Anatomic Pathology

Bone and soft tissue pathology encompasses a wide variety of neoplastic and non-neoplastic diseases. Malignant bone and soft tissue tumors (sarcomas) are a large family comprising more than 50 subtypes. Due to their rarity and diversity, sarcomas remain challenging to diagnose and manage, and they require a multidisciplinary collaborative approach between radiology, pathology, surgical oncology, radiation oncology, and medical oncology. Our highly recognized bone and soft tissue pathology specialist collaborates with sarcoma pathologists and oncologists around the nation and the world to study these rare tumors.

We provide comprehensive consultative anatomical pathology services related to diseases of the tubular gastrointestinal tract and pancreas. Our faculty of expert pathologists evaluates approximately 30,000 specimens annually, ranging from biopsies to complex surgical resections, and is widely sought for second opinion consultations. The faculty is involved in medical education at all levels and members lecture around the world. We maintain productive research programs in gastrointestinal disorders such as colorectal cancer and inflammatory bowel disease that are funded by the NIH, the International Organization for the Study of Inflammatory Bowel Disease, and philanthropic sources. We also offer a Gastrointestinal Pathology fellowship that has been preparing trainees for careers in gastrointestinal pathology for more than 20 years.

We are responsible for assessing obstetrical and gynecologic specimens for rendering the final pathologic diagnosis. Each year, our 13,000 cases include consultations, biopsies, and larger surgical specimens ranging from ovarian cystectomies and hysterectomies for benign disorders to cancer staging procedures. Teaching sign-outs are the norm with house staff, fellows, and students in attendance. We closely coordinate with members of the Department of Obstetrics, Gynecology, and Reproductive Science in Tumor Board conferences and research. We also offer an ACGME-approved Gynecologic Pathology fellowship that provides in depth training and enables trainees to practice as a specialist. 

Our Division offers expertise in all aspects of pathology related to ear, nose and throat, thyroid, parathyroid, and maxillofacial pathology. The Division of Otolaryngology/Head and Neck Surgery at the Mount Sinai Health System is ranked among the top 25 nationally, resulting in a wealth of clinical material and more than 2,500 specimens, annually. Our academic pathologists are actively engaged in collaborative, multidisciplinary research with our clinical colleagues and include world-recognized leaders in the field of head and neck and thyroid pathology. Particular areas of ENT clinical and pathological expertise include HPV-associated oropharyngeal squamous cell carcinomas, salivary gland tumors, and thyroid tumors. We also offer an ENT/Endocrine Pathology fellowship that provides an unparalleled opportunity to interact with leading head and neck surgeons and oncologists in clinical care and research.

This subdivision of Molecular Pathology bridges Anatomic and Clinical Pathology and provides Clinical Diagnostic, Education, and Research services. Clinical Diagnostic Services include expert, state-of-the art, contemporary, World Health Organization (WHO) diagnoses and consultation of benign and neoplastic hematopoietic processes in the adult and pediatric populations on a wide range of specimen types (Bone Marrow, Nodal, Extranodal tissues, FNAs, and Fluids including Peripheral Blood) in a broad range of clinical settings. Our Diagnostic services include data integration and reporting of clinical laboratory, morphologic, phenotypic (immunohistochemistry, flow cytometry, mass spectrometry), cytogenomic (karyotype, FISH, CGH array), and molecular diagnostics (standard B, T cell gene rearrangements, mutation, GEP, and next generation sequencing) in the context of clinical imaging.

Education activities include teaching medical students, residents, and fellows, enrolled in the ACGME-accredited Hematopathology Fellowship as well as other Programs pertaining to hematopoiesis and oncology in weekly multidisciplinary meetings. Research activities span basic science (in vitro stem cell, murine models), translational (precision medicine biomarkers in CLIA settings), providing colleagues with accurate diagnoses for regional, national and international clinical trials for patients with hematologic malignancies (leukemia, lymphoma, myeloproliferative/myelodysplastic stem cell neoplasms, myeloma, and transplantation).

Our division handles approximately 2,000 specimens a year including 1,600 liver biopsies and 400 liver resections. Of the resections, 100 to 120 are explanted liver specimens from liver transplantation surgeries for acute liver failure and end stage chronic liver disease, while the remainders are predominantly for malignant and benign tumors. Liver biopsies cover a large range of liver diseases including diagnosis of acute and chronic liver diseases, grading and staging of known chronic liver diseases, and evaluation of liver allografts following liver transplantation. We also provide a consult service for review of cases from outside the Mount Sinai Health System. The division is actively involved in teaching of pathology residents and medical students, including hosting one of the nation’s best recognized Liver Pathology Fellowship Programs. We work closely with the Division of Liver Diseases of the Department of Medicine, the Recanati-Miller Transplantation Institute, and the Division of Hepatobiliary Surgery of the Department of Surgery, and the Mount Sinai Liver Cancer Program in clinical and research pursuits.

We provide a comprehensive in-house and consultative neuropathology service related to primary and secondary central nervous system (CNS), nerve, and skeletal muscle diseases. Our division offers a broad array of specialized histochemical and molecular studies and both correlation and collaboration with neuroradiology, neurosurgery, and neuro-oncology. Our faculty of expert Neuropathologists evaluates approximately 1,500 neurosurgical specimens annually including adult and pediatric benign and malignant primary CNS tumors, metastatic tumors, epilepsy-related lesions, developmental abnormalities, and both nerve and skeletal muscle disorders. Our faculty provides comprehensive evaluation of approximately 200 autopsy brains annually, including a broad array degenerative and developmental abnormalities. We maintain productive research programs in CNS degenerative disorders, neurodevelopment, glioma stem cell biology, and neuroepigenetics. We offer a Neuropathology fellowship that has been preparing trainees for careers in Neuropathology for more than 18 years.

Our Division has been in operation since 1920. The laboratory accessions nearly 2,000 surgical specimens and about 20 pairs of autopsy eyes per year. The surgical specimens which are examined include globes, eyelids, orbits, vitrectomies and vitreous body biopsies, exfoliative cytology of the cornea and conjunctiva, and temporal artery biopsies. The New York Eye and Ear Infirmary of Mount Sinai is one of the world’s leading centers for diseases of the eyes and ears.

We evaluate disorders that affect the perinatal and pediatric organ systems in the midst of dramatic growth and maturation, which give rise to a variety of abnormalities typically not encountered in adult population. This includes pediatric tumors, developmental anomalies, genetic diseases, and placental abnormalities. Gastrointestinal biopsies are one of the major type of specimens we handle. Inflammatory bowel disease, eosinophilic esophagitis, celiac disease, infections, and transplant pathology are among the common conditions that we encounter. We also perform pediatric and fetal autopsies. This helps the family and the clinical team to understand the disease and helps family members who may experience the similar disease process to take preventive action.

Our renal pathologists evaluate the findings of tissue submitted by nephrologists, and transplant surgeons from light microscopy, electron microscopy, and immunofluorescence to obtain a definitive diagnosis. Medical renal diseases may affect the glomerulus, the tubules and interstitium, the vessels, or a combination of these compartments.

Our Division has a full range of diagnostic services for adults and children with kidney disease, including light microscopy, immunofluorescence, immunohistochemistry, and electron microscopy. Our clinical laboratory offers numerous tests that may be useful in establishing a diagnosis and following the course of the patient’s disease during and after therapeutic intervention. We also offer a novel combined Renal/Genitourinary Pathology Fellowship that allows fellows to develop superb diagnostic skills and provides ample teaching and research opportunities.

Thoracic pathology has a strong tradition at Mount Sinai, where Drs. Jacob Churg and Lotte Strauss collaborated to improve our understanding of interstitial lung disease. The division continues to make contributions to our understanding of diseases of the lungs through multi-center intradisciplinary research.  

We provide the highest level of diagnostic services and work closely with Molecular Pathology to provide evaluation of tumors on a genetic level to optimize patient care using mutation specific therapy when appropriate. We also collaborate with our lung cancer screening program, the International Early Lung Cancer Action Program, and the Initiative for Early Lung Cancer Research on Treatment. Mount Sinai is also a leader in the area of mesothelioma, a rare tumor occurring in the tissue covering the lung and lining the chest wall.

Diseases of the lung are not limited to malignancies, and many benign diseases of the lung can have a prognosis that is equally poor or potentially worse than a carcinoma. The Mount Sinai-National Jewish Health Respiratory Institute focuses on this group of disorders. Our primary focus is diseases causing interstitial fibrosis, be they of unknown origin or secondary to underlying systemic disease such as rheumatoid arthritis or other connective tissue disorders. Through our multidisciplinary translational and basic science research efforts, we aim to move the field forward in our understanding of the development and cure of these diseases.