Jimmie Stewart, III, MD

Associate Professor, Department of Laboratory Medicine and Pathology

Jimmie Stewart, III

Contact Info

jstewart@umn.edu

Office Phone 612-273-5758

Mailing Address:
Anatomic Pathology
MMC 76 Mayo
8076A (Campus Delivery Code)
420 Delaware St SE
Minneapolis, MN 55455

MD, University of Arkansas for Medical Sciences, 1992

University of Kentucky (Anatomic Pathology/Clinical Pathology), 1996-2000

University of Arkansas for Medical Sciences (Post-Sophomore Fellowship in Pathology), 1989-1990

University of Arkansas for Medical Sciences (Transitional Internship), 1992-1993

University of Wisconsin-Madison (Cytopathology), 2000-2001

University of Pittsburgh Medical Center (Informatics), 2001-2002

BS, University of Arkansas, Fayetteville, 1987

Summary

Dr. Stewart is an anatomic and clinical pathologist with research interests in cytopathology, telepathology, and improved diagnostic utility of fine-needle aspiration (FNA) cytology, a diagnostic technique used to sample cellular material from superficial and deep masses. These efforts involve finding better ways of delivering advanced patient care using deep FNAs to obtain biopsy material.They also involve telepathology in which cytotechnologists, residents, and fellows working with clinicians at one site can prepare specimens and transmit images for cytopathologists at another site to analyze in real time and render a preliminary diagnosis.This is also known as telecytopathology.

Professional Associations

  • Group for Research in Pathology Education
  • American Society of Cytotechnology
  • United States and Canadian Academy of Pathology
  • American Society of Cytopathology
  • College of American Pathologists
  • American Society of Clinical Pathology

Research

Research Summary/Interests

Stewart has participated in validation studies of telecytopathology including a retrospective one that combined mostly ultrasound-guided fine-needle aspiration of thyroid and head and neck lesions and real-time images of stained cytology smears.These images were transmitted via a secured virtual private network by cytotechnologists to cytopathologists who made a preliminary diagnosis. The results showed a high degree of concordance between the preliminary diagnosis based on telecytopathology and review of slides via direct microscopy after an appropriate “wash out” period of at least two weeks.

In Stewart’s view, telecytopathology has the potential to enhance the efficient use of time and resources for cytopathologists as well as provide more timely diagnosis for patients.Although telecytopathology has achieved diagnostic quality resolution, each telepathology protocol is subject to careful study and must undergo and pass a validation process to be approved for general use in the field as per College of American Pathology (CAP) checklists and Center for Medicare and Medicaid Services (CMS) regulations.Potential obstacles include patient identifiable data security during image transmission, adapting to advances in technology such as whole-slide scanning in multiple-planes (3D), and narrowing differences in “locator skills” among cytotechnologists.These locator skills involve locating and highlighting the parts of the transmitted image that merit the attention of the cytopathologist.

Dr. Stewart sees continuing progress in telecytopathology in light of advances in technology, changes in the practice of medicine that emphasize efficiencies, cost savings, and improved clinical outcomes, and the incorporation of telepathology into the training of pathology residents and fellows.He will be involved in these efforts as well as efforts to incorporate advances in fine-needle aspiration cytology into molecular diagnostics and resident and fellowship training.

Publications

  • Vahidi S, Stewart J, Amin K, Racila E, Li F. Metastatic medullary thyroid carcinoma or calcitonin-secreting carcinoid tumor of lung? A diagnostic dilemma in a patient with lung mass and thyroid nodule. Diagnostic Cytopathology. 10 Nov 2017, DOI: 10.1002/dc 23852 http://onlinelibrary.wiley.com/doi/10.1002/dc.23852/full
  • Vahidi S, Amin K, Stewart, J 3rd, Laryngeal Chondrosarcoma mimicking medullary thyroid carcinoma on fine needle aspiration cytology: A case report of a diagnostic pitfall, EARLY VIEW Online Diagn. Cytopathol. June 2017 http://onlinelibrary.wiley.com/doi/10.1002/dc.23764/full
  • Sekulic M, Amin K, Mettler, T, Miller LK, Mallery, S, Stewart J 3rd, Pancreatic involvement by metastasizing neoplasms as determined by endoscopic ultrasound-guided fine needle aspiration: a clinicopathologic characterization, Diagn. Cytopathol. 45(5)pp 418–425, May 2017 https://www.ncbi.nlm.nih.gov/pubmed/28205397
  • Sekulic M, Gilles S, Amin K, Stewart Jimmie III. Undifferentiated (anaplastic) carcinoma with osteoclast-like giant cells of the pancreas: a series of 5 cases with clinicopathologic correlation and cytomorphologic characterization. J Amer Soc Cytopath 2016. DOI: http://dx.doi.org/10.1016/j.jasc.2016.04.003.
  • Wotruba AL, Stewart J, 3rd, Scheberl T, Selvaggi SM. (2011) Added value, decreased cost: The evolving role of the cytotechnologist for preliminary screening and triage of thyroid aspirates. Diagn Cytopathol 39(12): 896-9. Concept
  • Bixler HA, Castro MJ, Stewart J, 3rd. (2011) Cytologic differentiation of squamous elements in the pancreas. Diagn Cytopathol 39(7): 536-9; quiz 9-40.
  • Tyler KL, Selvaggi SM, Stewart J, 3rd. (2011) Pneumocystis jirovecii in a bronchoalveolar lavage specimen on ThinPrep(R) cytology. Diagn Cytopathol 39(9): 675-6.
  • Xiao J, Selvaggi SM, Leith CP, Fitzgerald SA and Stewart J 3rd. (2013) Kaposi Sarcoma Herpesvirus/Human Herpesvirus-8–Negative Effusion-Based Lymphoma: Report of 3 Cases and Review of the Literature. Cancer Cyto. 2013 Nov;121(11):661-9.
  • Moore M, Stewart J 3rd. Cytologic Diagnosis of Esophageal Glomus Tumor Presenting as an Incidental Posterior Mediastinal Mass in an 80-Year Old Male. Diagn Cytopathol. 2013 Jul 27 [Epub ahead of print]
  • Kasper K, Stewart J 3rd, Das KFine Needle Aspiration Cytology of Thyroid Nodules with Hürthle Cells: Cytomorphologic Predictors for Neoplasms, Improving Diagnostic Accuracy and Overcoming Pitfalls. Acta Cytologica Vol. 58, No. 2 2014: 145-152,
  • Barasch S, Choi M, Stewart J 3rd, Das KSignificance of Atypical Category in Voided Urine Specimens prepared by liquid based technology: Experience of a Single Institution, JASC, In Press, Corrected Proof, Available online 30 October 2013
  • McMahon RQ, McCarthy EE, Hetzel SJ, Das K, Stewart J 3rd, Focus on Technology, How Important is Resolution in Telecytopathology, Cancer Cyto. Feb 2014 IN PRESS ACCEPTED,
  • McCarthy EE, McMahon RQ, Das K, Stewart J 3rd, Internal Validation Testing For New Technologies: Bringing Telecytopathology Into The Mainstream" IN PRESS ACCEPTED TO Diagn. CytopathoL. MAY 2014 Concept 100%, Design 90%, Barasch S, Zhanhai L,Stewart J 3rd,Telepathology for Frozen Section: Validation and Quality Metrics, SUBMITTED TO American Journal of Clinical Pathhology, JAN 2015

Teaching

Academic Interests and Focus

Director, Cytopathology Fellowship Program

Clinical

Board Certifications

  • Anatomic and Clinical Pathology, American Board of Pathology
  • Cytopathology, American Board of Pathology for Cytopathology