Miller selected as division director of neuropathology at University of Alabama

C. Ryan Miller, MD, PhD

The University of Alabama at Birmingham Department of Pathology has recently named C. Ryan Miller, MD, PhD as director of the neuropathology division. He starts in that position on April 1.

Miller was most recently a professor in the Department of Pathology and Laboratory Medicine at the University of North Carolina-Chapel Hill. Miller also served as faculty director of the UNC Translational Pathology Laboratory in conjunction with the Lineberger Comprehensive Cancer Center

“We are excited to have Dr. Miller back at UAB in the Department of Pathology, where his experience in research on tumors of the brain and work with proteomics will enhance the Neuropathology Division’s portfolio for future growth in this important area,” said department chair George Netto, MD.

In 1999, prior to medical school, Miller completed a Ph.D. in the department’s Cellular and Molecular Pathology Graduate Program. He earned his medical degree from the UAB School of Medicine in 2002 and completed a postdoctoral fellowship in the UAB Brain Treatment and Research Program. Miller then moved to Washington University School of Medicine, where he completed a residency in anatomic pathology in 2004 and a fellowship in neuropathology in 2006.

Polymer coating embolism from intravascular medical devices

The deaths of at least three people who had hospital procedures in Vancouver were caused by coatings that sloughed off medical devices like catheters and scattered through blood vessels to major organs, a recent study has found. Here's a link to the relevant news article.

Rupal I. Mehta, MD

Thanks to Dr. Rupal I. Mehta of the University of Rochester for alerting me to this article. Dr. Mehta herself has published on this increasing recognized phenomenon. Here's a link to her update on the topic.

Dr. Harry Vinters had this to say about the new study coming out of Canada: “Their study is especially intriguing in that it utilizes what could be considered old technology — careful tissue analysis of autopsy specimens — to derive extremely important new information that has a direct impact on outcomes in a select group of patients. Indeed, the autopsy is about the only way this data could have been derived, and Dr. Maguire and his colleagues are to be congratulated for the care with which the study was performed and the data analyzed.” Dr. Vinters has published on this topic as well. Here is a link to his review.

Glial cytoplasmic inclusions filling putaminal pencillary fibers in a case of multiple system atrophy (striatonigral type)

Putamen (alpha-synuclein immunohistochemistry)

Best Post of December 2018: Giant cell GBM masquerading as an anaplastic PXA

The next in our "Best of the Month" series is from December 4, 2018:

At first glance, this tumor with pleomorphic cells and prominent perivascular lymphocytic cuffing strikes one as a pleomorphic xanthoastrocytoma (PXA).

The relative circumscription, as demonstrated by the stark difference in tumor burden in adjacent gyri depicted above also suggests the possibility of  PXA.

The presence of mitotic figures (center of picture above) and a small amount of necrosis and microvascular proliferation (not pictured) suggests the possibility of anaplastic PXA.

However, perivascular lymphocytes and relative circumscription can be seen in giant cell glioblastoma (GC-GBM). Pointing away from anaplastic PXA is the fact that there was no evidence of Rosenthal fibers and eosinophilic granular bodies. Additionally, there was strong p53 immunohistochemical positivity. The final diagnosis was Glioblastoma, IDH-wildtype, WHO grade IV, giant cell variant.

Donahue does it again: a case of type 2 myotonic dystrophy from Providence, Rhode Island

A case from Dr. John Donahue, inimitable neuropathologist and neuropathology fellowship program director at Brown University:

"This is a fast myosin immunostain on a gluteus maximus biopsy from a 45-year-old woman who went on to have genetically-proven myotonic dystrophy, type 2 (DM2; proximal myotonic myopathy; PROMM).  The type 2 muscle fibers are EXTREMELY atrophic."

Dr. Fausto Rodriguez presents on the topic of tumefactive pseudoneoplasms on PathCast

Here's a link to the whole PathCast series on YouTube. Great lectures from prominent pathologists -- completely free! Dr. Rodriguez has another lecture uploaded on the site, and Dr. Arie Perry has two.

Primum non nocere

Dr. Edward Lee

Dr. Edward Lee is among several others who have authored an interesting commentary on CTE entitled: Primum non nocere: a call for balance when reporting on CTE. It's worth a read!

Neuropathologist Robert Corona named CEO of Upstate Medical University

Robert J. Corona, DO, MBA

Dr. Robert Corona has been named chief executive officer of Upstate University Hospital in Syracuse, NY. Corona had been serving as the hospital’s interim CEO before his permanent appointment last month.

Corona did his neuropathology fellowship at the Armed Forces Institute of Pathology in Washington, DC (1990) and SUNY Health Sciences Center at Syracuse (1991).

At Upstate, Corona has served as chair of the pathology department, and medical director of neuropathology. He previously worked as a vice president at Welch Allyn in Skaneateles, NY.

Corona was on my 2016 list of neuropathologists who are department chairs.

Stanford neuropathologist Hannes Vogel featured on cover of the Palo Alto Weekly

A blog fan spotted this while walking his dog down a street in Palo Alto today:

The story about Dr. Vogel can be seen here.

Radiologically suspected meningioma turns out to be WHO grade II Pleomorphic Xanthoastrocytoma

Rosethal fiber in oval. Eosinophilic granular body in rectangle

Rosenthal fibers can be seen in non-neoplastic "compressed" brain tissue. For example, I once saw Rosenthal fibers in the spinal cord adjacent to an epidural abscess.

An inquiry from Dr. Mike Lawlor

Dr. Mike Lawlor (Medical College of Wisconsin)

Hi Everyone,

The time has come for me to pursue re-certification from the American Board of Pathology, and my test period is in March.  As I’ve become a bit super-specialized in a single area, I feel that I’ll likely need to brush up on some topics in order to continue to be considered a neuropathologist.  I haven’t kept up very well with the range and type of educational resources available to neuropathologists for test preparation, and I could use some advice.  Does anyone have advice on educational materials appropriate for ABP re-certification in neuropathology?  I’m sure that others taking the exam this year would also read your comments with interest.

Thanks again,

-Mike Lawlor