Neuropathology

Overview


The training program in neuropathology prepares the resident (or fellow) for the practice of diagnostic neuropathology and the conduct of research. The program emphasizes clinicopathologic correlation as well as basic mechanisms in diseases of the central and peripheral nervous systems and of muscle. There is a close collaboration with neurologists, neurosurgeons, neuroradiologists, and various basic neuroscientists and clinicians in such other specialties as rheumatology.

During the rotations in surgical pathology and/or neuropathology, the residents are instructed in the different diagnostic skills and procedures necessary to diagnose neurological disease. Material from postmortem nervous system examination and neurosurgical biopsy specimens, as well as from consultations with regional and overseas institutions are used for training and investigation.

Direct supervision of the residents on this rotation is provided by the 2 staff neuropathologists. Instruction also includes the study of ophthalmic pathologic specimens. A resident will have the opportunity to study approximately 100 different brain tumors during a typical rotation.

Materials Available

  1. Current neuropathologic material consists of specimens from both autopsy and surgical pathology. The autopsy brain specimens are all dissected, processed, and interpreted by the neuropathologists at the institution. Special studies are performed at the neuropathology laboratory and the molecular diagnostics laboratory.
  2. Six self-study (microscopic) slide sets with explanations for each slide are available for study.
  3. Teaching slide sets, including up to 3,000 2 x 2-inch Kodachrome slides, have been developed by neuropathology faculty for use by residents.
  4. Quizzes featuring 2 x 2-inch slides of less common disorders occur 1-2 times each month.
  5. Reading materials include:
  1. Escourolle and Poirer's handbook
  2. Neuropathology atlases
  3. Neuroanatomy atlases
  4. Surgical Pathology of the Nervous System and Its Coverings, (3rd ed.) by Burger, Scheithauer, and Vogel
  5. WHO Manual on CNS Tumors, (2nd ed.) 

Conferences

  1. Participation in the weekly gross brain cutting conference every Tuesday at 8:30 am, and microscopic signout of ensuing slides with the neuropathology attending MD the following Friday, are mandatory for all trainees in neuropathology.
  2. Participation in the weekly neuropathology conference on alternate Tuesday afternoons at 2:15, together with neuroradiology, neurology, and neurosurgery conferences (each for 1/2 hour), are mandatory for all trainees.
  3. Trainees are coached to present neuropathology autopsies and selected surgical cases, as well as to give talks on selected subjects of neurologic/neurosurgical interest.

House Officer Duties

  1. House officer trainees sign out surgicals with the neuropathology attending physician on call. The materials include CNS and PNS tumors, and muscle and nerve biopsies. Significant numbers of outside muscle and nerve biopsies are processed in the laboratory for smaller regional hospitals. Neurosurgery and pathology house officers attend all frozen sections on neuropathologic cases. This is optional for neurology house officers.
  2. Neurology and neurosurgery house staff are encouraged to write papers based on pathologic materials in the neuropathology files.
  3. Residents on the neuropathology rotation participate in the daily processing of neuropathology surgical specimens in the second-floor DOC laboratory by making gross descriptions and submitting appropriate blocks for microscopy. The details are contained in the Neuropathology House Officer's Manual.
  4. Residents participate, along with the neuropathologist on-call, in the removal of brain specimens on complicated neurologic/neurosurgical cases on request.
  5. Residents are evaluated by faculty appraisals of their performance of autopsy brain processing, neuropathologic surgical specimens, conference preparation and presentations, and participation in research activities. There are also quiz sessions once or twice each month during the rotation.

Objectives

  1. To learn the various diagnostic skills and procedures necessary to diagnose neurologic/neurosurgical diseases and rheumatologic conditions.
  2. To become familiar with the widely used methods of light microscopy as well as other techniques such as enzyme histochemistry, histochemistry, immunocytochemistry, tissue culture, electron microscopy, and molecular biology as applied to diseases of the nervous system.

Faculty and Staff

Ryan T. Mott, MD 
 Director, Neuropathology

Kimberly Stogner-Underwood, MD
 Assistant Professor, Pathology

Quick Reference

Pathology Residency Training Program
Program Director:
Ryan T. Mott, MD

Tel: 336-716-4311
Fax: 336-716-7595

Wake Forest Baptist Medical Center
Medical Center Boulevard
Winston-Salem, NC 27157
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Last Updated: 10-02-2013
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