Scholars@Duke
Sarah Muntzing Bean

Sarah Muntzing Bean

Professor of Pathology
Pathology
sarah.bean@duke.edu
Duke Box 3712, Durham, NC 27710
Rm 3420 Duke Hospital South, Durham, NC 27710

Selected Publications

Endometrial Adenocarcinomas With No Specific Molecular Profile: Morphologic Features and Molecular Alterations of "Copy-number Low" Tumors.

Journal Article Int J Gynecol Pathol · November 1, 2021 The study evaluated morphologic patterns, mutational profiles, and β-catenin immunohistochemistry (IHC) in copy-number low (CNL) endometrial adenocarcinomas (EAs). CNL EAs (n=19) with next-generation or whole genome sequencing results and available tissue ... Full text Link to item Cite

Primary hepatic neoplasms arising in cirrhotic livers can have a variable spectrum of neuroendocrine differentiation.

Journal Article Hum Pathol · October 2021 Primary hepatic neoplasms with neuroendocrine differentiation are extremely rare. Their clinicopathological features and molecular genetic basis are largely unknown. We identified four cases of primary hepatic neoplasms with neuroendocrine differentiation. ... Full text Link to item Cite

Change in Pathology Medical Education: The Time Is Now.

Journal Article Arch Pathol Lab Med · September 1, 2021 Full text Link to item Cite

Evaluation of pelvic washing specimens in patients with endometrial cancer: Cytomorphological features, diagnostic agreement, and pathologist experience.

Journal Article Cancer Cytopathol · July 2021 BACKGROUND: Pelvic washings for patients with endometrial cancer is recommended but not used for staging. The International System for Reporting Serous Fluid Cytology (TIS) has standardized diagnostic categories, but the criteria remain incomplete. The 3 p ... Full text Link to item Cite

Natural history, trajectory, and management of mechanically ventilated COVID-19 patients in the United Kingdom.

Journal Article Intensive Care Med · May 2021 PURPOSE: The trajectory of mechanically ventilated patients with coronavirus disease 2019 (COVID-19) is essential for clinical decisions, yet the focus so far has been on admission characteristics without consideration of the dynamic course of the disease ... Full text Link to item Cite

NCCN Guidelines Insights: Cervical Cancer, Version 1.2020.

Journal Article J Natl Compr Canc Netw · June 2020 The NCCN Guidelines for Cervical Cancer provide recommendations for diagnostic workup, staging, and treatment of patients with the disease. These NCCN Guidelines Insights focus on recent updates to the guidelines, including changes to first- and second-lin ... Full text Link to item Cite

Gestational Trophoblastic Neoplasia, Version 2.2019, NCCN Clinical Practice Guidelines in Oncology.

Journal Article J Natl Compr Canc Netw · November 1, 2019 Gestational trophoblastic neoplasia (GTN), a subset of gestational trophoblastic disease (GTD), occurs when tumors develop in the cells that would normally form the placenta during pregnancy. The NCCN Guidelines for Gestational Trophoblastic Neoplasia prov ... Full text Link to item Cite

Emerging From the Basement: The Visible Pathologist.

Journal Article Arch Pathol Lab Med · August 2019 Full text Link to item Cite

Placental mesenchymal dysplasia: Key clinical and pathology features to aid in differentiation from molar pregnancy a case report

Journal Article Journal of Reproductive Medicine · June 1, 2019 BACKGROUND: Placental mesenchymal dysplasia (PMD) is a rare placental disorder characterized by placentomegaly. It carries a high incidence of adverse fetal outcomes, and its ultrasound appearance is similar to a partial hydatidiform mole and a complete hy ... Cite

The association between progesterone receptor expression and survival in women with adult granulosa cell tumors.

Journal Article Gynecol Oncol · April 2019 BACKGROUND: Granulosa cell tumors (GCT) variably express estrogen receptors (ER) and progesterone receptors (PR). The goal of this study is to evaluate the relationship between ER and PR expression patterns and clinical outcomes in women with GCT. METHODS: ... Full text Link to item Cite

Giving and Receiving Effective Feedback: A Review Article and How-To Guide.

Journal Article Arch Pathol Lab Med · February 2019 CONTEXT.—: Feedback is the delivery of information based on direct observation that is meant to improve performance. Learning is at the heart of feedback, and as such, feedback is a required competency in pathology resident education. In the laboratory set ... Full text Link to item Cite

Cervical Cancer, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology.

Journal Article J Natl Compr Canc Netw · January 2019 Cervical cancer is a malignant epithelial tumor that forms in the uterine cervix. Most cases of cervical cancer are preventable through human papilloma virus (HPV) vaccination, routine screening, and treatment of precancerous lesions. However, due to inade ... Full text Link to item Cite

Evolving Roles of Histologic Evaluation and Molecular/Genomic Profiling in the Management of Endometrial Cancer.

Journal Article J Natl Compr Canc Netw · February 2018 Endometrial cancers are the most common gynecologic malignancies. The staging of endometrial cancer has evolved from a clinical-based system to a comprehensive surgical-pathologic approach that allows for better risk stratification and treatment planning. ... Full text Link to item Cite

Uterine Neoplasms, Version 1.2018, NCCN Clinical Practice Guidelines in Oncology.

Journal Article J Natl Compr Canc Netw · February 2018 Endometrial carcinoma is a malignant epithelial tumor that forms in the inner lining, or endometrium, of the uterus. Endometrial carcinoma is the most common gynecologic malignancy. Approximately two-thirds of endometrial carcinoma cases are diagnosed with ... Full text Link to item Cite

An Assessment of Pathology Resident Access to and Use of Technology: A Nationwide Survey.

Journal Article Arch Pathol Lab Med · March 2017 CONTEXT: - Current technologies including digital slide scanners and handheld devices can revolutionize clinical practice and pathology graduate medical education (GME). The extent to which these technologies are used in pathology GME is unknown. OBJECTIVE ... Full text Link to item Cite

Pathology's Stepchild.

Journal Article Arch Pathol Lab Med · February 2017 Full text Link to item Cite

A meaningful MESS (Medical Education Scholarship Support).

Journal Article Med Educ Online · 2016 BACKGROUND: Graduate medical education faculty bear the responsibility of demonstrating active research and scholarship; however, faculty who choose education-focused careers may face unique obstacles related to the lack of promotion tracks, funding, caree ... Full text Open Access Link to item Cite

A meaningful MESS (Medical Education Scholarship Support).

Journal Article Med Educ Online · January 2016 Background Graduate medical education faculty bear the responsibility of demonstrating active research and scholarship; however, faculty who choose education-focused careers may face unique obstacles related to the lack of promotion tracks, funding, career ... Full text Link to item Cite

Prognostic significance of differential expression of angiogenic genes in women with high-grade serous ovarian carcinoma.

Journal Article Gynecol Oncol · October 2015 OBJECTIVES: To identify angiogenic biomarkers associated with tumor angiogenesis and clinical outcome in high-grade serous ovarian cancer (HGSC). METHODS: 51 HGSC samples were analyzed using Affymetrix HG-U133A microarray. Microvessel density (MVD) counts ... Full text Link to item Cite

Image-guided fine-needle aspiration of secondary pancreatic neoplasms: A case series and review of the literature

Journal Article Pathology Case Reviews · July 10, 2015 Background Endoscopic ultrasound-guided fine-needle aspiration (FNA) has become a well-established diagnostic method for evaluation of focal lesions in the pancreas. While the majority of malignant lesions evaluated are primary pancreatic adenocarcinomas, ... Full text Cite

Extramedullary plasmacytoma of the gallbladder diagnosed by endoscopic ultrasound fine needle aspiration (EUS-FNA).

Journal Article J Gastrointest Oncol · April 2015 Extramedullary plasmacytoma (EMP) is a rare entity that can exist independently or in conjunction with underlying plasma cell myeloma (PCM). When there is underlying multiple myeloma, the presence of EMP portends a poor prognosis. The most common locations ... Full text Link to item Cite

An Innovative Interactive Modeling Tool to Analyze Scenario-Based Physician Workforce Supply and Demand.

Journal Article Acad Pathol · 2015 Effective physician workforce management requires that the various organizations comprising the House of Medicine be able to assess their current and future workforce supply. This information has direct relevance to funding of graduate medical education. W ... Full text Link to item Cite

Lesions of the Bartholin gland: a review.

Journal Article J Low Genit Tract Dis · October 2014 Most lesions of the Bartholin gland are cysts or abscesses. Clinicians are taught that lesions of the Bartholin gland occurring in older women should raise the differential diagnosis of malignancy, although these are uncommon. A variety of more unusual and ... Full text Link to item Cite

Relationship between minimally invasive hysterectomy, pelvic cytology, and lymph vascular space invasion: a single institution study of 458 patients.

Journal Article Gynecol Oncol · May 2014 OBJECTIVE: The aim of this study is to determine whether a minimally invasive approach to hysterectomy is associated with an increased rate of lymph vascular space invasion (LVSI) and/or malignant pelvic peritoneal cytology in endometrial cancer. METHODS: ... Full text Link to item Cite

Obesity is associated with worse overall survival in women with low-grade papillary serous epithelial ovarian cancer.

Journal Article Int J Gynecol Cancer · May 2014 OBJECTIVE: The objective of this study was to evaluate prognostic risk factors for survival in women with low-grade serous epithelial ovarian cancer (LGSC). METHODS: A multicenter retrospective analysis of patients with LGSC was conducted. Potential epidem ... Full text Link to item Cite

Lesions of the bartholin gland: A Review

Journal Article Journal of Lower Genital Tract Disease · 2014 © 2014, American Society for Colposcopy and Cervical Pathology.Most lesions of the Bartholin gland are cysts or abscesses. Clinicians are taught that lesions of the Bartholin gland occurring in older women should raise the differential diagnosis of maligna ... Cite

Pathologist workforce in the United States: I. Development of a predictive model to examine factors influencing supply.

Journal Article Arch Pathol Lab Med · December 2013 CONTEXT: Results of prior pathology workforce surveys have varied between a state of equilibrium and predictions of shortage. OBJECTIVE: To assess the current and future supply of pathologists, and apply a dynamic modeling tool for assessing the effects of ... Full text Link to item Cite

Pulmonary alveolar proteinosis.

Journal Article Diagn Cytopathol · July 2013 Full text Link to item Cite

What are the pathology education requirements for all nonpathology ACGME-accredited programs in an academic center?

Journal Article Am J Clin Pathol · September 2012 This study aimed to determine institution-wide graduate medical education (GME) requirements in pathology (exclusive of pathology residency and fellowships) at an academic center. All documents related to residency review committee (RRC) program requiremen ... Full text Link to item Cite

Vagina

Chapter · July 16, 2012 Cite

Malignant struma ovarii: a blinded study of 86 cases assessing which histologic features correlate with aggressive clinical behavior.

Journal Article Arch Pathol Lab Med · February 2012 CONTEXT: Struma ovarii exhibiting malignant histology are uncommon, and an aggressive clinical course in the form of initial extraovarian spread or recurrence is even more exceptional for these tumors. OBJECTIVE: To determine whether specific histologic fe ... Full text Link to item Cite

Recent developments in defining microinvasive and early invasive carcinoma of the uterine cervix.

Journal Article J Low Genit Tract Dis · April 2011 Although only a small proportion of invasive squamous carcinoma of the cervix present with microinvasive disease, consistent recognition of this entity is important because it carries important management implications. The objective of this review was to r ... Full text Link to item Cite

Thyroid carcinoma showing thymus-like differentiation (CASTLE): case report with cytomorphology and review of the literature.

Journal Article Diagn Cytopathol · March 2011 Thyroid carcinoma showing thymus-like differentiation (CASTLE) is a rare tumor of the thyroid gland or adjacent soft tissues of the neck. Given the comparatively good prognosis of CASTLE, it is crucial to distinguish this neoplasm from other more aggressiv ... Full text Link to item Cite

Endoscopic ultrasound-guided fine-needle aspiration of intrathoracic and intra-abdominal spindle cell and mesenchymal lesions.

Journal Article Cancer Cytopathol · February 25, 2011 BACKGROUND: The role of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in the evaluation of spindle cell and mesenchymal lesions is unclear. This study reviews the use of EUS-FNA in diagnosing intrathoracic and intra-abdominal spindle and me ... Full text Link to item Cite

The oncotype DX recurrence score is correlated with a composite index including routinely reported pathobiologic features.

Journal Article Cancer Invest · November 2010 In a series of 177 breast carcinomas, we found that the Oncotype DX Recurrence Score (RS) was correlated with six pathobiologic features: estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 status, and the three component ... Full text Link to item Cite

Minocycline-induced black thyroid.

Journal Article Diagn Cytopathol · August 2010 Featured Publication Full text Link to item Cite

Anal-rectal cytology: a review.

Journal Article Diagn Cytopathol · July 2010 Featured Publication The incidence of invasive anal squamous cell carcinoma, a human papilloma virus (HPV) related cancer, is on the rise, especially in HIV positive men who have sex with men (MSM). Like cervical cancer, anal cancer is associated with precursor lesions detecta ... Full text Link to item Cite

Pathogenesis of endometriosis.

Journal Article Reprod Biomed Online · July 2010 Many theories have been proffered to explain the histogenesis of endometriosis (Robboy et al., 2009). Generally, they divide into those that favour transplantation of endometrial fragments to ectopic sites, metaplasia of the multipotential celomic peritone ... Full text Link to item Cite

Natural history of biologically malignant struma ovarii: analysis of 27 cases with extraovarian spread.

Journal Article Int J Gynecol Pathol · May 2010 The natural history of 27 cases of biologically malignant struma ovarii from a series of 88 cases of histologically malignant or histologically proliferative struma ovarii is described. The extraovarian spread was evident at presentation in 17 patients. Th ... Full text Link to item Cite

Anal-rectal cytology: correlation with human papillomavirus status and biopsy diagnoses in a population of HIV-positive patients.

Journal Article J Low Genit Tract Dis · April 2010 Featured Publication OBJECTIVES: We describe the cytological distribution of disease, correlate cytological diagnoses with human papillomavirus (HPV) DNA status and surgical biopsy diagnoses, determine if CD4 counts correlate with lesion severity, and compare anal-rectal data ... Full text Link to item Cite

Paget disease of the vulva: a study of 56 cases.

Journal Article Eur J Obstet Gynecol Reprod Biol · March 2010 OBJECTIVE: To resolve controversial issues regarding vulvar Paget disease through analysis of a substantial number of cases. STUDY DESIGN: The medical records and pathology slides of 56 patients with a diagnosis of vulvar Paget disease were reviewed. Possi ... Full text Link to item Cite

Ovarian cancer tumor infiltrating T-regulatory (T(reg)) cells are associated with a metastatic phenotype.

Journal Article Gynecol Oncol · March 2010 OBJECTIVE: The objective of this study was to examine the clinicopathologic correlates of T-regulatory (T(reg)) cell infiltration in serous ovarian cancers and to define gene signatures associated with high T(reg)s. METHODS: Tumor infiltrating T(reg) and c ... Full text Link to item Cite

Anal-rectal cytology: The other pap test

Journal Article Laboratory Medicine · March 1, 2010 Anal cancer screening programs are gaining momentum within the United States and Europe. The goal of such programs is to detect and eradicate human papillomavirus (HPV) related intraepithelial lesions of the anal canal before progression to invasive squamo ... Full text Cite

Paget Disease of the Vulva - A Study of 56 Cases

Conference LABORATORY INVESTIGATION · February 1, 2010 Link to item Cite

High poly(adenosine diphosphate-ribose) polymerase expression and poor survival in advanced-stage serous ovarian cancer.

Journal Article Obstet Gynecol · January 2010 OBJECTIVE: To estimate the range of poly(adenosine diphosphate [ADP]-ribose) polymerase expression in serous ovarian cancers and to determine whether expression is associated with response to therapy and outcome. METHODS: Immunostaining for poly(ADP-ribose ... Full text Link to item Cite

Paget disease of the vulva: a histologic study of 56 cases correlating pathologic features and disease course.

Journal Article Int J Gynecol Pathol · January 2010 The Duke experience with 56 vulvar Paget disease patients was analyzed emphasizing pathologic features and controversial issues. Nearly all patients were Caucasian, and their mean age was 69 years. The average length of follow-up was 5.6 years. For each ca ... Full text Link to item Cite

Visible light optical spectroscopy is sensitive to neovascularization in the dysplastic cervix.

Journal Article J Biomed Opt · 2010 Neovascularization in cervical intraepithelial neoplasia (CIN) is studied because it is the precursor to the third most common female cancer worldwide. Diffuse reflectance from 450-600 nm was collected from 46 patients (76 sites) undergoing colposcopy at D ... Full text Link to item Cite

Paget Disease of the Vulva - A Study of 56 Cases

Conference MODERN PATHOLOGY · 2010 Cite

Malignant struma ovarii: an analysis of 88 cases, including 27 with extraovarian spread.

Journal Article Int J Gynecol Pathol · September 2009 Struma ovarii that display extraovarian spread or later recurrence is exceedingly rare. Among 88 patients with "malignant" struma ovarii followed for prolonged periods, several features helped to predict the adverse clinical course. Adhesions (graded 2 to ... Full text Link to item Cite

A retroperitoneal bronchogenic cyst.

Journal Article Clin Gastroenterol Hepatol · August 2009 Full text Link to item Cite

p16 Improves interobserver agreement in diagnosis of anal intraepithelial neoplasia.

Journal Article J Low Genit Tract Dis · July 2009 Featured Publication OBJECTIVES: Evaluation of anal intraepithelial neoplasia (AIN) is subjective. Previous studies have shown p16 and Ki-67 expressions to correlate with AIN grade. Biomarkers like p16 and Ki-67 may improve interobserver agreement. The objectives were (1) to d ... Full text Link to item Cite

Quantitative physiology of the precancerous cervix in vivo through optical spectroscopy.

Journal Article Neoplasia · April 2009 Featured Publication Cervical cancer is the second most common female cancer worldwide. The ability to quantify physiological and morphological changes in the cervix is not only useful in the diagnosis of cervical precancers but also important in aiding the design of cost-effe ... Full text Link to item Cite

Independent prognostic relevance of microvessel density in advanced epithelial ovarian cancer and associations between CD31, CD105, p53 status, and angiogenic marker expression: A Gynecologic Oncology Group study.

Journal Article Gynecol Oncol · March 2009 OBJECTIVES: The aims of this study were to examine prognostic significance of microvessel density (MVD) in previously-untreated, advanced epithelial ovarian cancer (EOC) and explore associations between MVD and factors that affect angiogenesis. METHODS: MV ... Full text Link to item Cite

Endoscopic ultrasound-guided fine needle aspiration is useful for nodal staging in patients with pleural mesothelioma.

Journal Article Diagn Cytopathol · January 2008 Featured Publication Patients with malignant pleural mesothelioma and negative N2 stage lymph nodes may benefit from extrapleural pneumonectomy with adjuvant therapy. The objective of this study is to describe the use of EUS-FNA to determine N2 stage status in patients with me ... Full text Link to item Cite

Immunohistochemical expression of p16 and Ki-67 correlates with degree of anal intraepithelial neoplasia.

Journal Article Am J Surg Pathol · April 2007 Featured Publication Anal intraepithelial neoplasia (AIN) is a human papilloma virus related lesion. It has been shown that infection with high-risk human papilloma virus results in up-regulation of p16 and increased cellular proliferation. The objective of this study is to co ... Full text Link to item Cite

Wegener's granulomatosis of the uterine cervix: a case report and review of the literature.

Journal Article Int J Gynecol Pathol · January 2007 Featured Publication In this report, we present the case of a 32-year-old woman with Wegener's granulomatosis of the uterine cervix, review the literature, and discuss the differential diagnosis. ... Full text Link to item Cite

Incidence and clinical significance of morphologically benign-appearing endometrial cells in patients age 40 years or older: the impact of the 2001 Bethesda System.

Journal Article Cancer · February 25, 2006 Featured Publication BACKGROUND: The 2001 Bethesda System (TBS 2001) introduced a new diagnostic category-normal endometrial cells in women age 40 years or older (EM >or= 40). The objective of the current study was to determine whether there was any significant increase in the ... Full text Link to item Cite

A man with chronic leg edema, purpuric skin lesions, and abdominal lymphadenopathy.

Journal Article Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · August 2005 Cite

Preoperative diagnosis of a mediastinal granular cell tumor by EUS-FNA: a case report and review of the literature.

Journal Article Cytojournal · June 8, 2005 Featured Publication We report the first case of a posterior mediastinal granular cell tumor initially diagnosed on cytologic material obtained via endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in a 51-year-old male with a prior history of colon cancer. Aspirat ... Full text Link to item Cite