Tamara Lotan, MD Profile
Tamara Lotan, MD

@LotanLab

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Molecular pathologist with focus on prostate cancer. Johns Hopkins University.

Joined May 2019
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@LotanLab
Tamara Lotan, MD
3 years
Beautiful #tweetorial on intraductal and cribriform PCa from @rovingatuscap . While both seem to be associated with aggressive PCa, it is important to note that these can be difficult or impossible to distinguish without immunostains and this has been a confounder. #ProstateJC
@rovingatuscap
Samson W. Fine, MD
3 years
Spectrum of Intraductal Carcinoma of the Prostate (IDC-P) is broader: Most common definition: Expanded intraductal proliferation w/either: ➡️dense cribriform/solid architecture ➡️loose cribriform/micropapillary architecture +marked atypia +/- necrosis #prostateJC #gupath
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@LotanLab
Tamara Lotan, MD
3 years
This study raises the interesting question of the extent to which PCa morphology is associated with underlying genomic alterations. To date, there are no known architectural patterns that are invariably associated with specific underlying genomic changes.
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@LotanLab
Tamara Lotan, MD
3 years
Rather, it seems that some morphologies such as IDC-P and cribriform carcinoma are more generally associated with underlying genomic alterations seen in aggressive disease, such as PTEN or BRCA2 loss.
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@LotanLab
Tamara Lotan, MD
2 years
@Chucktowndoc @rovingatuscap @IHC_guy @daniel_berney @Williamson_SR @fabiotavora @PathDocBoston Lost in about 80% of NEPC cases in our experience. We have definitely seen NEPC cases with retained expression even when PSA is negative. Usually AR still positive in these cases as well.
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@LotanLab
Tamara Lotan, MD
3 years
In this study with @Ecastromarcos we used IHC for basal cells to distinguish IDC-P and invasive cribriform carcinoma. Interestingly, both were associated with bi-allelic BRCA2 mutations. #ProstateJC
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@LotanLab
Tamara Lotan, MD
3 years
This contrasts with other tumor types such as renal cell carcinoma where the appearance under the microscope may be highly predictive of the underlying genomic drivers (eg, VHL loss in clear cell renal cell carcinoma)
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@LotanLab
Tamara Lotan, MD
4 years
@rovingatuscap @lalpritu We’ve found it is possible to standardize staining and reporting with the CST D4.3 clone, the BenchMark and a simple dichotomous scoring system. BUT there are rare cases of HGPIN with loss and the natural history of these lesions is uncertain, so it is difficult to be definitive
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@LotanLab
Tamara Lotan, MD
1 year
@ModernPathology @JHUPath Thrilled to join this stellar team!
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@LotanLab
Tamara Lotan, MD
3 years
@fabiotavora Great question. Homozygous PTEN deletion was significantly more common in cases with gBRCA2 mutations than controls (42% vs 27%). Though we don’t know whether the second hit to BRCA2 occurs before or after PTEN loss. #prostatejc
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@LotanLab
Tamara Lotan, MD
1 year
@GladellPaner @drmehrarohit We have a new mouse model of SFPQ-TFE3 carcinoma with very similar bi-phasic pattern—would be interested to know fusion partner in this case!
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@LotanLab
Tamara Lotan, MD
2 years
@brady_urology @allaf_mo @HopkinsMedicine Congratulations, Mo! So excited to see what the next era of Brady Urology will bring!
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@LotanLab
Tamara Lotan, MD
1 year
@OSU_Urology @Sood11 @ctleeuro @OSUWexMed @OSUCCC_James Congrats, Akshay! So proud of all you have accomplished!!
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@LotanLab
Tamara Lotan, MD
2 years
@FKhaniPath @uroegg Agree. No PTEN loss in isolated HGPIN, nor is it an invasive lesion as is GG1 PCa.
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@LotanLab
Tamara Lotan, MD
2 years
@fabiotavora @01sth02 @Chucktowndoc We were just babies ourselves!
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@LotanLab
Tamara Lotan, MD
1 year
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@LotanLab
Tamara Lotan, MD
3 years
@daninava Yes! They seem to be associated with high rate of underlying pathogenic mutations in DNA repair genes (HR and MMR) though the rates differ a bit by center, likely due to differences in how pathologists identify ductal CA.
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