MedStar Georgetown University Hospital is staffed with two board-certified hematopathologists (Dr. Metin Ozdemirli and Dr. Bhaskar Kallakury) that are responsible for the diagnosis of hematologic disorders, which include benign and neoplastic disorders of blood cells, bone marrow, nodal and extranodal lymphomas and histiocytic disorders. Comprehensive analysis using morphology, flow cytometry, immunohistochemistry, in situ hybridization, electron microscopy and molecular pathology according to the complexity of the cases allows timely diagnosis and treatment of patients by Lombardi clinicians.
Dr. Metin Ozdemirli, Professor, Department of Pathology, Director of Hematopathology; Program Director, Hematopathology Fellowship
Our Surgical Pathology department services all areas within Medstar Georgetown University Hospital including the Operating Rooms, Labor and Delivery, and Endoscopy. We provide integrated pathology services to offsite MedStar Health locations including Lafayette Centre and MedStar Brandywine. Our laboratory includes Pathologists’ Assistants (PA’s), PA students, and pathology residents who are trained to perform accurate and timely evaluation and processing of all pathological specimens. Our PA’s and residents perform a variety of responsibilities including gross examination, dissection, description, specimen radiography, specimen photography, intraoperative consultations including frozen sections, tissue banking, and triaging of specimens. The laboratory personnel will obtain patient clinical history, describe the gross presentation of the tissue, and prepare the tissue for processing for light microscopy evaluation. Tissue is obtained in collaboration with multiple departments for flow cytometry, electron microscopy, immunofluorescence, and research. MedStar Georgetown University Hospital prides itself on its commitment to academic research through its participation in the tissue processing for hundreds of research cases per year.
For imformation on submitting a case to the Department of Surgical Pathology, please contact the pathology customer service officer at (202) 784-3614.
The Neuropathology service is led by Dr. Brent Harris and offers full diagnostic laboratory services to support the MedStar Health network. Institutional and consult surgical pathology services are available for CNS/PNS tumors and other lesions including coordination for advanced molecular testing.
In addition, MedStar Georgetown University Hospital functions as a full muscle and nerve diagnostic laboratory. Muscle biopsy helps to identify unexplained muscle weakness, fatigue and elevated CPK, and distinguish between dystrophies, metabolic myopathies, inflammatory myopathies, and neurogenic myopathies. Nerve biopsies can assist with diagnosis of CIDP, vasculitis, amyloidosis, and other neuropathies. Muscle and nerve biopsy tissues can be sent to MedStar Georgetown using our easy-to-use kits that are sent to you free of cost. We accept all of MedStar Georgetown biopsies as well as consults from around the country.
Pathological interpretation including advanced histochemistry, nerve teasing, and electron microscopy
To request a muscle/nerve biopsy kit, contact the neuropathology lab at least 48 hours before the muscle biopsy is collected at (202) 687-4282. Biopsies are accepted Monday through Friday. Turnaround time is 7 to 10 days.
Additional neuropathology services such as CNS biopsy, autopsy consultations, and brain biobanking are available from the Georgetown Brain Bank. For more information about diagnostic services provided please contact the Department of Pathology at (202) 784-3614
The Molecular Diagnostics Laboratory (MDL) at MedStar Georgetown University Hospital is a comprehensive multidisciplinary division including the Immunohistochemistry (IHC), Flow Cytometry, Fluorescence In-Situ Hybridization (FISH), and Molecular operations.
The IHC section comprises a wide variety of markers used for the histogenetic diagnosis of morphologically non-differentiated neoplasias, subtyping neoplasias, and the characterization of primary site of malignant neoplasias. Offered in the IHC section as well are a set of predictive markers that contributes towards surgical and therapeutic conducts of some diseases.
The flow cytometry section is focused on Leukemia and Lymphoma Immunophenotyping using the 6-color FACS Canto platform. The distributed nature of the hematopoietic system makes it amenable to flow cytometric analysis. Many surface proteins and glycoproteins on erythrocytes, leukocytes, and platelets are tested with a variety of antibodies, in addition to antibodies against intracellular proteins such as myeloperoxidase and terminal deoxynucleotidyl transferase.
The FISH section plays an important role in detecting specific biomarkers in solid neoplasms such as ALK-1 gene rearrangement in Non-Small Cell Lung Cancer (NSCLC) and HER-2 for Breast Cancer.
The molecular operation is divided into four major sections:
The molecular hematopathology section offering assays for the diagnosis and prognosis of lymphoid and myeloid neoplasms by capillary electrophoresis, and monitoring Minimal Residual Diseases (MRD) by Real-Time Polymerase Chain Reaction (PCR).
The molecular oncology section offering assays for the detection of specific mutations in key genes in Lung Cancer, Colorectal Cancer, and Melanoma by Real-time PCR.
The molecular virology section offering a long list of assays to monitor the viral loads of several infectious diseases by Real-Time using a combination of FDA-approved and analytically validated Laboratory Developed Tests (LDTs).
The molecular genetics section offering molecular coagulation assays by Real-Time PCR.
To inquire about sending samples to our laboratory for testing please contact the Pathology Customer Service Office at (202) 784-3614.
MedStar Georgetown University Hospital Department of Pathology’s Histology Laboratory offers both routine H&E staining, Immunofluorescence for Renal and Dermatopathology, and special stains. We provide special staining for Cytology, Dermatopathology, Hematology, and slide preparation for molecular and ancillary services.
To inquire about sending slides to our facility for staining, please contact the department’s customer service office at (202) 784-3614.
The Electron Microscopy Laboratory of the Department of Pathology is a clinically based facility providing diagnostic support to pathologists and clinicians both here at MedStar Georgetown University Hospital as well as at other medical centers. Our principle focus is renal and neuro-pathology but our collective expertise ensures we are able to provide knowledgeable ultrastructural evaluation of a broad range of tissue types and their various pathologies.
In addition, electron microscopy personnel assist in the production of the director’s twice monthly intra and extra-mural renal conferences and take an active role in the education of pathology residents and nephrology fellows as part of their respective training programs.
Please contact the department’s customer service office for shipping information and specimen requests at (202) 784-3614.
The Cytopathology division of the Department of Pathology and Laboratory Medicine at MedStar Georgetown University Hospital evaluates specimens from various body sites for the detection of cancer, precancerous, organisms, and other benign conditions. The lab provides preparatory and diagnostic services for gynecologic (PAP) specimens and non gynecologic specimens consisting of fluids, smears, and fine-needle aspirations. The goals of the Cytology service include:
Maintaining excellence in specimen preparation and diagnostic accuracy.
Providing high quality intradepartmental and extra departmental consultative services for patients and colleagues.
Training Pathology residents, fellows, and medical students in diagnostic cytopathology
To incorporate advanced diagnostic and molecular techniques to improve diagnostic accuracy.
Providing on-site adequacy assessments in ultrasound, ENT and CT suites.
The Cytology laboratory process and screens about 5,000 specimens per year. Of these around 2,000 are GYN specimens with the remainder being non-GYN specimens. Pathologist performed fine-needle aspirations (FNAs) services are also provided at the referral of physicians. HPV co-testing is provided on gynecologic pap specimens along with Chlamydia (CT) and Gonorrhea (NG) testing on our Roche Cobas® 4800 system. The lab is fully accredited by The College of American Pathologists (CAP). Cytopathology staff, including Pathologists and cytotechnologists, is tested yearly by the American Society for Clinical Pathology GYN proficiency test (PT) to maintain high diagnostic accuracy in gynecologic examination.
MedStar Georgetown University Hospital Department of Pathology provides consultation and second opinion services to our existing patients. Our experienced team of nine pathologists performs consultations in the specialized areas of Cytopathology, Hematopathology, Renal Pathology, Transplant Pathology, Neuropathology, and Ophthalmic Pathology. Consultation and Second Opinion requests are handled by our Anatomic Pathology Customer Service Office. The customer service office provides patient and provider support and can answer questions relating to shipment and retrieval of slides and blocks, pathology reports, pending cases, testing, and general pathology inquires.
In order to have your slides reviewed by our physicians, please contact your Medstar Georgetown Clinician’s office to arrange for your slides to be sent to our facility.
In order to have your slides sent out to another institution, please complete the Medical Release Consent Form and fax to (202) 687-8935 or call (202) 784-3614.
Breast Cancer Patient Chooses Proton Therapy for Precision, Protection
After a routine mammogram detected a lump in her right breast in 2009, Debbie Koss of Rockville, Md., considered herself lucky. The tumor was small and in its very early stages, treatable through a lumpectomy and radiation therapy alone.
Nevertheless, Debbie sought out her own specialist for follow-up and discovered medical oncologist Claudine Isaacs, MD, co-director of the Breast Cancer Program at MedStar Georgetown University Hospital. She saw her faithfully for an annual checkup and always got a clean bill of health.
So, in 2016—a full six years after her original cancer treatment ended— Debbie was shocked to learn that she had a new breast cancer in her lymph nodes, this time on the left side, close to her heart.
Eleni Tousimis, MD, chief of Breast Surgery, removed Debbie’s cancerous nodes and some surrounding healthy ones, as well. As part of Debbie’s treatment plan, she then underwent chemotherapy with Dr. Isaacs and radiation therapy with Sonali Rudra, MD, director of the Breast Cancer Radiation Oncology Program.
That was when Debbie first learned about proton therapy, a more advanced cancer-fighting radiation treatment than what she had undergone previously.
“My brother-in-law suggested I look into it,” she says. “And I was impressed by what I read about proton therapy’s precision and heightened ability to avoid surrounding healthy tissue. So, I asked Dr. Rudra point-blank: ‘If I were your mother, what would you recommend?’”
Dr. Rudra’s response sealed the deal.
“Patients like Debbie, with left-sided breast cancer and lymph node involvement, are among the breast cancer patients most likely to benefit from proton therapy,” she explains. “Debbie’s cancer was close to her heart, so traditional radiation therapy could have put her at higher risk of developing secondary heart or lung disease in the future. In her case, those odds were even higher since she had undergone radiation before.”
Convinced proton therapy was the right choice for her, Debbie asked Dr. Rudra to make the necessary arrangements. Soothed by the sounds of Frank Sinatra, Debbie sailed through every proton therapy session.
“Each treatment only lasted a few minutes,” says Debbie, now cancer-free. “And throughout it all, I was able to continue going to the gym and attend my spin classes. I have no doubts about my decision to go with proton therapy. I’ve recovered well.”
The Transfusion Service, formerly known as the Blood Bank, provides Red Blood Cells, Plasma, Apheresis Platelets, Cryoprecipitated AHF and other blood products to support medical care, including surgeries, bone marrow and solid organ transplants. The hospital’s computerized blood order entry (CPOE) program supports blood orders in compliance with national guidelines for Patient-Centered Blood Management. A daily Blood Utilization Review including all transfusions of Red Blood Cells and Apheresis Platelets is conducted by a specialist in Transfusion Medicine. The Transfusion Service is partnered with the American Red Cross, supporting Red Cross blood drives at the Georgetown University School of Medicine and at the Medical Center for MGUH staff. All blood components issued by the Transfusion Service are collected by the Red Cross from volunteer donors. In 2017, the Transfusion Service issued approximately 10,000 units Red Blood Cells, 4,500 units of Plasma, 1,100 units of Cryoprecipitate and 2,200 units of Apheresis Platelets.
The Transfusion Service provides immunohematology laboratory services 24/7/365. Blood typing and screening for blood group antibodies is performed using two ultra-sensitive, state-of-the-art automated solid phase immunohematologic analyzers. For patients requiring transfusions of red blood cells, but who have allergies to plasma, the Transfusion Service removes plasma by saline washing using automated cell washing centrifuges. For patients with a requirement for red blood cells of a rare type, typically for multi-transfused patients with sickle cell disease, the Transfusion Service maintains an inventory of red blood cells of rare types frozen at -80C. This inventory of frozen red cells is selected to match the requirements of patients who require lifelong transfusions of red cells of rare types. The frozen red cells, which are viable for more than 10 years, are obtained prospectively from the American Rare Donor File. The Transfusion Service provides in-hospital laboratory services for antibody identification, immunohematologic studies for the diagnosis of autoimmune hemolytic anemia and antibody titers for women whose pregnancy is at risk for hemolytic disease of the fetus/newborn. The laboratory performs serologic titers of anti-A1 and anti-A2 (Asub) for kidney transplant patients, increasing the number of cadaver kidneys available for transplantation. The Transfusion Service partners with the American Red Cross Reference Laboratory, Baltimore, MD, for provision of specialized immunohematologic testing, and with the National Molecular Laboratory, Philadelphia, for molecular diagnostics. Representatives from the Transfusion Service participate in the MedStar Work Group on Transfusion Services, supporting MedStar’s efforts to standardize laboratory services. In 2017, the Transfusion Service performed 29,000 ABO/Rh typings, 20,000 antibody screens and 20,000 crossmatches.
The Transfusion Service supports the training of Pathology residents and medical students in the subspecialty of Transfusion Medicine. During the prior 5 years, the Transfusion Service has supported scientific journal publications in medical journals on the subjects of non-hemolytic passenger lymphocyte syndrome, the DEL phenotype, serologic weak D phenotype, Rh immunoprophylaxis, and blood group genotyping.
The Transfusion Service is registered with the US Food and Drug Administration and accredited by the AABB (formerly, American Association of Blood Banks) and the College of American Pathologists. Oversight of regulatory and accreditation requirements is provided by the Blood Utilization Review Committee composed of representatives from Anesthesia, Surgery, Transplantation, Medicine, Pediatrics, Obstetrics, Nursing, Pharmacy and Administration.
The Transfusion Service maintains a consultation service for physicians. Patients with autoimmune hemolytic anemia, refractoriness to platelet transfusions, difficulty locating rare blood, pregnancy complicated by blood group antibodies or a history of transfusion reactions may request a consultation with a Transfusion Medicine specialist who will join their physician for consultation.