Yale Gynecologic Pathology

Gynecologic Pathology

gyn micrograph

The Yale Gynecological Pathology Program at Yale Medicine engages in clinical service, translational research, and teaching. The program emphasizes diagnostic tissue evaluation, oncological biomarker identification and clinical applications, and understanding the pathogenesis of various gynecological cancers. The core faculty members have particular clinical expertise in the diagnostic workup of gestational trophoblastic disease. 

Gynecologic Pathology Service

The Gynecological Pathology Service provides diagnostic tissue evaluation for various lesions of female reproductive organs, including ovary, fallopian tube, uterus, cervix, vagina and vulva. Faculty members also assess various biomarkers for diagnosis, prognosis and therapeutic guidance for patients with gynecological cancers.
Services and Expertise
The Gynecologic Pathology Diagnostic Service is a fundamental component in the prevention, diagnosis and treatment of diseases of the female genital organs at Yale-New Haven Hospital and Smilow Cancer Hospital. Our pathologists are subspecialty-trained and highly experienced, with a passion for patient care.  Our Service encounters a high volume of complex, neoplastic gynecologic surgical specimens from the Yale Gynecologic Oncology Service and biopsy specimens from many outpatient clinics in the greater New Haven area. Beyond routine tissue diagnosis, team members actively participate in the real-time decision-making processes for patient management, including daily intraoperative consultation, weekly Gynecologic Tumor Conferences, and many on-going cancer clinical trial programs. Currently, team members function as the center pathologists in the study design and patient selection for the clinical trial programs, several of which are multi-institutional efforts led by the Yale Gynecologic Oncology Service in the search for alternative therapies for gynecological cancers. In the era of precision medicine, team members provide timely and informative genomic analysis of various gynecological cancers for prognostic and therapeutic guidance for target genomic medicine and immunotherapy. 
Expertise
For consultation diagnostic services, we provide diagnostic expertise for pathologists throughout the United States and abroad who submit cases for second opinion.  The Gynecologic Pathology Service also reviews a large number of specimens from patients who are referred to Yale for further treatment options. As a leading institution, we have a national and international reputation as experts in the diagnosis of gestational trophoblastic diseases (complete and partial hydatidiform moles, gestational trophoblastic tumors) and endometrial cancer. We are among the few institutions to offer molecular genotyping as part of our routine diagnostic algorithm for molar pregnancies.

Expert Consultation Service Program – Gestational Trophoblastic Disease

Lead expert consultants: Drs. Pei Hui and Natalia Buza

            (Weblink/pdf link)

Yale Pathology Gynecological Service

Director

Bio Profile

Pei Hui, PhD, MD

Director

Professor of Pathology and of Obstetrics, Gynecology and Reproductive Sciences

Director, Gynecologic Pathology

Clinical Director, Molecular Diagnostics Laboratories

Director, Gynecologic Pathology Fellowship Program.

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Pathologists

Bio Profile

Natalia Buza, MD

Associate Professor of Pathology

Associate Director of Gynecologic Pathology

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Bio Profile

Peter A Humphrey, MD, PhD

Professor of Pathology

Director, Genitourinary Pathology

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Bio Profile

Olivia Lyn Snir, MD

Instructor

Chief Resident 2016 - 2017

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Bio Profile

Serena Wong, MD

Assistant Professor of Pathology

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Our team has a broad academic interest in the pathogenesis, diagnosis, and prognostic and therapeutic markers of neoplastic and pre-neoplastic lesions of gynecological organs — ovary, uterus, cervix, vulva and vagina. With available state-of-the-art molecular and genetic technology, we are currently undertaking focused investigations of the disease entities including gestational trophoblastic disease, endometrial cancers, uterine smooth muscle neoplasms and cervical glandular lesions. These research endeavors involve highly committed faculty and enthusiastic pathology trainees. A major effort in the gestational trophoblastic disease research program is to improve diagnostic accuracy by incorporating ancillary techniques, including DNA genotyping and immunohistochemistry. Studies of major endometrial cancers are aimed at identifying early precursor lesions and predictive biomarkers for cancer detection, prognosis, and therapeutic guidance. Many of the projects are designed and tailored to the long-term academic career development of individual faculty members and trainees. Many translational research projects involve close collaboration with the Yale Gynecologic Oncology group.
Publications (selected recent)

• Buza N, Hui P: Immunohistochemistry in Gynecologic Pathology: An Example-Based Practical Update. Arch Pathol Lab Med. 2017 Aug. PMID: 28745567
• Buza N, Wong S, Hui P: FOXL2 Mutation Analysis of Ovarian Sex Cord-Stromal Tumors: Genotype-Phenotype Correlation With Diagnostic Considerations. Int J Gynecol Pathol. 2017 Jul 11; 2017 Jul 11. PMID: 28700438
• Menderes G, Bonazzoli E, Bellone S, Altwerger G, Black JD, Dugan K, Pettinella F, Masserdotti A, Riccio F, Bianchi A, Zammataro L, de Haydu C, Buza N, Hui P, Wong S, Huang GS, Litkouhi B, Ratner E, Silasi DA, Azodi M, Schwartz PE, Santin AD: Superior in vitro and in vivo activity of trastuzumab-emtansine (T-DM1) in comparison to trastuzumab, pertuzumab and their combination in epithelial ovarian carcinoma with high HER2/neu expression. Gynecol Oncol. 2017 Jul 10; 2017 Jul 10. PMID: 28705408
• Menderes G, Bonazzoli E, Bellone S, Black JD, Predolini F, Pettinella F, Masserdotti A, Zammataro L, Altwerger G, Buza N, Hui P, Wong S, Litkouhi B, Ratner E, Silasi DA, Azodi M, Schwartz PE, Santin AD: SYD985, a Novel Duocarmycin-Based HER2-Targeting Antibody-Drug Conjugate, Shows Antitumor Activity in Uterine and Ovarian Carcinosarcoma with HER2/Neu Expression. Clin Cancer Res. 2017 Jul 5; 2017 Jul 5. PMID: 28679774
• Menderes G, Bonazzoli E, Bellone S, Black J, Altwerger G, Masserdotti A, Pettinella F, Zammataro L, Buza N, Hui P, Wong S, Litkouhi B, Ratner E, Silasi DA, Huang GS, Azodi M, Schwartz PE, Santin AD: SYD985, a novel duocarmycin-based HER2-targeting antibody-drug conjugate, shows promising antitumor activity in epithelial ovarian carcinoma with HER2/Neu expression. Gynecol Oncol. 2017 Jul; 2017 May 1. PMID: 28473206
• Snir OL, DeJoseph M, Wong S, Buza N, Hui P: Frequent homozygosity in both mature and immature ovarian teratomas: a shared genetic basis of tumorigenesis. Mod Pathol. 2017 Jun 30; 2017 Jun 30. PMID: 28664933
• Rawish KR, Buza N, Zheng W, Fadare O: Endometrial Carcinoma With Trophoblastic Components: Clinicopathologic Analysis of a Rare Entity. Int J Gynecol Pathol. 2017 Jun 2; 2017 Jun 2. PMID: 28582346
• Wong S, Hong W, Hui P, Buza N: Comprehensive Analysis of PAX8 Expression in Epithelial Malignancies of the Uterine Cervix. Int J Gynecol Pathol. 2017 Mar. PMID: 27362905
• Alvero AB, Kim D, Lima E, Sumi NJ, Lee JS, Cardenas C, Pitruzzello M, Silasi DA, Buza N, Fahmy T, Mor G: Novel approach for the detection of intraperitoneal micrometastasis using an ovarian cancer mouse model. Sci Rep. 2017 Jan 25; 2017 Jan 25. PMID: 28120873
• Hui P, Buza N, Murphy KM, Ronnett BM: Hydatidiform Moles: Genetic Basis and Precision Diagnosis. Annu Rev Pathol. 2017 Jan 24. PMID: 28135560
• Santin AD, Bellone S, Buza N, Schwartz PE: Regression of metastatic, radiation/chemotherapy-resistant uterine serous carcinoma overexpressing HER2/neu with trastuzumab emtansine (TDM-1). Gynecol Oncol Rep. 2017 Feb; 2016 Dec 14. PMID: 28018954
• Santin AD, Bellone S, Buza N, Choi J, Schwartz PE, Schlessinger J, Lifton RP: Regression of Chemotherapy-Resistant Polymerase ε (POLE) Ultra-Mutated and MSH6 Hyper-Mutated Endometrial Tumors with Nivolumab. Clin Cancer Res. 2016 Dec 1; 2016 Aug 2. PMID: 27486176
• Zhao S, Bellone S, Lopez S, Thakral D, Schwab C, English DP, Black J, Cocco E, Choi J, Zammataro L, Predolini F, Bonazzoli E, Bi M, Buza N, Hui P, Wong S, Abu-Khalaf M, Ravaggi A, Bignotti E, Bandiera E, Romani C, Todeschini P, Tassi R, Zanotti L, Odicino F, Pecorelli S, Donzelli C, Ardighieri L, Facchetti F, Falchetti M, Silasi DA, Ratner E, Azodi M, Schwartz PE, Mane S, Angioli R, Terranova C, Quick CM, Edraki B, Bilgüvar K, Lee M, Choi M, Stiegler AL, Boggon TJ, Schlessinger J, Lifton RP, Santin AD: Mutational landscape of uterine and ovarian carcinosarcomas implicates histone genes in epithelial-mesenchymal transition. Proc Natl Acad Sci U S A. 2016 Oct 25; 2016 Oct 10. PMID: 27791010
• Snir OL, Buza N, Hui P: Mucinous epithelial tumours arising from ovarian mature teratomas: a tissue genotyping study. Histopathology. 2016 Sep; 2016 Apr 12. PMID: 26952875
• Black J, Menderes G, Bellone S, Schwab CL, Bonazzoli E, Ferrari F, Predolini F, De Haydu C, Cocco E, Buza N, Hui P, Wong S, Lopez S, Ratner E, Silasi DA, Azodi M, Litkouhi B, Schwartz PE, Goedings P, Beusker PH, van der Lee MM, Timmers CM, Dokter WH, Santin AD: SYD985, a Novel Duocarmycin-Based HER2-Targeting Antibody-Drug Conjugate, Shows Antitumor Activity in Uterine Serous Carcinoma with HER2/Neu Expression. Mol Cancer Ther. 2016 Aug; 2016 Jun 2. PMID: 27256376
• Cocco E, Lopez S, Black J, Bellone S, Bonazzoli E, Predolini F, Ferrari F, Schwab CL, Menderes G, Zammataro L, Buza N, Hui P, Wong S, Zhao S, Bai Y, Rimm DL, Ratner E, Litkouhi B, Silasi DA, Azodi M, Schwartz PE, Santin AD: Dual CCNE1/PIK3CA targeting is synergistic in CCNE1-amplified/PIK3CA-mutated uterine serous carcinomas in vitro and in vivo. Br J Cancer. 2016 Jul 26; 2016 Jun 28. PMID: 27351214
• Buza N, Ziai J, Hui P: Mismatch repair deficiency testing in clinical practice. Expert Rev Mol Diagn. 2016; 2016 Mar 10. PMID: 26895074

Books: 
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https://images.springer.com/sgw/books/raw/9781617793936.tif

International Gynecologic Pathology Programs
https://medicine.yale.edu/pathology/people/huivideo.aspx

Yale medical school teaching
Yale pathology resident teaching and training
Yale Gyncologic Onology clinical fellow teaching and training
National and International training programs