcome, there will always be another game: new questions, new data to acquire.  So we pick ourselves up, dust ourselves off, and start all over again.

© 2015 Susan M. Staugaitis, M.D., Ph.D. 
Retired Consultant Staff, Departments of Pathology and Neurosciences, Cleveland Clinic
Adjunct Assistant Professor of Molecular Medicine

Cleveland Clinic Lerner College of Medicine of Case Western Reserve University

Monday, March 21, 2016

Cornea of an elderly female soft contact lens wearer afflicted by acanthamoeba keratitis

Evacuated cyst walls embedded in corneal stroma
Acathamoeba keratitis classically afflicts soft contact lens wearers who use contaminated homemade saline solutions or wear their contact lenses while swimming or in hot tubs. Corneal infection is usually very painful. In some medically intransigent cases, as exemplified in this case, corneal transplantation may be necessary. The chitinous wall of the organism is oval, while the cytoplasm typically retracts from the cyst wall in tissue sections. The cyst contains a round nucleus with a distinct nucleolus.
Acanthamoeba nucleus with distinct nucleolus

Monday, March 14, 2016

Neuropathologist Thomas J. Montine named new chair of Stanford Pathology

Thomas J. Montine, MD, PhD
Thomas J. Montine, chair of pathology at University of Washington, has been named new chair of the Department of Pathology at Stanford University.

The dean at Stanford stated the following in announcing the appointment: "Tom embodies the academic mission of Stanford Medicine as well as the creativity and collaboration that is our hallmark. He is a consummate clinician scientist committed to our vision to lead the biomedical revolution in Precision Health. The national centers for research on Alzheimer’s disease and Parkinson’s disease that he directs at UW emphasize functional genomics, early detection, and the discovery of tailored therapies. Tom’s research has greatly enhanced our understanding of the structural and molecular bases of cognitive impairment. Ranked among the top recipients of NIH funding among pathology faculty in the United States, he is the author of nearly 500 publications. Through service to the NIH he has helped develop national research priorities for Alzheimer’s disease and Parkinson’s disease."

Montine, who joins a growing list of pathology department chairs who are neuropathologists, starts his new job at Stanford on May 1. Other departmental chairs who are neuropathologists include David Louis at Mass General Hospital, Jeffrey Golden at Brigham and Women's Hospital, Eyas Hattab at University of Louisville, Amyn Rojiani at Augusta University, Doug Anthony at Brown University, Robert Mrak at University of Toledo, and Kevin Roth at Columbia.

Friday, March 11, 2016

Featured Neuropathologist: Michael D. Norenberg, MD

On March 18, the University of Colorado Department of Pathology will be honored to host Dr. Michael Norenberg at grand rounds. Dr. Norenberg's talk will be entitled "Chronic Traumatic Encephalopathy: Mechanisms and Potential Treatments". I take this occasion to feature Dr. Norenberg on this blog. A professor at the University of Miami, Dr. Norenberg was honored last year by the journal Neurochemical Research, which dedicated its February issue to contributions Dr. Norenberg has made to the fields of neuroscience and neuropathology.

Michael D. Norenberg, MD
 “Mike has made seminal contributions to our understanding of the brain and brain pathology,” said Richard J. Cote, M.D., chair of pathology at UMiami. “He was one of the first to show that astrocytes play crucial roles in brain function, and are not merely scaffold cells, as had been previously thought... His work on hepatic encephalopathy — a serious neurological condition that results from liver failure — has basically defined our understanding of this debilitating and prevalent condition. Mike is also particularly proud of uncovering the cause of central pontine myelinolysis (CPM), a devastating demyelinating disorder, usually occurring in chronically ill individuals, and often with prolonged periods of hospitalizations. He and his colleagues found that CPM is caused by an overly rapid correction of hyponatremia. As such, CPM is currently an extremely rare condition. Mike has received numerous awards for his work, but having an entire journal dedicated to him is a rare and very appropriate honor.”

According to a UMiami press release, Norenberg described himself as “totally surprised, shocked and humbled” by the honor. He said, “Research can be a difficult, grueling and a sometimes thankless task, often colored by disappointments and frustrations, but it is also associated with great joy when useful knowledge is generated, and your achievements are recognized and appreciated by your peers and colleagues.”

Dr. Norenberg graduated with a B.A from Trinity College in 1960, then graduated medical school from the University of Rochester in 19645. He did his post-graduate training at Strong Memorial Hospital in Rochester, New York.

Wednesday, March 2, 2016

Lisch nodules in a patient with NF-1



A. Multiple tan or pale brown dome-shaped nodules on surface of iris of patient with NF-1. Lisch nodules occur in nearly all affected adults with neurofibrosis, type 1. B. Focus of partially pigmented cells rests on anterior iridic surface. Lisch nodules are melanocytic hamartomas.

From: Eagle, Ralph C. Jr.. Eye Pathology: An Atlas and Text. Second Edition (2011). Page 20.