Hematopathology
The resident hematopathology experience consists of a four-month rotation, which is divided up into a three-month block during the second year of residency and a one-month rotation in the fourth year. Residents will have exposure to hematologic diseases seen uniquely at a tertiary referral and bone marrow transplant center, including acute leukemias, B- and T-cell lymphomas, myelodysplastic/myeloproliferative disorders, multiple myeloma, and aplastic bone marrow states.
Initially, the resident will rotate through the hematology laboratory at Dynacare Laboratories, and under the supervision of senior technologists, learn the basics of hematology instrumentation- specifically the Bayer Advia
®, peripheral blood and bone marrow morphology, white blood cell differential counting, and body fluid analysis. During this time, the resident will slowly integrate into the daily routine of the in-patient hematopathology service, initially concentrating on peripheral blood smears and body fluid reviews with the hematopathologists. With experience, the resident will become involved in bone marrow examination, first emphasizing the morphologic assessment of aspirate smears, touch imprints, core biopsies, and clot sections. Instruction on the basics of four- and six-color flow cytometry is provided initially, with more advanced training and experience in analysis, offered in the final months of the rotation. Throughout the rotation, residents will also gain experience in the work-up of tissues which are procured to rule out hematolymphoid neoplasia, through interpretation of frozen sections, assessment of imprint cytology, and the appropriate triage of specimens for ancillary studies, including flow cytometry and cytogenetics. Concentration in the later months of the rotation will be on the development of appropriate differential diagnoses and targeted strategies for work-up, including utilization of a robust menu of immunohistochemical stains. Exposure to consultation cases is also provided.
Residents will participate in daily hematopathology consensus conferences, weekly hematolymphoid malignancy conferences, bimonthly hematology/pathology conferences, monthly lymphoma tumor boards, and monthly pediatric hematology conferences, with our clinical colleagues. Experience performing bone marrow biopsies is also available in cooperation with the Hematology/Oncology division.