Fall 2000

From the Editor's Desk
Art Weinberg

This issue marks the first electronic-only edition of the SPP Newsletter; no printed version will arrive in your mailbox. The cost saving to the Society is considerable and this new format will allow for more flexible deadlines as well as the option for expanded text and color, when appropriate. Unfortunately, there are 140 members whose e-mail addresses are not registered in the Society database. Those individuals will not receive a broadcast e-mail message when a new edition of the Newsletter is posted to our website. It is likely that most of those individuals are, in fact, connected to the web despite the gap in their demographic data and efforts are underway to fill in the missing blanks. We are mailing a downloaded version of this issue of the Newsletter to those individuals along with a request for their current e-mail address, but this snail mail service will cease after the upcoming winter issue. Also, it is likely that some of you have outdated or malfunctioning e-mail addresses recorded in our records. Please follow the instructions given by Beverly Rogers elsewhere in this Newsletter to be certain that your demographic data are current and complete. And be certain to notify the Central Office (socpedpath@degnon.org) whenever you change your demographics. The Society will increasingly utilize technology afforded by the Internet to engage our members in a more opportune and interactive manner than can be achieved solely through our traditional biannual meetings.

You will notice that new position postings now appear in the Newsletter only as listings, with links to the “positions” section elsewhere on this website. And please don’t be shy about sending information to me for the Comings and Goings section of the Winter edition of the Newsletter. I would also like more notices about upcoming meetings.

President's Message
Claire Langston

The recent Vancouver meeting was a great success.  We were gifted with four days of fine early autumn weather with bright sunshine.  Thanks to the fine organization by the Education committee, the Scientific Program was superb with numerous excellent papers and posters. Also featured, was a fascinating talk by Lotte Strauss Award winner, Anirban Maitra, and an interesting and informative seminar, Embryopathology to Gene Identification, with a group of local luminaries moderated by Dagmar Kalousek. The venue was so charming, that despite the stellar program, it was hard to stay inside and concentrate. Thanks to Jim and Judy Dimmick with the support of British Columbia Children’s & Women’s Health Centre and numerous people who worked hard to make the meeting run smoothly and apparently effortlessly, a fine time was had by all. 

As we all get busier and busier with our work and lives, so the pace of change in the Society continues to accelerate. The responsibility for this weighs heavily on those who guide the various committees that further the mission of the Society, and on the members of Council who provide guidance for committee activities. The Council meeting in Vancouver addressed a number of issues, some unresolved from previous years, and some just emerging.  The time allotted for the various committee and council meetings is never enough to adequately address the issues involved, and committee members could be seen conversing outside on the patio and in other locations to complete their business and take advantage of the beautiful weather. 

The attempt to manage the changes confronting the Society is nowhere more evident than in the Publication Committee, a group that must now oversee searches for both a new editor for Pediatric and Developmental Pathology and for a website editor. Because of the limitations on time at the Interim and Annual meetings and the need to address important looming issues in a timely fashion, the Publication Committee will hold a retreat in the near future in an attempt to provide direction to the new editors. The website is undergoing rapid evolution and plans for the orderly movement of various activities to the website are underway.

Although the Society continues to operate with a deficit budget, endowment funds have increased to a point where it will shortly become possible to use them to further the mission of the Society in new ways. Discussion related to this happy prospect has begun both in Council and in the Long-Term Planning Committee. This process was initiated at the New Orleans Council meeting and should continue for some time, hopefully with broad input from Society members.

Committee Reports

Publications Committee
Beverly Rogers

I want to extend a warm thanks to all on the Publications Committee who put forth their time and effort to make the meeting a productive one. And thanks also to those among us who braved the bright Vancouver sun during the latter part of the meeting. We had a lot to talk about.

The website has been moved to Health IT, Inc. Art Weinberg and I worked closely with our webmaster (Ricky Lark, Ph.D., from Health IT), along with the input from Paul Dickman and the website Board, to make the site as complete as possible at this time. Dr. Paul Dickman is the current editor-in-chief and members of the board are: Hal Pinar (Meetings/Events), Glenn Taylor (Fellowship/Membership), Larry Becker (Publications), Raj Kapur (Research/Awards/Grants), and Art Weinberg (Newsletter). Each member of the board will be responsible for his own section, with the editor-in-chief responsible for the overall look, content, and administration of the site. There is a new, potentially very important, addition to the site. That addition is an online e-mail database. This database allows the SPP administration to send important notices and website updates to all members who have e-mail addresses. This is NOT the ListServe, which reaches only a portion of our members as well as many non-members. 

Note: Please go to the membership section of the SPP website -- clicking here will open a new web browser window) and check to see if your current e-mail address is listed and is correct. At the bottom of the membership page is “membership database”. The User ID is SPP and the Password is member. Send any additions or corrections to our Central Office (socpedpath@degnon.org). 

Look for more new additions to our site as we join the electronic age. Elsewhere in this newsletter, Dr. Collins has placed an advertisement for applications for the position of editor-in-chief of the website. Dr. Dickman’s term expires after the spring 2001 meeting, so the position is open for applications. Please send your inquiry and/or application directly to Dr. Margaret Collins.

Pediatric and Developmental Pathology will be going through some changes in the near future.  Dr. Denis Benjamin has expressed his desire to resign as editor-in-chief. I want to thank Dr. Benjamin for his 6 (yes, 6) years of hard work seeing the journal through a new publisher and bringing Pediatric and Developmental Pathology as we know it on line. We still have a way to go, though. Our institutional subscription base is static at 59 US/Canadian and 30 European. We have to improve this. Springer has agreed to expand their marketing initiatives in response to our concerns.  Dr. Benjamin reports the dismal news that submissions to the journal so far for this year are about half that of previous years. The Publications Committee reviewed submissions from members of the editorial board of the journal and found that board members published 9% of their articles in PDP. We will be looking at ways to improve this. Council approved funds for a small retreat to discuss the future of SPP publications. This retreat will occur within the next few months and a report will be presented to Council at our spring meeting.

Perspectives in Pediatric Pathology continues to serve as the lead article in each issue of Pediatric and Developmental Pathology. The Executive Committee polled the membership about whether or not to continue financial support for the year-end bound compilation of these articles. By a 3:1 majority, the members voted against continued financial support for the bound volume. The manner of funding this volume now resides with the editors.

Long Term Planning Committee
Derek deSa

The Long Term Planning Committee (LTPC) convened in Vancouver on 9/23/00. Claire Langston told the group that endowment funds had increased to the point where new projects could be funded and that the Council had discussed this issue. She asked the Committee to propose a process for deciding how these additional funds should be allocated. A variety of comments were offered and discussed. Based on the this discussion, the following motion was seconded, and passed without objection: The Committee recommends to Council that a Foundation be formed to oversee these additional funds, and a Board of Directors be appointed to evaluate new proposals. During the discussion, it was suggested that input from members be solicited through the Newsletter. If you have any comments or suggestions regarding this matter, please send them to Dr. Langston.

Bob Bendon briefly related the historical aspects of the Perinatal Group and its relationship to the Society. He stated that the concepts surrounding formation of the group and its interaction with the Society were well founded, but details relating to the functioning of the Group were more challenging. Some LTPC members suggested that Perinatal Group members should integrate into the Society by serving on SPP committees. It was also suggested that there be representation of the Perinatal Group on Council.  Dr. Langston noted that it is the responsibility and privilege of the SPP President to make numerous committee appointments and that inclusion of Perinatal Group members on appropriate SPP committees could be achieved with little difficulty. She reminded the group that service on any SPP committee requires membership in the Society. It was suggested that the Interim meeting be lengthened to better accommodate the Perinatal Group and prevent overlap of Perinatal Group sessions with general SPP sessions. Potential problems raised by this suggestion were financial reimbursement of the host institution for additional expenses incurred by a longer meeting and travel concerns of the attendees. After a brief discussion, Dr. deSa indicated that he would poll the SPP membership via the Internet regarding a lengthened interim meeting and report to the LTPC at its next meeting. Please email your pro or con opinion on this matter directly to Derek at DDESA@cw.bc.ca.

Dr. Bendon also requested that the Perinatal Group be given an official name. The LTPC recommended to President Langston that an ad hoc Perinatal Steering Committee be formed, and she indicated that she would comply with this suggestion.

Practice Committee
Ted Pysher

The Committee recommended and Council approved a change in the SPP Slide Survey. The previous offering of 3 mailings of four slides will be changed to a choice between 3 mailings of five slides, two of which will be perinatal cases and three of which will be general pediatric cases, or 3 mailings of just the two perinatal cases. The charges for these new surveys will be $150 for the fifteen case option and $75 for the six case option.  The assistance of the perinatal pathology group in developing this plan and making the perinatal options feasible is greatly appreciated. The arrangements for CME credit for participation in the Slide Survey will remain the same, but the slide survey subcommittee will poll participants in 2002 to determine whether this option is worth the considerable effort that it requires. If you have opinions about this, please contact Dr. Robert Novak, survey coordinator, at rwn@riker.neoucom.edu The Practice Committee is also exploring the possibility of developing a CD-ROM based on previous slide survey cases.

Dr. Gareth Jevon has modified the staffing and activities questionnaire developed by the College of American Pathologists, and Practice Committee members are reviewing the latest draft prior to surveying their own practice groups. The revised instrument is most applicable to children's hospital settings, but any SPP member who would be willing to complete this form for their practice should contact Dr. Jevon at gjevon@cw.bc.ca. We hope that the data will provide a "snapshot" of pediatric pathology in the settings surveyed. We will release summary information after the data have been compiled by the Practice Committee and reviewed by Council.

The Committee discussed the need for quantitative data on practices such as microscopic examination of tonsils and inguinal hernia sacs.  If you perform these examinations, and would be willing to share summary data with the Committee, or if you have ideas for studies of related issues, please contact Ted Pysher at pctpyshe@ihc.com.

Awards presented at the Vancouver meeting
Jeffrey Goldstein

Suzanne Chan, M.D., from the Hospital for Sick Children, Toronto, received the Gordon F. Vawter Pathologist-in-Training Award for her presentation: Adenovirus E1A is not Detected in Ewing Family of Tumors. 

The Harry Neustein Award for use of new or novel technology was presented to Pam Groen and David Witte, Childrens Hospital Medical Center, Cincinnati, for their paper: Quantitative EBV Assay Using the LightCycler Instrument to Monitor Transplant Patients at Risk for PTLD.

Welcome New Members


Samuel Pepkowitz (Los Angeles, CA)
John D. Christie (Greenville, NC)
Peter Stenzel (Portland, OR)
Sandra Conradi (Charleston, SC)
Muhammad Ashraf Ali (Riyad, Saudi Arabia)
Bo Y. Ngan (Toronto, ON)
Kamran Badezadegan (Boston, MA)


Eduardo V. Zambrano (Hamden, CT)
Mary Jo Willard (Winnipeg, MB)
Van-Hung Nguyen (Columbus, OH)
Marianne E. Greene (Chicago, IL)
Amu Elizabeth Heerema (San Francisco, CA)
Angelica Oviedo (Chicago, IL)
Rafal Kozielski (Cincinnati, OH)


Mazen Khubieh (Limassol, Cyprus)
Serban Rogoz (Brasor, Romania)

Comings and Goings

Joe Rutledge, immediate past president of the Society, has been named Director of Laboratories at Children’s Hospital and Medical Center, Seattle, WA. Congratulations and Good Luck.

Ben Landing’s Memorial Service
Allen Lipsey writes that a wonderful memorial service was held for Ben Landing at his home. Several groups were represented: Friends from the hospital, from his Unitarian Church group, from a discussion group, neighbors and old time buddies like Hart Isaacs, Daria Haust, Harvey Rosenberg, Steve Romansky, Virginia Anderson and others. The service was brief, but the stories about Ben were very moving and brought to light his work with his church, his love of butterflies and his scholarship. We learned about his personal life and his wonderful relationship with Dottie. He wrote Haiku poems and was a wonderful friend to so many people. I am sure that Dotty would like letters in the spirit of the memorial reflecting Ben's life and importance to the individual in lieu of sympathy cards.


Lotte Strauss Prize – Call for nominations

The Committee on Distinctions and Awards is seeking nominations for the Lotte Strauss Award, which recognizes meritorious work by an individual 40 years of age or younger in a subject germane to pediatric pathology, published or accepted for publication during 2000. The winner will receive a $1000 cash prize and expenses to attend the fall meeting of the Society. Nomination requires submission of five copies of the completed paper, a supportive letter from the nominee, sponsor, and five copies of the nominee’s curriculum vitae. The deadline for nominations is Jan 1, 2001. Please submit to:

Jeffrey D. Goldstein, M.D.
Wolfson Children's Hospital
800 Prudential Drive
Jacksonville, FL 32207
(904) 202-8104
(904) 202-8110 (Fax)

Young Investigator Research Grant - Call for Applications


  1. To foster research within the SPP by providing funds to young investigators in pediatric pathology.
  2. To fund a pilot project which will lead to long-term research support from other granting agencies.

Use of Funds: The funds are to be used to facilitate basic or applied research by a young investigator in the field of pediatric pathology. Research into any aspect of pediatric disease will be considered, including morphological, biochemical, behavioral, physiological, genetic, and epidemiological studies. Appropriate expenditures include capital equipment, reagents and supplies, research-related travel, salary supplementation, service costs (e.g., electron microscopy, histology), and animal care costs. Indirect costs are not allowed.

Eligibility: Applicants must be

  • a MD or DO
  • either a resident or fellow, full-time, in an accredited pathology training program or a faculty/staff person in pediatric pathology for less than 5 years
  • either a member of the SPP or sponsored by a member of the SPP

Amount of Award: An award of $10,000 will be made.

Selection Process: Complete applications must be received for review by the Research Committee no later than February 1, 2001. The award will be announced at the SPP meeting in March. Consideration will be given to scientific merit and the background and career goals of the applicant. Award funding will begin July 1, 2001.

Application Instructions: Application Instructions can be obtained by mail from the SPP Executive Office, Degnon Associates, Inc., 6728 Old McLean Village Drive, McLean, VA 22101, (703)-556-9222 or FAX (703)-556-8729 or e-mail (socpedpath@degnon.org). Completed applications should be sent to: 

Raj P. Kapur, M.D., Ph.D.
Chairman, Research Committee
Department of Pathology - Box 357470, Room D502
University of Washington Medical Center
1959 NE Pacific Street
Seattle, Washington 98195

A. James McAdams Short-Term Study Stipend Call for Applications

Background: The Society for Pediatric Pathology and Children’s Hospital Medical Center of Cincinnati established the Short-Term Study Stipend to honor A. James McAdams, M.D, by promoting opportunities for pediatric pathologists to learn investigative techniques that are not available at their institution.


  1. To honor the memory of A. James McAdams, M.D.
  2. To facilitate training of pediatric pathologists in investigative techniques available at other institutions.

Use of Funds: The funds may be used to offset travel and living expenses incurred by a pediatric pathologist who visits another institution in order to develop new research skills related to either clinical or laboratory investigations.

Eligibility: Applicants must be

  • a MD or DO
  • either a resident or fellow, full-time, in an accredited pathology training program or a faculty/staff person in pediatric pathology for less than 5 years
  • either a member of the SPP or sponsored by a member of the SPP

Amount of Award: An award of up to $2,000 will be made to support travel and living expenses for up to one month.

Selection Process: Complete applications must be received for review by the Research Committee no later than February 1, 2001. The award will be announced at the SPP meeting in March. Consideration will be given to scientific merit, the background and career goals of the applicant, the expertise and/or resources available at the remote institution. Award funding will begin July 1, 2001.

Application: An application can be obtained by mail from the SPP Executive Office, Degnon Associates, Inc., 6728 Old McLean Village Drive, McLean, VA 22101, (703)-556-9222 or FAX (703)-556-8729 or e-mail (socpedpath@degnon.org). Completed applications should be sent to:

Raj P. Kapur, M.D., Ph.D.
Chairman, Research Committee
Department of Pathology - Box 357470, Room D502
University of Washington Medical Center
1959 NE Pacific Street
Seattle, Washington 98195

Editor-in-Chief - Pediatric and Developmental Pathology

The Society for Pediatric Pathology and the European Paediatric Pathology Society announce a search for the position of editor-in-chief of Pediatric and Developmental Pathology. Pediatric and Developmental Pathology is the only major journal devoted to the timely communication of peer-reviewed articles providing significant new information and insights into the study of disease from conception through adolescence. The journal is published by Springer-Verlag, with 6 issues produced each year. The editor-in-chief will serve a 5-year term and, with the Board of Editors, will be responsible for the editorial content of the journal. The editor-in-chief is responsible for acquiring, reviewing, and collating manuscripts for publication, and shall work with the publisher to produce a timely and informative publication.

In addition, the editor-in-chief will interface with the editors of Perspectives in Pediatric and Developmental Pathology to incorporate a review article submitted by these editors with each issue. Persons applying for the position of editor-in-chief should have a working knowledge of the field of pediatric pathology. He/she should be willing to interface with electronic publishing available through Springer-Verlag. Springer-Verlag will be responsible for the manufacturing, distribution, and marketing of the journal. Limited color prints are available with each issue, at the editor’s discretion. The publisher will also sponsor a yearly editorial board meeting, which will be the responsibility of the editor-in-chief to coordinate. Springer-Verlag will provide some financial support to run the editorial office, and the Society for Pediatric Pathology provides a stipend for the editor-in-chief. Those interested in applying for the position of editor-in-chief should send a letter of intent and curriculum vitae by March 1, 2001 to:

Beverly B. Rogers, MD
Department of Pathology
Children’s Medical Center of Dallas
1935 Motor St.
Dallas, TX 75235

Editor-in-Chief: SPP Website

The Society for Pediatric Pathology recently moved its website from the University of Pittsburgh to a commercial firm, Health IT, Inc. The SPP is seeking an editor-in-chief for the website for a term of three years to commence in March 2001.

The website is a highly visible interface between the SPP and Internet users and represents the initial contact between the Society and some of those users. The website editor-in-chief and the editorial board that he/she directs will determine website content and will be responsible for coordinating the ongoing activities of the board, assuring that the content of the website is current and that appropriate use of the site is maintained.

The editor-in-chief must be a member of the SPP. In addition, a successful website editor-in-chief should meet the following criteria:

  1. excellent managerial skills, including but not limited to effective communication, attention to detail, and ability to complete tasks expeditiously
  2. some familiarity with computer technology, the Internet, search engines, and indexes. Knowledge of HTML and computer programming are helpful but not necessary and will be provided by Health IT
  3. journalistic skills, manifested by publications in peer-reviewed journals
  4. comprehension of the SPP and its goals, so as to establish proper links within the Society and between the SPP and other organizations

The Publications Committee asks that all qualified SPP members give serious consideration to applying for this very important position in our Society. The 3-year term will begin immediately following the spring 2001 meeting. Candidates should provide a letter of application, a letter of intent and an updated CV by January 1, 2001 to:

Margaret H. Collins, MD
Department of Pathology
HT 4231
Children’s Hospital Medical Center
3333 Burnet Ave.
Cincinnati, OH 45229
Telephone: 513/636-4261
Fax: 513/636-3924
Email: Margaret.Collins@UC.Edu

SPP Spring Meeting Program - Atlanta

-- Saturday, March 3 --

Platform and poster presentations

Symposium -- Pediatric Neoplasia: From Morphology to Molecules and Back Again
Moderator: Poul H. B. Sorensen, Ph.D., British Columbia Children’s Hospital, Vancouver, BC

Poul H.B. Sorensen, Ph.D., British Columbia Children’s Hospital, Vancouver, BC

Timothy J. Triche, M.D., Ph.D., Children’s Hospital of Los Angeles, Los Angeles, CA

James R. Downing, M.D., St. Jude Children’s Hospital, Memphis, TN

Stephen J. Qualman, M.D., Children’s Hospital, Columbus, OH

Objectives: Update attendees on known molecular changes in pediatric solid and hematologic malignancies. Update attendees on relationships between the morphology, molecular aberrations, and clinical behavior of pediatric solid tumors. Bring attendees up to date on some novel findings on the biology of pediatric neoplasms.

Business Meeting and Banquet

-- Sunday, March 4 --

Platform and poster presentations

Strauss, Vawter and Neustein Award presentations

Young Investigator Award presentation

Sidney Farber Lecture - Louis P. Dehner, MD

Workshops -- 

3rd Year:
Pediatric Bone Tumors and Tumor-like Lesions: An integrated approach to differential diagnosis.
Faculty: Lisa A. Teot, M.D., University of Rochester Medical Center, Rochester, NY
Objectives: Recognize histologic and, where appropriate, cytologic features of neoplastic and non-neoplastic bone lesions occurring in the pediatric population; correlate the histologic features of neoplastic and non-neoplastic bone lesions with the clinical, radiographic and, where appropriate, cytologic findings; and develop a differential diagnosis of bone lesions utilizing this integrated approach.
Congenital Malformations in the Fetus: Approaches to Examination and Diagnosis

Faculty: Joseph R. Siebert, Ph.D., and Raj. P. Kapur, M.D., Ph.D., Children’s Hospital and University of Washington, Seattle, WA

Objectives: Develop a systematic approach to the practice of fetal pathology. Learn to apply ancillary techniques to fetal pathology. Define the role of the fetal pathologist, including establishing and operating a fetal pathology service.

2nd Year:
Pediatric Renal Biopsy Pathology

Faculty: Helen Liapis, M.D., Washington University School of Medicine, St. Louis, MO

Objectives: Recognize the diagnostic features and generate a differential diagnosis for the entities presented. Understand our current knowledge of the pathogenesis of each disorder. Evaluate prognosis and risk for recurrence based on pathology.

Pathology of Heart, Lung, and Liver Transplantation

Faculty: Aliya N. Husain, M.D., Loyola University, Chicago, IL and Maria Parizhskaya, M.D., Children’s Hospital, Pittsburgh, PA

Objectives: Learn the current terminology and grading of rejection of heart, lung and liver with consideration of the difficult differential diagnosis. Understand the pathologic features of opportunistic infections and the use of newer diagnostic techniques; e.g. polymerase chain reaction and in-situ hybridization. Recognize the pathologic features of post-transplant lymphoproliferative disorders.
New Workshops:
Selected Diagnostic Problems and Controversies in Pediatric GI Pathology

Faculty: Pierre Russo, M.D., and Eduardo Ruchelli, M.D., Children’s Hospital of Philadelphia

Objectives: Acquire practical insights into the differential diagnosis of malabsorption in childhood, with emphasis on the role of the GI biopsy. Learn to evaluate and understand the significance of eosinophilia in various segments of the GI tract. Understand specimen handling and the diagnosis of intestinal innervation disorders. 
Morphology of Complex Congenital Heart Disease

Faculty: William A Devine, BS, Children’s Hospital, Pittsburgh, PA and Carole A. Vogler, M.D., St. Louis University Health Sciences Center, Cardinal Glennon Children’s Hospital, St. Louis, MO

Objectives: Develop an understanding of the “sequential segmental analysis” method for examining hearts. Become familiar with the morphology of a variety of complex cardiovascular malformations. Learn methods for examining surgically repaired and palliated congenitally malformed hearts, including cardiac explants.

The Society for Pediatric Pathology is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Society for Pediatric Pathology takes responsibility for the content, quality, and scientific integrity of this CME activity.

Other Upcoming Meetings

SPP/USCAP Meetings
2002: Chicago, February 22-23
2003: Washington, DC, March 21-22

SPP Interim Meetings
2001: Memphis, TN
2002: Dallas, TX

Children’s Oncology Group: November 1 through November 5, 2000, Hyatt Regency Hotel and Convention Center, Phoenix, AZ.  More details:

Children’s Oncology Group Meeting

The Children’s Oncology Group will meet November 1-5 at the Hyatt Regency Hotel and Convention Center, Phoenix, AZ. A complete program and on-line registration form can be found on the National Childhood Cancer Foundation website at www.nccf.org (this link will open a new web browser window). You can then select "COG Member Info", but you will first need to obtain a log-on code and password from the COG Principal Investigator in your institution. The first two days will have most of the meetings for leukemia and lymphoma studies, and the next two will have most of the solid tumor meetings. The Biology and Translational Research Program, of which Pathology is an integral part, will meet on Thursday. The Pathology and Radiology Committees are sponsoring a workshop on bone tumor diagnosis on Friday morning (see below), and there will be a group-wide symposium on bone tumor biology that afternoon to which pathologists are invited. The Pathology Committee meeting on Saturday morning will include updates on the new group, membership criteria, reports from several of the review pathologists, and discussions about selection of the new Group Chair (candidates will make presentations during the Phoenix meeting), the new chair of the Pathology Committee, and the educational program for 2001.

Please send any questions about the meeting or workshop directly to Ted Pysher at pctpyshe@ihc.com.

Children’s Oncology Group
Pathology-Radiology Workshop on Bone Tumor Diagnosis
Friday, November 3, 2000
Phoenix Convention Center

0800 Imaging of Bone Tumors
Dr. James Meyer, Pediatric Radiologist, CHOP
0840 Nuclear Medicine Imaging of Bone Tumors
Dr. Helen Nadel, Pediatric Radiologist and Nuclear Medicine Physician, British Columbia Children’s Hospital
0920 Break
0930 Pathology of Osteosarcoma
Dr. Kevin Raymond, Pathologist, M. D. Anderson Cancer Center
1010 Pathology of Ewing’s Sarcoma and Related Entities
Dr. Bogdan Czerniak, Pathologist, M. D. Anderson Cancer Center
1100 Adjourn

New Position Postings

Pediatric Pathologist - Seattle, WA

Pediatric Pathologist – Kansas City

Assistant or Associate Professor - Milton S. Hershey Medical Center/Penn State University

Millennium Meeting

Fergall Magee organized a set of round table discussions at the Vancouver meeting that dealt with various issues facing pediatric and perinatal pathology in the new millennium. This was not an official proceeding of the SPP Long Term Planning Committee and does not represent the opinions of the Society, but the thoughts expressed may be of interest to you and could stimulate further discussion within our organization. The following is an edited summary:

Pediatric solid tumor diagnosis: what we must achieve in the next 10 years.
This will depend upon the speed with which basic science translates into clinical practice, but we expect the following. Current classifications based on similarities of tumors to stages of development will be replaced by schemes based upon genetic mechanisms of oncogenesis or susceptibility to biological modulation. The distinction between current diagnostic modalities will blur as molecular markers are applied to imaging. The autopsy will become even more important as a means of evaluating unexpected complications of evolving new therapies. Archived tissue will be extremely valuable for comparing the expression of newly identified markers with traditional histopathologic categories.

Placental examination as a predictor of poor pregnancy outcome.
There is still much work to be done to identify strong predictors for recurrent adverse pregnancy outcome. Some distinctive lesions are good predictors of poor outcome, e.g. storage disease, maternal floor infarct, fetal thrombotic vasculopathy, severe villitis of unknown etiology, chorangiomatosis. Some highly predictive lesions are “after the fact”, but still useful, e.g. torn velamentous vessel causing fetal anemia. Understanding the etiology for IUGR (uteroplacental ischemia versus intrinsic fetal disorder) is important in predicting the likelihood of its recurrence.

Intrauterine death: The micro-autopsy -- are 5 microscopic sections enough.
The proposition was barely credible to most participants. Four or fewer sections would suffice to answer only a few very specific questions. The value of archived material from well-performed autopsies will continue to provide opportunities to evaluate new diagnostic tools and hypotheses to solve old problems, e.g. brain tissue form Down Syndrome babies in which were identified the Beta amyloid elements that were later found in Alzheimer Disease. Shortsighted pragmatism should not limit the known value of well-performed autopsies. A minimalist autopsy has little value to the family and concerned physician.

Utilization of autopsy data to effect beneficial changes in child health.
The pathologist should facilitate the obtaining of autopsy permission through consultation with the medical staff, consultation with parents, and active pursuit of consent under certain circumstances. The ideal autopsy should be complete and thorough. An effort should be made to examine the placenta in all perinatal cases. Consideration should be given to developing a regional pediatric pathology service so that cases go to those with specific interest and expertise. Close professional relations between pediatric pathologists and forensic pathologists should be fostered.

The autopsy report must be issued in an expeditious manner so that it retains relevance to the clinicians and parents. Timely reporting may quell anxiety or anger in the parents. An effort must be made to ensure that information is distributed to all relevant parties, such as parents and health board officials in addition to clinicians.

There should be appropriate and thorough mortality reviews to ensure optimal clinicopathologic correlation. Appropriate analysis of such data is fundamental to quality assurance of therapeutic and diagnostic programs. Analysis of data at the state/provincial levels may result in recognition of common factors and larger trends relative to specific diseases. The Society (or similar interest national organization) could promote analysis of autopsy data on a national level. 

Recruitment and education for the future of pediatric pathology.
Early and repeated exposure to Pediatric Pathology and Pediatric Pathologists at the level of medical students and general pathology residents would enhance mentoring. Other suggestions that might lead to improved recruitment are improving salaries for fellows, generating more information about rotations in Pediatric Pathology, and reemphasis of good job prospects.

Formalized transfer periods to improve Fellowship Programs.
No need to formalize, but ask directors to summarize the fellowship specific rotations in their programs and investigate opportunities to place this information on the SPP website. Consider 2-year programs for university/research positions with 1-year programs for community positions.

Second and third world pediatric laboratory medicine: role of the Society.
The SPP could help to identify persons who will provide leadership within developing countries. Focusing on improvements in Anatomic Pathology would be more productive than Clinical Pathology because of the lack of infrastructure. The SPP could offer help in upgrading equipment such as microwaves and cryostats. Sending journals and textbooks to developing countries has been productive. The website is another way the SPP can help pathologists in developing countries. Listing areas of interest on the membership page would be useful. St. Jude Hospital currently provides journal access to developing countries by providing the password to them. Perhaps the SPP could contribute to this effort.

Beyond the laboratory; the role of the pediatric pathologist as an advocate for child health.
Pediatric pathologists should be advocates for child health. A first step would be to become more available and active in the education of our clinical colleagues; advocacy is more successful when conducted by a team. For example, Child Protection teams in Houston used data to identify buckets as a risk for infant drowning. Federally mandated Fetal and Infant Mortality Committees target specific groups to assess the cause of death. In this context, we could recommend a more thorough examination of the placenta. We need to systematically gather data and should focus not only on deaths, but also on surgical specimens pointing to accidents (e.g. digits from accidents with lawnmowers). We must ensure the storage of diagnostic material that may provide answers for tomorrow.

Ethical Issues for the pediatric pathologist.
Do families understand what they give consent to when they sign an autopsy permit? May tissues be used for research, including distribution to other investigators? How is DNA testing to be handled? Several institutions have become more specific in their consent forms. The consensus was that families need to be fully informed of specifics of what we do when an autopsy is performed. Consent for use of tissue for research should be obtained as part of autopsy consent options and the consent should contain the option for return of organs to the body. 

Our sensitivity needs to be raised about patient confidentiality when we communicate electronically through e-mail etc. Linkage of patient name with diagnosis should be avoided as far as possible. Data bases, particularly, need to be secure.

Photos from Vancouver

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Council hard at work in a dark back room: Glenn Dickey, Larry Becker, Kathy Patterson, Joel Haas, Raj Kapur, Bev Rogers and Carole Vogler.

Long Term Planning Committee (and hangers on) hard at work in the sun: David Parham, Derek deSa, CaroleVogler, Virginia Anderson, Bob Bendon, Yee Khong, John Gillan, Leon Metlay, Jeff Goldstein, Ted Pysher, Deb Perry, Bev Rogers, and Claire Langston's back.

Some traveled far (Sir Colin Berry and Petr Florescu).

Some locals (Poul Sorensen, Gareth Jevon, Jackie Bourgeois) with David Becroft from Auckland.

Jim Dimmick seems pleased with his production.

Some happy guests (Ilana Ariel, Rosa Fuksman, Alba Greco, Leon Metlay, Ron Jaffe).

More happy guests (John Gillan, Ona Faye-Petersen, Monica Hrynchak, Grael O'Brien, Beverly Dahms, Virginia Baldwin).

Deb Perry, Jeff Goldstein, Bev Rogers and Ted Pysher, who looks like he could use some wine instead of paperwork.