Graduate Medical Education (GME): Cytopathology
National Institutes of Health - Research Triangle Park, NC

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Graduate Medical Education (GME): Cytopathology

Armando Filie, MD
Entry Id: TP-53

Eligibility Criteria
Candidates must be licensed to practice medicine in the United States and certified by or eligible for the American Board of Pathology in anatomic pathology or anatomic pathology/clinical pathology.

Overview
The Cytopathology Section of the National Cancer Institute provides diagnostic cytopathology services to the National Institutes of Health (NIH) and its associated clinical services in the Clinical Center, a 240-bed research hospital. The relatively high frequency of pathologic findings combined with the diversity of types of exfoliative and fine needle aspiration (FNA) specimens seen in our Section provide a broad experience in diagnostic cytopathology. The goals of the fellowship are to develop a strong foundation in diagnostic cytopathology and introduce clinically oriented physicians to current research techniques.

Structure of the Clinical Training Program
The Fellowship program is 12 months in duration. For the clinical training, Fellows are assigned to the cytology diagnostic service approximately seventy-five percent (75%) of the time. While on service, the Fellow will have progressive and supervised responsibility for the accessioned cases and for performing FNAs. A staff pathologist is available for back-up and consultation at all times. Daily working conferences which all staff members attend are an integral component of the training. The Section accessions approximately 3,000 specimens per year. Ninety percent (90%) of our caseload is non-gynecologic cytology including 26% FNA samples. The Fellow will also rotate for one month each through the Cytopathology Divisions of the National Naval Medical Center and the George Washington University Medical Center. Our Section also has an active immunocytochemistry service utilized for diagnostic and research purposes. Remaining 25% of the time is spent in clinical research training where the Fellow will familiarize him/herself with current techniques that can be applied in the research and clinical setting. Completion of the program qualifies the candidate for the cytopathology special qualification board exam.

Program Faculty and Research Interests

Armando Filie, MD: application of ancillary techniques in cytopathology and clinical research, fine needle aspiration, thyroid, immunocytochemistry.

Mark Roth, MD: enhancing diagnosis and clinical management through the integration of cytologic sampling and advanced microdissection techniques.

Examples of Papers Authored by Program Faculty

Roy Chowdhuri S, Xi L, Pham THT, Hanson J, Rodriguez-Canales J, Berman A, Rajan A, Giaccone G, Emmert-Buck M, Raffeld M, Filie AC. EGFR and KRAS mutation analysis in cytologic samples of non-small cell lung carcinoma enabled by laser capture microdissection. Mod Pathol (submitted 4/11)

Matsuda KM, Nóbrega R, Quezado M, Schrump DS, Filie AC. Melanocytic bronchopulmonary carcinoid tumor in a patient with multiple endocrine neoplasia syndrome type 1: a case report with emphasis on intraoperative cytological findings. Diagn Cytopathol. 38:669-74, 2010

Palavalli LH, Prickett TD, Wunderlich JR, Wei X, Burrell AS, Porter-Gill P, Davis S, Wang C, Cronin JC, Agrawal NS, Lin JC, Westbroek W, Hoogstraten-Miller S, Molinolo AA, Fetsch P, Filie AC, O'Connell MP, Banister CE, Howard JD, Buckhaults P, Weeraratna AT, Brody LC, Rosenberg SA, Samuels Y. Analysis of the matrix metalloproteinase family reveals that MMP8 is often mutated in melanoma. Nat Genet. 41:518-20, 2009

Loud JT, Thiébaut AC, Abati AD, Filie AC, Nichols K, Danforth D, Giusti R, Prindiville SA, Greene MH. Ductal lavage in women from BRCA1/2 families: is there a future for ductal lavage in women at increased genetic risk of breast cancer? Cancer Epidemiol Biomarkers Prev. 18:1243-51, 2009

Filie AC, Asa SL, Geisinger KR, Logani S, Merino M, Nikiforov YE, Clark DP. Utilization of ancillary studies in thyroid fine needle aspirates: a synopsis of the National Cancer Institute Thyroid Fine Needle Aspiration State of the Science Conference. Diagn Cytopathol. 36:438-41, 2008

Adams L, Roth MJ, Abnet CC, Dawsey SP, Qiao YL, Wang GQ, Wei WQ, Lu N, Dawsey SM, Woodson K. Promoter methylation in cytology specimens as an early detection marker for esophageal squamous dysplasia and early esophageal squamous cell carcinoma. Cancer Prev Res (Phila). 1:357-61, 2008

Pan QJ, Roth MJ, Guo HQ, Kochman ML, Wang GQ, Henry M, Wei WQ, Giffen CA, Lu N, Abnet CC, Hao CQ, Taylor PR, Qiao YL, Dawsey SM. Cytologic detection of esophageal squamous cell carcinoma and its precursor lesions using balloon samplers and liquid-based cytology in asymptomatic adults in Llinxian, China. Acta Cytol. 52:14-23, 2008

Dawsey SP, Roth MJ, Adams L, Hu N, Wang QH, Taylor PR, Woodson K. COX-2 (PTGS2) gene methylation in epithelial, subepithelial lymphocyte and stromal tissue compartments in a spectrum of esophageal squamous neoplasia. Cancer Detect Prev. 32:135-9, 2008

Rapkiewicz A, Espina V, Zujewski JA, Lebowitz PF, Filie A, Wulfkuhle J, Camphausen K, Petricoin EF 3rd, Liotta LA, Abati A. The needle in the haystack: application of breast fine-needle aspirate samples to quantitative protein microarray technology. Cancer. 111:173-84, 2007

Panelli MC, Stashower ME, Slade HB, Smith K, Norwood C, Abati A, Fetsch P, Filie A, Walters SA, Astry C, Aricó E, Zhao Y, Selleri S, Wang E, Marincola FM. Sequential gene profiling of basal cell carcinomas treated with imiquimod in a placebo-controlled study defines the requirements for tissue rejection. Genome Biol. 8:R8, 2007

Manosca F, Schinstine M, Fetsch PA, Sorbara L, Maria Wilder A, Brosky K, Erickson D, Raffeld M, Filie AC, Abati A. Diagnostic effects of prolonged storage on fresh effusion samples. Diagn Cytopathol. 35:6-11, 2007

Schinstine M, Filie AC, Wilson W, Stetler-Stevenson M, Abati A. Detection of malignant hematopoietic cells in cerebral spinal fluid previously diagnosed as atypical or suspicious. Cancer (Cytopathol), 108:157-62, 2006

Schinstine M, Abati A, Tsokos M, Fox E, Filie AC. Cytological identification of metastatic nephroblastoma in pleural fluid: report of a case and review of literature. Diagn Cytopathol, 34:621-5, 2006

Program Graduates
Recent program graduates, including their current positions, are listed below:

Gulsun Erdag, MD. University of Virginia School of Medicine, Charlottesville, VA

Kathryn Rizzo, DO, PhD. Indiana University School of Medicine, Indianapolis, IN

Yonca Kanber, MD. McGill University, Montreal, Quebec, Canada

Frances Manosca, MD. John H. Stroder Jr. Hospital of Cook County, Chicago, IL
Application Information

A single fellowship position, which is a one year combined service and research appointment, is available. Candidates must be physicians licensed to practice medicine in the US and board certified/eligible in anatomic pathology or anatomic pathology/clinical pathology. Our program is recognized by the American Board of Pathology as satisfying training requirements necessary to qualify for the examination for added qualification in cytopathology.

Electronic Application
The quickest and easiest way to find out more about this training program or to apply for consideration is to do it electronically.

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