Tribute to Brian T. Collins, MD

Volume LIV | Number 2

March 2017 T h e A S C B u l l e t i n ® i s p u b l i s h e d b y t h e A m e r i c a n S o c i e t y o f C y t o pat h o l o g y

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Tribute to Brian T. Collins, MD

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Case Study: Posterior Auricular Mass in a 34 Year Old Woman

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Case Study: A 58 Year Old Male with a Right Hepatic Lobe Mass

VIII Gynecologic Cytology-Histology Correlation Guideline XIV Cyto-econference – March 2017 XV

Cyto-econference Series 2017–2018

XVI Book Review: Practical Cytopathology: A Diagnostic Approach to Fine Needle Aspiration Biopsy

Tribute to Brian T. Collins, MD On December 23, 2016, the profession of cytopathology lost a highly respected colleague, mentor, teacher, leader and friend.

Brian T. Collins, MD

Dr. Brian T. Collins completed his pathology residency at Indiana University and was Associate Professor and Section Head of Cytopathology at Washington University in St. Louis. He was the Cytopathology Fellowship Program Director at Barnes-Jewish Hospital and Medical Director of the Cytotechnology Program at Saint Louis University. Dr. Collins was a proponent of new practice paradigms including telepathology and used evidenced based research to advocate for ROSE FNA biopsy service. He published 120 peer-reviewed journal articles, 75 abstracts and book chapters. As an educator, he presented at national workshops, ASC Annual Scientific Meetings and teleconferences. Dr. Collins joined the ASC as a resident member and consistently participated in ASC Annual Scientific Meetings. He was the Chair of the Scientific Program Committee and an Executive Board member. Brian is survived by his wife and five children. Some of us who were fortunate to know Brian through our daily work, committee involvement and/ or through our shared interests in technology or sports share our thoughts on what Brian meant to us, our profession and his tireless efforts to improve the lives of patients.

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D He carried an aura of grace that encompassed the people around him. Matters always seemed to move more smoothly when Brian was involved.

r. Brian Collins joined the Washington University School of Medicine and the cytopathology laboratory of Barnes-Jewish Hospital in St. Louis in the latter part of 2010. Within a very short time he began to make significant changes in the day-to-day activities of the lab and in the long-term projection of the entity within the greater cytology community. His was a “work in progress” as he never stopped adapting and implementing newer methods of providing service to the clinicians. In the busy environment of the lab, it was not always possible to have long conversations or discussions with him. But he was always forthcoming and helpful whenever he was approached regarding any academic or continuing education topic. I will never forget the time in 2012 when I asked him to be a referee for my cytotechnology fellowship application of the IAC. Even though he had only known me for a short time, he readily agreed. When I received my CFIAC credentials, he was one of the first faculty members to congratulate me. Later on, when I became President of the St. Louis Society of Cytology, he was always there for us with his advice on several meeting related issues. When Dr. Ed Cibas could not attend our 2016 meeting due to a family emergency, Dr. Collins stepped in for him the moment he was asked. Just this past November, I told Dr. Collins I would speak to him about my IAC Tutorial presentation in Abu Dhabi in December, which he helped me prepare. Unfortunately that opportunity never came! – Ranjit Sarkar, CT(ASCP),CFIAC, Barnes-Jewish Hospital, St. Louis, Missouri To see the trajectory of a firework cut short before it reaches its zenith is disturbing. One never gets to see the illumination at its fulfillment. To lose a comrade like Brian is grievous. He was already a leader in cytopathology and was on track to help direct our Society and profession towards the second quarter of the century, but chance took him from us. The loss of Brian is incalculable, as a voice for cytopathology, as a scholar, as a pathologist, as a co-conspirator for modern technology, but especially as a friend. Always calm with an easy smile,Brian created many fond memories for those of us who knew him. Characteristically professional and appropriate, but capable of loosening up over a beer to celebrate his heritage and his companions. I distinctly remember a bizarre green and white top hat with decorator shades for St. Patrick’s Day. He carried an aura of grace that encompassed the people around him. Matters always seemed to move more smoothly when Brian was involved. Committee work for the College of American Pathologists, the American Board of Pathology and the American Society of Cytopathology were significantly enhanced by his contributions. The couple of presentations that we did together were seamless and enjoyable. Brian accomplished a lot in the time that was allotted to him. We would all be fortunate to be so fondly remembered. – Daniel Kurtycz, MD, University of Wisconsin, Madison, Wisconsin Brian was the epitome of a collaborator as he easily connected with people. Even with those he disagreed he remained affable and respectful to their opinions while voicing his own thoughts. He could discuss ROSE- FNA, telecytology as easily and enthusiastically as parenting, sports and office organization habits during a scientific platform. How incredibly rewarding to adore a colleague not only for his intellect but also for his character. Brian poured himself into the ASC and had already set to work planning the 2017 Annual Scientific Meeting as the Chair of the Scientific Planning Committee, a position and charge he II

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was honored and thrilled to hold. This untimely death leaves a huge gap in our cytology family. This next Meeting we will honor him by emulating his embracing charm and fostering new relationships with younger cytologists. –K  risten Atkins, MD, University of Virginia, Charlottesville, Virginia

As a cytopathologist, Brian donated his time and work generously to both organizations and was quickly selected for leadership positions

Every time I returned from a pathology meeting (ASC, ASCP, USCAP, etc.) where I met up with Brian, I would receive a friendly email from him very soon afterwards mentioning how it was great for us to catch up in person. He was an outstanding professional and gentleman. I know he sent similar emails to other pathologists. Many times when I came up with a good idea for a study/project in cytopathology to work on, I would first check PubMed to see if anyone else had published on this topic. Several times I found that Brian had beaten me to it and did an awesome job at it. Brian was one of those people who “walked the walk, not just talked the talk.” His embrace of telecytology is a great example. While most people perseverated over using it (and some still are), Brian had done over 1000 rapid on-site evaluation (ROSE) cases like this already. Brian was also one of those committed committee members who always showed up (in person or on calls) and made valuable contributions. Whenever I was assigned to a committee or had to chair one and Brian was involved, I knew that we’d get the job done. I guess I saw him as the “glue” that helped keep people together without (seemingly) much effort. – Liron Pantanowitz, MD, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania

because of his personal integrity and work ethic.

On behalf of the American Society of Cytopathology (ASC) and the College of American Pathologists (CAP), I would like to express our sincere remorse at the loss of an esteemed colleague and wonderful person, Brian Collins, MD. As a cytopathologist, Brian donated his time and work generously to both organizations and was quickly selected for leadership positions because of his personal integrity and work ethic. The ASC was particularly fortunate to have Brian elected to the Executive Board last year. As the CAP Chair of the Cytopathology Committee, I had to select new committee members each year. It is not unusual for other CAP members to recommend people they know who would be a good fit to the committee. It takes a unique blend of sacrifice, generosity, teamwork, motivation, and creative use of personal time to be a committee member for either organization. The time commitment can be quite demanding. When Brian applied for the position, I was inundated with phone calls and email singing his praises and highly recommending him to the position. Initially I thought to myself, “Boy, this guy really knows how to run an effective campaign!” and it was almost a little off-putting. How could anyone be that great? He had his own fan club! I had never had this experience with any other candidate. What I didn’t know until later, after he had been selected, was that these recommendations were entirely unsolicited and in fact, he was encouraged by his friends and colleagues to apply for the position. As a new member, he unabashedly contributed his wisdom and judgment to our difficult problems and volunteered to work on the on-line educational products from the first meeting. He was so effective with his work in the first year that I selected him to be in charge of an online educational module as the “uber editor.” He made the work seem effortless. Brian had extensive background in education and teaching, which was also recognized by the ASC, III

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and he was selected as Chair of the Scientific Program Committee, arguably one of the hardest working committees in the ASC. He had already spent several years previously orchestrating the ASC e-conferences with great success and being very active as a member in many other ways. But what really made Brian so special was his warm, humorous and intellectual personality. I loved to sit by him at the CAP dinners because I could be assured of an interesting, thought-provoking conversation. He was a very modest individual who had a naturally positive disposition, and he was often an advocate for the “other side,” even if it was not his side. He was exceedingly fair and thoughtful, a warm individual who always remembered details about your family and had a sincere interest in how you and they were doing. He was eager to help others, whether it was recommending good restaurants or vacation spots, writing articles, brain-storming research ideas, or just giving a lift to the airport. He has left a strong legacy in his wake; his work has improved education and women’s health through his consistency and high quality. It is still so hard to believe that he is gone and even harder to imagine our organizations without him. I know that I speak for many others in our organization when I say that some people are just not replaceable and Brian was certainly one of them.

He was exceedingly fair

– Barbara A. Crothers, DO, President-Elect, American Society of Cytopathology and Past Chair, Cytopathology Committee, College of American Pathologists

and thoughtful, a warm individual who always remembered details about your family and had a sincere interest in how you and they were doing.

As a neophyte on the College of American Pathology Cytopathology (CAP) Committee in January 2015, along with my “assigned mentor,” Dr. Daniel Kurtycz, Brian was an invaluable resource to “show me the ropes.” While all the veteran members were mentors to us “younger” members, Brian was a mentor to me, on and off the Committee. He was gentlemen and a scholar, the rare mix of intelligence, calm, modesty, patience, wit, sense and a willingness to do more for you than you could return for him. A person of integrity and honor. A mensch among mensch. After every Committee meeting or USCAP or ASC, Brian would always send a “nice to see you” e-mail about chatting in Chicago, Florida or Canada. He said he looked forward to the next time we would see each other. He sent one shortly after the ASC Annual Scientific Meeting this year. Unfortunately, we will not see each other again. I assumed one day, not so far from today, that I would own a two-volume textbook on Cytopathology, its practices and principles, edited by Dr. Collins. He had the passion, fortitude, skill, strength and political savvy a multi-author textbook editor takes to get published. And he would have been the first one to volunteer to edit the second edition without hesitation. I just saw Brian last November at the ASC Annual Scientific Meeting in New Orleans where he and I presented on the use of real-time video technology for cytopathology, an area of interest we shared and a topic I considered Brian an expert in; he was a long-time advocate of rapid onsite evaluations for fine needle aspirations (ROSE FNA) to provide high quality patient care at the bedside. I think he recognized the importance of this before many of his contemporaries, fully recognizing it would take additional time, resources and costs to do so, but it was the right thing to do by patients. He practiced what he preached and taught his fellows and residents to do the same as Head of Cytopathology and Fellowship Program Director at Washington University School of Medicine and Medical Director of Cytopathology at Barnes-Jewish hospital in St. Louis. When we saw each other in New Orleans last November, just days after the World Series, Brian reminded me that his Cardinals still had more World Series victories than my Cubs. We talked about seeing a Cubs-Cardinals game this Spring or Summer. Or perhaps a playoff game between our teams this Fall. To my favorite Cardinals fan, you will be missed by those of us who were fortunate to know you. – Keith J. Kaplan, MD, Wake Forest School of Medicine, Winston-Salem, North Carolina IV