The ability to contribute to the diagnosis and treatment of children is what propelled me into the field of pediatric pathology. My initial experiences in India made me realize how neglected children’s diseases are, and I wanted to change the situation in a small, personal way. That prompted me to get into pediatric pathology and hone my skills to provide the best possible service for the diagnosis of pediatric diseases.
There is a great need for pediatric pathologists as they form a very small group. Children are not “small adults”! They have a unique set of diseases that need to be recognized and treated if they are to be productive adults in the future.
I am the director of the Division of Pathology at Cincinnati Children’s. I’m involved in the diagnosis of all childhood diseases, and I have special expertise in the areas of solid tumors, liver diseases, kidney diseases and pediatric transplant pathology.
Pathologists are rarely seen at the forefront of patient care. They are always thought to be “someone who generated a report on my child’s illness that led to my physician successfully treating my child.” The role of the pathologist is not well known, but we are the only ones who can provide a definite diagnosis of your child’s illness, which guides your physician’s treatment process.
I always approach each of my cases with the understanding that there is a patient and a family at the end of my microscope waiting for me to put a stamp on a child’s diagnosis that will start effective therapy. This puts a big responsibility on our shoulders and helps us serve with humility and respect knowing that we are the final word.
As division chief of Pathology and Laboratory Medicine at Cincinnati Children’s, I am proud of the dedication and efforts of my colleagues who have stepped up to form an expert team. Our unique experiences and expertise enable us to project ourselves as one of the leading pediatric pathology divisions in the country. Our team works closely together to provide the correct diagnosis to patients every single time. Together, we do our best to offer the highest quality of care every day.
In addition to my clinical work, I’m also involved in research. My interest in pediatric tumors began in the late 1990s, and since then I have been able to advance my career to become an expert in the pathology of several tumors, including liver tumors and post-transplant tumors. My specific research focus is on the study of pediatric liver tumors including hepatoblastoma, a unique embryonal tumor of childhood, and pediatric hepatocellular carcinoma.
I am currently the reviewing pathologist for the Children’s Oncology Group study of liver tumors as part of an international collaboration. I have been studying the pathogenesis of liver tumors with special focus on the Wnt/beta-catenin pathway and its relationship to others, such as the Hippo pathway or interactions with other oncogenic proteins, such as EGFR. I have collaborated on several mouse models of liver tumors at the University of Pittsburgh and continue this work today. I have also studied the mechanisms of transplant rejection and cellular pathways in intestinal and liver transplant. I hope to contribute to the understanding of the pathogenesis of hepatoblastomas and pediatric hepatocellular carcinoma (HCC) and to identify potential biomarkers that can be used to predict outcomes in these rare tumors.
Since my move to Cincinnati, I have been immersed in my work and have not had time to look around. I hope to spend quality time with my family, go sightseeing, watch classic movies and listen to old songs.
MBBS: University of Mumbai, Mumbai, India, 1987.
MD: Pathology, University of Mumbai, Mumbai, India, 1990.
Residency: Metropolitan Hospital Center/New York Medical College, Valhalla, NY.
Certification: Anatomic and Clinical Pathology, 1997.
Fellowship: St. Louis Children's Hospital/Barnes Jewish Hospital, Washington University School of Medicine, St. Louis, MO.
Certification: American Boards of Pathology - Pediatric Pathology, 1999.
Pediatric liver and extracranial solid tumors; pediatric liver diseases; medical renal diseases in children; pediatric transplant pathology, especially liver, small intestine and heart transplants
Pathology, Liver Tumor
Pediatric liver tumors; cholestatic liver diseases
Pathology
Upfront or delayed surgery in resectable hepatoblastoma: analysis from the children's hepatic tumors international collaboration database. EClinicalMedicine. 2024; 76:102811.
Diagnostic Utility of a Modified Reticulin Algorithm in Pediatric Adrenocortical Neoplasms. The American Journal of Surgical Pathology. 2024; 48:309-316.
GI and Liver Transplantation Pathology in Childhood. Pathology of Pediatric Gastrointestinal and Liver Disease. : Springer Nature; Springer Nature; 2024.
Biliary atresia is associated with polygenic susceptibility in ciliogenesis and planar polarity effector genes. Journal of Hepatology. 2023; 79:1385-1395.
Pediatric combined hepatocellular-cholangiocarcinoma (cHCC-CC) with neuroendocrine features: distinguishing genetic alterations detected by chromosomal microarray. Diagnostic Pathology. 2023; 18:20.
Pediatric hepatic vascular tumors: clinicopathologic characteristics of 33 cases and proposed updates to current classification schemes. Human Pathology. 2023; 141:78-89.
Consensus classification of pediatric hepatocellular tumors: A report from the Children's Hepatic tumors International Collaboration (CHIC). Pediatric Blood and Cancer. 2023; 70:e30505.
Retreatment with Cisplatin May Provide a Survival Advantage for Children with Relapsed/Refractory Hepatoblastoma: An Institutional Experience. Cancers. 2023; 15:3921.
Vincristine/irinotecan/temsirolimus upfront window treatment of high-risk hepatoblastoma: A report from the Children's Oncology Group AHEP0731 Study Committee. Pediatric Blood and Cancer. 2023; 70:e30365.
Outcomes of Patients Treated for Hepatoblastoma with Low Alpha-Fetoprotein and/or Small Cell Undifferentiated Histology: A Report from the Children's Hepatic Tumors International Collaboration (CHIC). Cancers. 2023; 15:467.
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