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Division of Cytopathology

Email sali@jhmi.edu
Phone (410) 955-1180

Related Websites
Hopkins Cytopathology

Cytopathology Tutorials

Syed Z. Ali, M.D., FRCPath, FIAC

Director, Division of Cytopathology;
Primary Appointment in Pathology;
Secondary Appointment in Radiology

Fine needle aspiration (FNA) has a widely recognized and established role as the initial diagnostic modality in most neoplastic and inflammatory disorders of the viscera and soft tissues. My major interest is focused on clinico-morphologic studies primarily based on FNA of thyroid and pancreas with integration of clinico-radiologic data and ancillary techniques such as immuno-cytochemistry and molecular studies. These latter techniques not only augment our morphologic diagnoses in difficult cases, but often also provide important prognostic information for better clinical management.

Digital photo imaging and telepathology is rapidly emerging as a major tool, not only in education and research, but also in diagnostic pathology. By utilizing state-of-the-art imaging equipment, I am involved in several on-going projects in this exciting new field ranging from web-based tutorials to sophisticated virtual photomicroscopy.


Collins J, Rossi ED, Chandra A, Ali SZ. Terminology and nomenclature schemes for reporting thyroid cytopathology: An overview. Semin Diagn Pathol. 2014 Dec 19. pii: S0740-2570(14)00114-2. doi: 10.1053/j.semdp.2014.12.007. [Epub ahead of print]

Toll AD, Rossi ED, Ali Z. Role of ancillary testing in thyroid fine needle aspiration: Review and update. Journal of the American Society of Cytopathology (JASC). 2014;3(4), 218-224.

Olson MT, Ali SZ. Cytotechnologist On-Site Evaluation of Pancreas Fine Needle Aspiration Adequacy: Comparison with Cytopathologists and Correlation with the Final Interpretation. Acta Cytol. 2012 Jul 25;56(4):340-346. [Epub ahead of print]

Cibas ES, Ali SZ; NCI Thyroid FNA State of the Science Conference. The Bethesda System For Reporting Thyroid Cytopathology. Am J Clin Pathol. 2009 Nov;132(5):658-65. Review. PubMed PMID: 19846805.

Holmes BJ, Hruban RH, Wolfgang CL, Ali SZ. Fine needle aspirate of autoimmune pancreatitis (lymphoplasmacytic sclerosing pancreatitis): cytomorphologic characteristics and clinical correlates. Acta Cytol. 2012;56(3):228-32. Epub 2012 Apr 26.

Email qli23@jhmi.edu
Phone (410) 550-0669
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Qing K Li, M.D., Ph.D.

Primary Appointment in Pathology

My main research interest is to apply the advanced technology of cellular and molecular biology to the field of cytopathology, particularly in the area of early detection of lung cancers. Currently, my research is focused on: (1) detection of circulating tumor cells in non-small cell lung cancer patients; (2) identifying what molecular markers and intracellular signal transduction pathways are involved, (3) and discovering novel molecular biomarkers with early diagnostic and prognostic significance.

Identification and utilization of these molecular markers not only augment our morphologic diagnoses in difficult cases, but also provide important pathogenetic and prognostic information of lung cancers.


Li Q, Subbulakshmi V, Oldfield C, Aamir R, Weyman CM, Wolfman A and Cathcart MK. Protein kinase C alpha regulates phosphorylation and enzymatic activity of cytosolic phospholipase A2 in vitro and in activated human monocytes. Cell Signal 2006. In press.

Li Q, Bavikatty N, and Michael CW. The role of Immunohistochemistry in the distinguishing squamous cell carcinoma from mesothelioma and adenocarcinoma in pleural effusion. Seminars of Diagnostic Pathol. 2006; 23:15.

Li Q, Murphy M, Ross JS, Sheehan C and Carlson JA. Skp2 and p27 kip1 expression in melanocytic nevi and melanoma: an inverse relationship. J. Cutan. Pathol. 2004; 31:633.

Email zmaleki1@jhmi.edu
Phone (410) 550-5220
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Zahra Maleki, M.D.

Primary Appointment in Pathology


Email molson8@jhmi.edu
Phone (410) 955-1180
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Matthew T. Olson, M.D.

Primary Appointment in Pathology

In broad terms, my research interests center on ancillary testing in cytopathology samples to achieve actionable clinical results more frequently. To that end, I am currently working on multiple levels including development, implementation, usefulness evaluation, practical issues, and clinical outcomes. My main strengths lie in computer programming, database management, data-mining, and analytical chemical techniques involving mass spectrometry. Subcategories of my research include test development of desorption electrospray ionization mass spectrometry (DESI-MS) on cytological preparations; bioinformatics approaches that benefit molecular testing in cytological samples; and adequacy assessment, metrics, and assurance for ancillary testing in cytological samples, including the role of cytotechnologists, telecytology, and on-site evaluation of adequacy for this important step of the diagnostic process.

For an up-to-date listing of my publications, please visit my google scholar profile: http://scholar.google.com/citations?user=D7FCUu4AAAAJ

Email erodri17@jhmi.edu
Phone (410) 955-1180
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Erika F. Rodriguez, M.D., Ph.D.



Email drosenthal@jhmi.edu
Phone (410) 550-4841

Related Websites
Division of Cytopathology

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Dorothy L. Rosenthal, M.D.

Primary Appointment in Pathology; Secondary Appointments in Oncology and Gynecology-Obstetrics

As a clinically-oriented cytopathologist, my research efforts are directed at answering diagnostic questions which are difficult or impossible when relying solely on morphologic features. Cervico-vaginal specimens (Pap smears) are perhaps the most challenging samples facing the cytologist. I have devoted much of my career to seeking ways to augment light microscopic diagnoses via computers. Neural networks combined with traditional image processing techniques have shown promise for automated scanning of slides. The ability of such systems to detect rare abnormal cells for human verification is currently being validated, but they promise to reduce the error rate of Pap Test interpretation. Our cytologists continue to be involved in the development of these devices.

Identification of molecular markers to diagnose high grade pre-malignant lesions (HSIL) of the uterine cervix is an exciting collaborative effort with members of our division and with TriPath Oncology, a subsidiary of TriPath Imaging. Not only will the markers enable location of rare HSIL cells on Pap tests, but they may be able to predict those women who are destined for cervical cancer without intervention. The intended goal is to accurately diagnose and avoid over treatment.


Rosenthal DL: Automation and the Endangered Future of the Pap Test (invited Commentary), JNCI 90:738-749, 1998.

ASCUS/LSIL Triage Study (ALTS)Group. Rosenthal DL, member of Pathology QC Group. Comparison of Three Management Strategies for Patients with Atypical Squamous Cells of Undetermined Significance: Baseline Results from a Randomized Trial. JNCI 93(4):293-299, 2001.

ASCUS/LSIL Triage Study (ALTS) Group. Rosenthal DL, member of Pathology QC Group. HPV DNA remains detectable longer than related cervical cytologic abnormalities. J Infect Dis 2002;186:1169-72.

Levi AW, Kelly DP, Rosenthal DL, Ronnett BM. Atypical Squamous Cells of Undetermined Significance (ASC-US) in Liquid-Based Cytologic Specimens: Results of Reflex HPV Testing and Histologic Follow-up in Routine Practice with Comparison of Interpretive and Probablistic Reporting Methods. Cancer Cytopath 2003;99:191-7.

Trimble CL, Richards LA, Wilgus-Weigweiser B, Plowden K, Rosenthal DL, Klassen A. Effectiveness of Screening for Cervical Cancer in an Inpatient Hospital Setting. Obstet Gynecol. 2004;103:310-16.

Email cjvand@jhmi.edu
Phone (410) 955-1180
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Christopher VandenBussche, M.D., Ph.D.

Assistant Professor of Pathology;
Associate Director of Cytopathology

The Paris System for Reporting Urinary Cytology, based in part on our own Johns Hopkins Hospital Template, has generated new enthusiasm for improving the quality of urinary cytopathology. Because bladder cancer survivors often require life-long monitoring due to a high recurrence rate, bladder cancer is one of the most expensive cancers to our health care system and causes a lifelong inconvenience to those it affects. In addition to clinical research in this area, I am working on several genetic, molecular, and immunological ancillary assays to improve our diagnostic ability.

I am also interested in the impact of recent policy changes and scientific advancements on both the practice of gynecologic cytopathology and the clinical and biological behavior of human papillomavirus (HPV). Because it is difficult to predict the long-term effects of guideline changes and HPV vaccination, there is a new need for well-designed multidisciplinary studies to ensure the best care for our patients. Will the HPV vaccine alone be sufficient to defeat cervical cancer? If not, then what must be done?

VandenBussche Research Group

My research focuses on translational research that combines traditional cytomorphology with novel molecular and immunological techniques in order to enhance the diagnostic and clinical value of cytologic specimens. Some examples of our current projects include:

1. Telomerase Immunocytochemistry
Using antibody technology developed by Sienna Cancer Diagnostics, we are currently investigating the expression of telomerase in cytopathology specimens using immunocytochemistry. Preliminary results have demonstrated excellent staining in urinary tract specimens containing high grade urothelial carcinoma (HGUC) while maintaining specificity, as shown by the absence of staining in benign samples (Figure 1). These promising results are currently being evaluated for clinical utility in resolving atypical urinary tract specimens, and detection of low grade disease in morphologically normal specimens.

2. Urinary Cytokine Assays
In collaboration with the Johns Hopkins Cytokine Laboratory directed by Dr. Barbara Detrick, we have identified a panel of cytokines that can be measured in urine supernatants and correlated with cytology specimen results. Preliminary results have shown correlation of particular cytokines with the presence of urothelial carcinoma. In addition, our work is helping define normal levels of cytokines in human urine, standardize methods for these assays, and reveal the biology of the immune response in the urinary tract.

3. Human Papillomavirus (HPV) Data Resource
The HPV Data Resource represents a collaborative resource shared between gynecologic oncologists, pathologists, colposcopists, biostatisticians, and public health researchers in the Johns Hopkins Hospital, Johns Hopkins University School of Medicine, and the Johns Hopkins Bloomberg School of Public Health. The primary goal of this resource is to coordinate databases and data management efforts to avoid overlap and promote data sharing for more powerful research on HPV.


VandenBussche CJ, Rosenthal DL, Olson MT. Adequacy in voided urine cytology specimens: the role of volume and a repeat void upon predictive values for high grade urothelial carcinoma. Cancer Cytopathol. In press.

Nguyen DN, Kawamoto S, Cimino-Mathews A, Illei PB, VandenBussche CJ. Metastatic metaplastic breast carcinoma mimicking pulmonary squamous cell carcinoma on fine-needle aspiration. Diagn Cytopathol. In press. PMID: 26238413

VandenBussche CJ, Cimino-Mathews A, Park BH MD, Emens LA, Tsangaris TN, Argani P. Reflex ER/PR/Her2 analysis of breast cancers in needle core biopsy specimens dramatically increases health care costs. Am J Surg Path 2015; 39(7):939-47. PMID: 25871620

Michailidi C, Hayashi M, Datta S, Sen T, Zenner K, Oladeru O, Brait M, Izumchenko E, Baras A, VandenBussche C, Argos M, Bivalacqua TJ, Ahsan H, Hahn NM, Netto GJ, Sidransky D, Hoque MO. Involvement of epigenetics and EMT related miRNA in arsenic induced neoplastic transformation and their potential clinical use. Cancer Prev Res 2015;8(3):208-21. PMID: 25586904

Onur I, Rosenthal DL, VandenBussche CJ. Atypical urothelial tissue fragments in noninstrumented voided urine specimens are associated with low but significantly higher rates of urothelial neoplasia than benign-appearing urothelial tissue fragments. Cancer Cytopathol 2015;123(3):186-192. PMID: 25586692

Onur I, Rosenthal DL, VandenBussche CJ. Benign-appearing urothelial tissue fragments in noninstrumented voided urine specimens are associated with low rates of urothelial neoplasia. Cancer Cytopathol 2015;123(3):180-185. PMID: 25586552

VandenBussche CJ, Illei PB, Lin M, Ettinger DS, Maleki Z. Molecular alterations in non-small cell carcinomas of the young. Hum Pathol 2014;45(12):2379-87. PMID: 25288236

Gurda GT*, VandenBussche CJ*, Yonescu R, Gonzalez-Roibon N, Ellis CL, Batista DA, Netto GJ. Saccrococcygeal teratomas: clinico-pathological characteristics and isochromosome 12p status. Mod Pathol 2014; 27:562-8. PMID: 24051698. * authors contributed equally

VandenBussche CJ, Elwood H, Cimino-Mathews A, Illei PB, Warzecha HN. Clinicopathologic features of ductal carcinoma in situ in young women with an emphasis on molecular subtype. Hum Pathol 2013; 44(11):2487-93. PMID: 24029706.

VandenBussche CJ, Khouri N, Sbaity E, Tsangaris TN, Vang R, Tatsas A, Cimino-Mathews A, Argani P. Borderline atypical ductal hyperplasia/low grade ductal carcinoma in situ on breast needle core biopsy should be managed conservatively. Am J Surg Pathol. 2013; 37(6):913-23. PMID: 23598968.

VandenBussche CJ, Sathiyamoorthy S, Owens CL, Burroughs FH, Rosenthal DL, Guan H. The Johns Hopkins Hospital template for urologic cytology samples: Parts II and III-Improving the predictability of indeterminate results in urinary cytology samples: an outcomes and cytomorphologic study. Cancer Cytopathol 2012; 121(1):21-8. PMID: 23192913.


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