Washington University Experience

Foreward to "The Washington University Experience" - A Neuropathology Atlas

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I have obsessively collected neuropathologic images from cases generated on the neurosurgical, neuromuscular and neuroautopsy services at Washington University School of Medicine (WUSOM) since I began as a pathology resident in 1977. This project began with my review of gross Kodachrome slides which had antedated my joining the department (some by more than 35 years) and has continued for the better part of 45 years (and counting) to generate a teaching resource. Over the years a number of our fellows and colleagues have encouraged me to make the images available for their use on a Departmental website and, possibly, consider making the images available more generally using a website available to all. This is my intention.

By my count 47+ physicians have been/are fellows at WUSOM and contributed to this project since the advent of the Neuropathology Fellowship at WUSOM. Anatomic Pathology residents at WUSOM participated with their careful gross photography of specimens and organized storage within the department of Pathology and Immunology. It is beyond my capability here to thank each resident and fellow for their participation in this tome but it is clear that all who have been through the residency and neuropathology fellowship have made their own contribution. However, I would be remiss not to thank Mary Duncan, DVM for allowing me to use images I prepared from slides generated at the St Louis Zoo veterinary pathology service. Before the advent of digital photography, Mike Kissane, Margaret McHugh, Walter Clermont and Louise Schoelch formed the photography group and, in no small part contributed to the excellent chronicling of our cases. Over many years the excellent work by the Electron Microscope Facility at WUSOM has enriched the presentation of pathology. Although many have participated, Karen Green, Lucie Beaudet, Lisa Snipes, Stephanie Lawson, Tom Cline, Chris Dunham, Kevin Boyer and the late Santiago Plurad are to be thanked in particular.

Finally, I have been assisted in this process by many colleagues at WUSOM and Saint Louis University School of Medicine who have over the years brought cases to my attention or shared glass slides sent to them as consults or for their interest (particularly Drs. Nigel Cairns, Steven Carroll, Joe Corbo, Sonika Dahiya, Chris Dunham, Miguel Guzman, William Hickey, Kyle Hurth, Beth Levy, John Morris, James Nelson, Richard Perrin, Arie Perry, Alan Pestronk, Kevin Roth, Kate Schwetye, Pang-Hsein Tu and Richard Torack). I have thanked others for contribution of individual cases. Thus, some cases originating elsewhere have made it into the "Washington University Experience". I have included rare images gifted to me by colleagues not at WUSOM; cases which have been part of the American Association of Neuropathologists diagnostic slide session; as well as rare cases of unknown origin. We have been blessed over the years with the help of collegial neuroradiologists (Drs. Jay Wippold, Moktar Gado, Aseem Sharma, Katie Vo, Michelle Miller-Thomas and their fellows)

Particular thanks to Jonathan Bihr for setting up the software and trouble shooting computer issues. Our administrative assistant Jordana Stewart has been invaluable to the production of this ATLAS. Takisha Patrick of Iron Mountain storage in Saint Louis has found old cases which required her special commitment.

I have extensively used and am indebted to a number of excellent references in constructing this neuropathology atlas:
1. WHO Classification of CNS Tumors (2021) - Online and Print (particularly the organization of tumor presentation and creation of introductory blurbs)
2. Perry and Brat (2017) - Practical Surgical Neuropathology: A Diagnostic Approach
3. Ellison and Love (2013) - Neuropathology: A Reference Text of CNS Pathology

The cases comprising this atlas have been accumulated over more than 75 years. It is not possible to revisit all the older cases and provide a modern molecular genetic analysis or detailed characterization. Perhaps the value of these cases lies in features that are timeless, translatable without molecular access and providing a histopathologic jumping off point for current and future discussions and eventual molecular interpretation. All data collected fairly, even if interpreted initially in an archaic system, maintains its timelessness.

RE Schmidt

The Knight ADRC has been a significant resource for making available cases of Neurodegenerative disease in their files and the exceptionally careful and detailed workups of their cases by Drs. Nigel Cairns and Richard Perrin incorporated in this atlas deserve special thanks. Similarly, Aime Burns and Erin Franklin deserve special thanks for their dedication to this atlas. They are supported by the following grants P01 AG03991, P30 AG066444 and P01 AG026276. Investigators interested in obtaining tissue samples may apply through the Knight ADRC Resource Request website (https://knightadrc.wustl.edu/professionals-clinicians/request-center-resources/submit-a-request/)

Copyright Notice: 2016-2024 Robert E Schmidt, MD, PhD. All rights reserved. Documents, including gross and microscopic images, HTML text files, and graphics at this website (The Washington University Experience), are meant for education and enjoyment, and it is my sincere desire that they be used and widely disseminated for these purposes. I therefore invite people to use these images in Powerpoint presentations, publications, etc. My only request is that the source of the image be acknowledged ("Image courtesy of Robert Schmidt") wherever it is presented.

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