Laboratory of Pathology

Graduate Medical Education (GME): Hematopathology

Stefania Pittaluga, MD, PhD

Eligibility Criteria
Candidates must have completed three years of training in anatomic pathology, or four years of training in anatomic and clinical pathology in a residency program accredited by the ACGME. Fellows must have a valid medical license in one of the 50 U.S. states, or Canada, at the time they begin their fellowship. Physicians who received their primary medical education outside the United States are eligible, as long as they meet other eligibility criteria. Prior research experience is highly desirable, as well evidence of commitment to an academic career.

Overview
The Hematopathology Section of the Laboratory of Pathology, National Cancer Institute offers a fully ACGME accredited fellowship in hematopathology, which provides broad exposure to the diagnostic and investigative aspects of neoplastic hematopathology. Material is derived principally from an active inhouse treatment program for both adult and pediatric hematologic malignancies. In addition, approximately over 2000 challenging cases are submitted in consultation each year. The Hematopathology Section collaborates with the Clinical Services of the NCI, NHLBI, and NIAID in both clinical management and research.

Participation in research is an intrinsic component of the fellowship program. Fellows have an opportunity to pursue laboratory interests related to experimental hematopathology and immunology. These investigations include the immunologic, functional, and molecular aspects of human leukemia and lymphoma. Appointments are for a period of two years, with extension available. In the first year, fellows focus primarily on clinical rotations, fulfilling the ACGME requirements to qualify for the Board Certification examination in Hematopathology. In the second year, the majority of time is available for research.

The Hematopathology Section of the Laboratory of Pathology, NCI, under the leadership of Dr. Elaine S. Jaffe, provides a diagnostic service, which includes routine morphology, immunocytochemistry, flow cytometry, classical and research cytogenetics, and molecular genetics. The clinical rotations allow for exposure to these specialized diagnostic modalities. The facilities of the NCI Core Laboratories including Laser-capture microdissection, Microarray facilities, just to mention a few, provide access to the most modern molecular techniques.

Our program is integrated with the Hematology Department of the Clinical Center, NIH, where fellows receive training in bone marrow pathology and laboratory hematology. Further exposure to laboratory hematology and bone marrow pathology is provided through elective rotations at George Washington University Hospital Children’s National Medical Center. Enhanced exposure to hematopathology and flow cytometry is also obtained through an elective rotation at Johns Hopkins University Medical Center.

Program Faculty and Research Interests

  Elaine S. Jaffe, M.D., Biology and classification of lymphomas

  Mark Raffeld, M.D., Molecular pathogenesis of lymphomas, molecular diagnostics

  Liqiang Xi, M.D., Molecular diagnostics

  Maryalice Stetler-Stevenson, M.D., Ph.D., Flow cytometry, biology of lymphoid neoplasia

  Stefania Pittaluga, M.D., Ph.D., pathogenesis of lymphoma, primary immunodeficiencies

  Constance Yuan, M.D., Flow cytometry

  Diane Arthur, M.D., Clinical Cytogenetics

  Raul Braylan, M.D., Hematology, Flow cytometry, plasma cell neoplasms

  Irina Maric, M.D.,Hematology, Bone marrow diagnosis, myeloproliferative disorders

  Katherine Calvo, M.D., Ph.D., Hematology Myeloproliferative/myelodysplastic disorders

  Jay Lozier, M.D. Ph.D, Hematology, coagulation and thrombosis

  Roger Kurlander, M.D. Ph.D., Hematology, Chimerism, minimal residual disease

Examples of Papers Written by Program Faculty and Fellows

Ganapathi KA, Townsley DM, Hsu AP, Arthur DC, Zerbe CS, Cuellar-Rodriguez J, Hickstein DD, Rosenzweig SD, Braylan RC, Young NS, Holland SM, Calvo KR. GATA2 deficiency-associated bone marrow disorder differs from idiopathic aplastic anemia. Blood. 2015 Jan 1;125(1):56-70

Ganapathi KA, Pittaluga S, Odejide OO, Freedman AS, Jaffe ES. Early lymphoid lesions: conceptual, diagnostic and clinical challenges. Haematologica. 2014 Sep;99(9):1421-32.

Song, J. Y., Pittaluga, S., Dunleavy, K., Grant, N., White, T., Jiang, L., Davies-Hill, T., Raffeld, M., Wilson, W. H. and Jaffe, E. S. (2014). "Lymphomatoid Granulomatosis-A Single Institute Experience: Pathologic Findings and Clinical Correlations." Am J Surg Pathol 2014 , Oct.

Flatley E, Chen AI, Zhao X, Jaffe ES, Dunlap JB, Pittaluga S, Abdullah S, Olson SB, Spurgeon SE, Fan G. Aberrations of MYC are a common event in B-cell prolymphocytic leukemia. Am J Clin Pathol. 2014 Sep;142(3):347-54.

Menon MP, Evbuomwan MO, Rosai J, Jaffe ES, Pittaluga S. A subset of Rosai-Dorfman disease cases show increased IgG4-positive plasma cells: another red herring or a true association with IgG4-related disease? Histopathology. 2014 Feb;64(3):455-9

Bajor-Dattilo EB, Pittaluga S, Jaffe ES. Pathobiology of T-cell and NK-cell lymphomas. Best Pract Res Clin Haematol. 2013 Mar;26(1):75-87s

Huppmann AR, Nicolae A, Slack GW, Pittaluga S, Davies-Hill T, Ferry JA, Harris NL, Jaffe ES, Hasserjian RP. EBV may be expressed in the LP cells of nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) in both children and adults. Am J Surg Pathol. 2014 Mar;38(3):316-24

Liu, Q., Pittaluga, S., Davies-Hill, T., Raffeld, M., Xi, L. and Jaffe, E. S. (2013). "Increased CD5-positive polyclonal B cells in Castleman disease: a diagnostic pitfall." Histopathology 63(6): 877-80.

Huppmann AR, Roullet MR, Raffeld M, Jaffe ES. Angioimmunoblastic T-cell lymphoma partially obscured by an Epstein-Barr virus-negative clonal plasma cell proliferation. J Clin Oncol. 2013 Jan 10;31(2):e28-30

Huppmann AR, Xi L, Raffeld M, Pittaluga S, Jaffe ES. Subcutaneous panniculitis-like T-cell lymphoma in the pediatric age group: a lymphoma of low malignant potential. Pediatr Blood Cancer. 2013 Jul;60(7):1165-70

Venkataraman, G., Song, J. Y., Tzankov, A., Dirnhofer, S., Heinze, G., Kohl, M., Traverse-Glehen, A., Eberle, F. C., Hanson, J. C., Raffeld, M. A., Pittaluga, S. and Jaffe, E. S. (2013). "Aberrant T-cell antigen expression in classical Hodgkin lymphoma is associated with decreased event-free survival and overall survival." Blood 121(10): 1795-804.

Eberle FC, Salaverria I, Steidl C, Summers TA Jr, Pittaluga S, Neriah SB, Rodriguez-Canales J, Xi L, Ylaya K, Liewehr D, Dunleavy K, Wilson WH, Hewitt SM, Raffeld M, Gascoyne RD, Siebert R, Jaffe ES. Gray zone lymphoma: chromosomal aberrations with immunophenotypic and clinical correlations. Mod Pathol. 2011 Dec;24(12):1586-97

Venkataraman, G., Berkowitz, J., Morris, J. C., Janik, J. E., Raffeld, M. A. and Pittaluga, S. (2011). "Adult T-cell leukemia/lymphoma with Epstein-Barr virus-positive Hodgkin-like cells." Hum Pathol 42(7): 1042-6.

Venkataraman, G., Rizzo, K. A., Chavez, J. J., Streubel, B., Raffeld, M., Jaffe, E. S. and Pittaluga, S. (2011). "Marginal zone lymphomas involving meningeal dura: possible link to IgG4-related diseases." Mod Pathol 24(3): 355-66.

Venkataraman, G., Raffeld, M., Pittaluga, S. and Jaffe, E. S. (2011). "CD15-expressing nodular lymphocyte-predominant Hodgkin lymphoma." Histopathology 58(5): 803-5.

Eberle FC, Song JY, Xi L, Raffeld M, Harris NL, Wilson WH, Pittaluga S, Jaffe ES. Nodal involvement by cutaneous CD30-positive T-cell lymphoma mimicking classical Hodgkin lymphoma. Am J Surg Pathol. 2012 May;36(5):716-25

Liu Q, Salaverria I, Pittaluga S, Jegalian AG, Xi L, Siebert R, Raffeld M, Hewitt SM, Jaffe ES. Follicular Lymphomas in Children and Young Adults: A Comparison of the Pediatric Variant With Usual Follicular Lymphoma. Am J Surg Pathol, 2012

Song JY, Eberle FC, Xi L, Raffeld M, Rahma O, Wilson WH, Dunleavy K, Pittaluga S, Jaffe ES. Coexisting and clonally identical classical Hodgkin lymphoma and nodular lymphocyte predominant Hodgkin lymphoma. Am J Surg Pathol, 35 (5):767-72, 2011

Program Graduates

  Ganapathi, Karthik, Columbia University, NY, Graduated 2013

  Zhao, Xiangrong (Alex), Pathology Consultants of New Mexico, Graduated 2013

  Bajor-Dattilo, Ewa, Saint Barbanas, NJ, Graduated 2012

  Menon, Madhu, Henry Ford, Detroit, MI, Graduated 2012

  Summers, Thomas, CPT. Walter Reed Army Medical Center, Graduated 2011

  Huppmann, Alison R, Children's National Medical Center, Graduated 2011

  Liu, Qingyan, Quest Diagnostics, Chantilly, VA, Graduated 2010

  Song, Joo Y, City of Hope National Medical Center, Duarte, CA, Graduated 2010