Thoracic Pathology

Mission Statement

Extensive involvement of a neoplasm in pulmonary vessels
Extensive involvement of a neoplasm in pulmonary vessels

The Thoracic Center of Excellence is based at UPMC Presbyterian and has a broad agenda focused on achieving excellence in clinical service, resident/fellow education, and translational research. The Center of Excellence supports diagnostic services at both Presbyterian and Shadyside Hospitals, offering skilled interpretation in the surgical pathology of thoracic, mediastinal, and cardiovascular diseases. This mission supports the focused efforts in thoracic oncology and interstitial lung disease of the Divisions of Thoracic Surgery and Pulmonary Medicine at the UPMCHS. The Thoracic Center of Excellence is active in housestaff education, with much of the educational efforts focused on training of residents through case analysis and discussion. A wealth of internal material is supplemented by an active consultation service, an extensive slide teaching collection and study sets in the pathology of lung transplantation. Housestaff officers are trained in the applications of histochemistry, immunohistochemistry, and molecular biological techniques in the evaluation of clinical and pathologic diagnostic problems as well as in the interpretation of radiologic images and functional studies. Our research focus is largely oriented toward utilizing our own and the resources of the Molecular Anatomic Pathology section of the Division of Anatomic Pathology for assessing the relationship of surgical pathology to molecular pathology to clinical outcome. Major focuses have been on clonality in unusual pulmonary proliferations, the relationship of molecular changes in non-small cell carcinoma to clinical outcome, and the utilization of histology and immunohistology in predicting acute and chronic rejection of lung allografts.

Clinical Services

Thoracic Pathology is a comprehensive area including all organs within the thoracic cavity including lungs, thymus, and heart. Two pathologists are committed to this Center of Excellence: Gabriel Sica, MD and N. Paul Ohori, MD. On this diagnostic bench, we handle all pulmonary specimens including all of the material from University of Pittsburgh Cancer Institute. This material however is supplemented by a huge volume of inflammatory lung disease derived from a very active interstitial lung disease program, from the world’s largest thoracic transplantation program, a brisk consultation service, and a very active cardiovascular group. Signout on the thoracic bench includes daily reviews of all biopsy and large resection specimens including over 150 native lungs. The wide array of materials that include neoplasms, inflammatory lung disease, thymic neoplasia, allograft lung biopsies, and cardiovascular pathology is a unique experience. Signout is associated with frozen section responsibilities although in the afternoons, housestaff officers are allowed protected time for both grossing specimens and reviewing glass slides of their cases.

Teaching Activities

Hürthle cell hyperplasia in follicles
Hürthle cell hyperplasia in follicles

In addition to participating in the general department–wide teaching activities including a weekly research conference, anatomic pathology grand rounds, and multiheaded slide conference, the thoracic pathology Center of Excellence is involved in several clinicopathologic conferences each week: the thoracic oncology conference on Tuesday morning, a general pulmonary medicine conference with pulmonary medicine fellows and faculty at 11:00 AM on Tuesday, a consultation practice slide review conference at 11:00 AM on Wednesday, and the interstitial lung disease/rheumatology conference at 8:00 AM on Thursday. This core group of weekly conferences is supplemented by at least five other monthly conferences that encompass the entire vast array of pulmonary pathology including research conferences on pulmonary fibrosis, pulmonary vascular disease, and Lung SPORE meetings with Jill Siegfried, PhD focused on hormonal and tyrosine kinase receptor studies and lung carcinogenesis.

Training Activities

The Thoracic Pathology Center of Excellence has a fellowship in Pulmonary Pathology. This training program can be one or two years in length, with the first year largely devoted to developing clinical expertise in Thoracic Pathology, and an optional second year focused on translational research in pulmonary disease, either inflammatory interstitial lung disease or thoracic neoplasia.


For Residents and Fellows