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Team Effort Among Yale Pathologists, Smilow Oncologists Leads to Rapid Diagnosis and Treatment

April 13, 2022

A young patient arrived at Smilow Cancer Hospital on a recent Friday evening with a large mediastinal mass and various resulting complications. The family is beyond distressed. Within 24 hours of arriving at Smilow, the patient was able to begin treatment, following counsel with the family, thanks in part to the urgent work of the Hematopathology Service at Yale Pathology, which obtained and interpreted a small core biopsy within two hours' notice.

At the foundation of this dedication to the patient and family is a concerted team effort of many at Smilow Cancer Hospital, including pathologists, oncologists, and other staff—even the courier who transported the slides to Yale Pathology.

“There are many times like this when we pull together and provide heroic service for our patients,” said Kevin Billingsley, MD, MBA, FACS, Chief Medical Officer of Smilow Cancer Hospital and Yale Cancer Center and Professor of Surgery (Oncology). “It’s what makes Yale Cancer Center and Smilow very special.”

The team worked with speed and precision. Mina Xu, MD, Director of Hematopathology, said that as soon as oncology contacted her about the biopsy, which was at Bridgeport Hospital, she notified Clinical Case Management Liaison Nicole DeJesus and William Laskin, MD, Associate Professor of Pathology.

Dr. Laskin had received the slides at Bridgeport and ordered initial stains, which were pending. Nicole helped to coordinate the shipment of slides with courier Nick Hanania, who waited for the slides to be packed, and then made a speedy delivery to the Yale New Haven Medical Campus.

Dr. Xu saw that the morphology on a small core needle biopsy, along with clinical presentation, was compatible with a particular WHO-subclassified lymphoma diagnosis. She immediately called the hematology/oncology team—Amer Zeidan, MBBS, Francine Foss, MD, and Clinical Fellow Kristina Fanucci, MD—with the findings. Together, they developed a treatment plan and communicated with the patient’s family. Dr. Xu later contacted Dr. Laskin and received the results of one of the stains, which confirmed her diagnosis.

“I looked at the slide. I had no special equipment other than microscope and eyes,” Dr. Xu said. “We didn't have the time to do special stains and other testing. But later studies confirmed my diagnosis.”

The treating physicians were so impressed with this expedient workup of a rapidly progressive cancer that they shared their appreciation with Smilow Cancer Hospital and Yale Cancer Center leadership.

Dr. Xu said the opportunity for Yale Pathology to help others, as they did here, is what motivates her and her colleagues each day.

“This is what we went into medicine for. I feel so fortunate to work with this group of colleagues and staff in Pathology.” Dr. Xu said. “Our team-oriented, patient-focused approach makes this an outstanding practice. My colleagues in hematology/oncology, led by Dr. Stephanie Halene (Chief of Hematology), are inspirational to work with because they are fierce advocates for our patients and communicate with our team so well, and excellent communication is more than half the battle.”

Submitted by Terence P. Corcoran on April 13, 2022