About

The Division of Urologic Pathology at Johns Hopkins is committed to diagnosing and curing diseases affecting the urinary tract and male genitourinary system. Faculty members in the Division are world leaders in the diagnosis of kidney tumors and diseases of the bladder, prostate, testis, penis, and scrotum with the largest consult service in the world composed of cases sent in by patients, clinicians, and pathologists. Clinically related research in the Division has made major contributions to the field’s diagnosis, classification, prognostication, and grading of urological tumors, while also contributing to knowledge affecting their clinical management.

Investigators have deep expertise in tissue-based biomarker studies and biobanking in genitourinary cancer. They have uncovered novel molecular mechanisms regarding the pathogenesis of prostate cancer initiation and progression. Related and ongoing areas of study include the roles of inflammation, infection, telomeres and telomere biology, MYC as an oncogenic cancer driver, PTEN as a tumor suppressor, and DNA repair alterations as prognostic and predictive biomarkers. Other areas of expertise include studies of infectious agents involving the prostate and the role of the microbiome in prostate cancer development, progression and response to treatment. Studies also investigate the role of racial ancestry in prostate tumor molecular classification and racial disparities in prostate cancer outcomes. Studies also involve the elucidation of the molecular mechanisms of kidney and bladder cancer pathogenesis.

Why would you request an expert opinion consult in Urologic Pathology?

The Urologic Pathology Division offers expert opinion on pathology specimens from kidney, ureters, bladder, prostate, adrenal, testis, penis, and scrotum. We have a large consultation service and cumulatively, our faculty have decades of experience diagnosing common and uncommon diseases. 

All cases are managed with a team approach involving pathologists who are expert in the morphologic and molecular biology of the full spectrum of urologic diseases including diagnosis and grading prostate cancer, and the classification of renal, bladder, testicular and penile tumors. We also have expertise in non-neoplastic conditions mimicking cancer, where the correct diagnosis could avoid unnecessary harm to the patients. Our leading experts perform cutting-edge research in urologic pathology, have published extensively in the field, and have lectured nationally and internationally. Most importantly, all urologic pathology consults are handled in the context of our wider department with experts in all disciplines and we regularly consult our colleagues when it is necessary to add the expertise of other subspecialties including dermatopathologists, gynecologic pathologists, bone and soft tissue pathologists, gastrointestinal and liver pathologists, hematopathologists and molecular pathologists. 

Our department has a robust menu of ancillary molecular tests, including over 300 immunohistochemistry markers, next generation sequencing, a comprehensive gene fusion panel that aid in the diagnosis of rare diseases and tumors. Our cancer cytogenetics laboratory routinely performs testing critical to the diagnosis of urologic diseases/tumors including isochromosome 12p, TFE3 and TFEB fluorescence in-situ hybridization. All challenging cases are discussed in our daily consensus conference joined by all faculty in the division, to ensure the most accurate diagnoses are rendered. Finally, we are happy to consult with clinicians, pathologists and patients by phone where appropriate. We look forward to reviewing your case. 

New Contemporary Prostate Cancer Grading System

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