About

Thomas John Cummings is a Professor of Pathology and a Professor of Ophthalmology at Duke University. He is also a member of the Duke Cancer Institute. His professional roles are based at the Duke South Hospital in Durham, North Carolina, where he is associated with the Davison Building in the Green Zone. His contact email is thomas.cummings@duke.edu. The page indicates his involvement in the academic and clinical activities of the Duke Department of Pathology, contributing to education, research, and patient care within these fields.

Research topics

• Medicine
• Biology
• Botany
• Food science
• Ecology
• Pathology
• Bioinformatics
• Psychology
• Medical education
• Pedagogy
• Oncology
• Internal medicine

Selected publications

• Visually significant corneal deposits associated with rifabutin therapy for Bartonella henselae

  American Journal of Ophthalmology Case Reports · 2026-04-20 · 1 citations

  articleOpen accessSenior author

  To report the clinical and histopathological features of a case of visually significant corneal deposits due to rifabutin therapy used to treat Bartonella henselae . A 73-year-old male with a history of recurrent bartonellosis on rifabutin therapy presented with glare and haloes in both eyes. Slit lamp examination showed pigmented corneal deposits, higher in density and larger in size in the periphery than the center. Rifabutin was discontinued, but the corneal deposits and visual symptoms persisted more than one year later. The patient underwent a penetrating keratoplasty of the left eye. Histopathologic evaluation of the cornea revealed focal tan-golden round/granular-like deposits in the deep corneal stroma and in rare endothelial cells. There was no evidence of inflammation. This case illustrates the histopathologic features of rifabutin-induced corneal deposits, providing novel insights about the pathophysiology of these deposits. Clinicians should be aware that rifabutin is a potential treatment for bartonellosis, and that rifabutin can cause visually significant corneal deposits. Multidisciplinary management is crucial for patients with corneal deposits associated with rifabutin therapy. • Rifabutin can cause visually significant corneal deposits. • Histopathology localizes these deposits to the deep stroma. • The corneal deposits may be due to the high lipid solubility of rifabutin. • Rifabutin is a potential treatment for Bartonella infections. • Management of associated corneal deposits requires multidisciplinary collaboration.

  PublisherDOI

• The design and initial service evaluation of a virtual tour of a radiotherapy department to improve patient experience

  Journal of Radiotherapy in Practice · 2025-01-01

  articleOpen access

  Abstract Introduction: For any patient’s cancer journey, effective communication and helpful information are key to staying informed and reducing anxiety; for radiotherapy, ideally before treatment commencement. This paper details the initial design and service evaluation of a virtual tour (VT) aimed at familiarising patients with the department before treatment starts. Methods: Created by local digital science students, with input from hospital Patient Public Involvement groups, patients were recruited (after their initial planning visit) into non-VT and VT groups; the latter viewing the VT before their first treatment. Both groups completed identical online surveys with Likert-style questions and free-text entry to assess knowledge and understanding. Results: Twenty-three completed survey responses were received: 9 and 14 from the non-VT and VT groups, respectively. • 66.7% of the non-VT group felt anxious attending the department for the first time; compared with 28.6% in the VT group. Key comments included ‘not now that I’ve seen the video’ • 92.9% of the VT group understood the queue calling and changing room systems compared with 55.6% in the non-VT group. • 85.7% of the VT group knew what to expect in the treatment room, compared to 33.3% in the non-VT group. Key comments included ‘the video helped’. Other comments included ‘excellent idea’ and ‘alleviates the concerns about where to go and what to expect ahead of that first visit’. Conclusion: The implementation of the VT has proved beneficial to patients, providing key information prior to treatment start, alleviating concerns and resulting in improved patient experience without the need for an extra visit.

  PublisherOA PDFDOI

• Patient-Reported Functional Outcomes and Quality of Life After Contact X-Ray Brachytherapy (CXB) in Organ-Preserving Management of Rectal Cancer

  Cancers · 2025-05-03

  articleOpen access

  Background/Objectives: With recent advancements in rectal cancer management leading to longer patient survival, the impact of various treatment approaches on patients’ quality of life (QOL) becomes an important focus of attention. While QOL studies exist for watch-and-wait after (chemo)radiation with/without local excision, data on health-related QOL (HRQOL) outcomes after contact X-ray brachytherapy (CXB) remain limited. This study evaluated functional and HRQOL outcomes in rectal cancer patients undergoing CXB and (chemo)radiation over one year. Methods: This prospective observational study (enrolment January–October 2023) with one-year follow-up assessed functional and HRQOL outcomes after CXB and (chemo)radiation using EORTC-QLQ-CR29, HADS, and EQ-5D-3L questionnaires. Longitudinal analyses were conducted using linear mixed-effects models, incorporating both fixed and random effects, following data processing based on relevant scoring manuals. Results: QOL was assessed in 53 patients who attended our centre for CXB for various clinical indications, with 51, 47, and 42 remaining at the end of treatment, 6-month, and 12-month follow-ups, respectively. Overall, symptom and functional scores from EORTC-QLQ-CR29 remained stable throughout the follow-up period. Significant improvements were observed in abdominal pain, flatulence, urinary frequency, and body weight at 12 months. HADS and EQ-5D-3L scores remained stable, while EQ-VAS scores showed improvement, indicating a good overall quality of life following CXB treatment. Conclusions: CXB treatment combined with (chemo)radiation maintained stable HRQOL, with some improvements in symptoms and QOL noted during the subsequent year. These findings will help rectal cancer patients understand the benefits and limitations of CXB as a treatment option.

  PublisherOA PDFDOI

• Intraoperative brain tumor classification via laser-induced fluorescence spectroscopy and machine learning

  Journal of neurosurgery · 2025-04-05 · 1 citations

  article

  OBJECTIVE: To optimize neurosurgical tumor resection, tissue types and borders must be appropriately identified. Authors of this study established the use of a nondestructive laser-based endogenous fluorescence spectroscopy device, "TumorID," to almost immediately classify a specimen as glioma, meningioma, pituitary adenoma, or nonneoplastic tissue in the operating room, utilizing a machine learning algorithm. METHODS: TumorID requires only 0.5 seconds to collect data, without the need for any dyes or tissue manipulation, and utilizes a 100-mW, 405-nm laser that does not damage the tissue. The system was used in the operating room to scan ex vivo specimens from 46 patients (mean age 52 years) with glioma (8 patients), meningioma (10 patients), pituitary adenoma (23 patients), and nonneoplastic tissue resected during an epilepsy operation (5 patients). A support vector machine algorithm was trained to distinguish between these lesions and classify them in near real time. Statistical significance was determined through a generalized estimating equation on the area under the known fluorophore emission regions for free reduced nicotinamide adenine dinucleotide (NADH), bound NADH, flavin adenine dinucleotide, and neutral porphyrins. RESULTS: Ultimately, the machine learning model showed a high degree of classification power with a multiclass area under the receiver operating characteristic curve of 0.809 ± 0.002. The areas under the curve for neutral porphyrins were found to be statistically significant (p < 0.001) and to have the largest impact on model output. CONCLUSIONS: This initial ex vivo clinical study demonstrated the ability of TumorID to rapidly differentiate and classify various pathologies and surrounding brain in a configuration that can be easily translated to scan in vivo. This classification power could allow TumorID to augment surgical decision-making by enabling rapid intraoperative tissue diagnostics and border delineation, potentially improving patient outcomes by allowing for a more informed and complete resection.

  PublisherDOI

• Iris Ganglion Cell

  JAMA Ophthalmology · 2025-06-20

  article1st authorCorresponding

  This case report discusses the finding of a ganglion cell in the iris of an adult patient who underwent enucleation for uveal melanoma.

  PublisherDOI

• Hybrid neurofibroma-schwannoma of the orbit: a case report and review of the literature

  Orbit · 2025-03-17

  article

  Hybrid peripheral nerve sheath tumor is a rare tumor subtype that infrequently occurs within the orbit. A 50-year-old male presented with a 6-year history of worsening left-sided proptosis and hypoglobus. Magnetic resonance imaging of the orbits revealed a left superior extraconal, muti-lobulated orbital lesion with extension into the left orbital apex originating from the left frontal nerve. The patient underwent surgical resection of the mass via a left orbito-cranial approach. Histopathologic examination was positive for orbital hybrid neurofibroma-schwannoma. Postoperatively, the patient had improvement in proptosis, resolution of symptoms, and improved cosmesis. This case represents the eleventh reported occurrence of orbital hybrid neurofibroma-schwannoma.

  PublisherDOI

• National pilot of entrustable professional activities in pathology residency training

  Academic Pathology · 2024 · 7 citations

  • Medical education
  • Medicine
  • Psychology

  Entrustable professional activities (EPAs) are observable clinical skills and/or procedures that have been introduced into medical education at the student and resident levels in most specialties to determine readiness to advance into residency or independent practice, respectively. This publication describes the process and outcomes of a pilot study looking at the feasibility of using two anatomic pathology and two clinical pathology EPAs in pathology residency in 6 pathology residency programs that volunteered for the study. Faculty development on EPAs and their assessment was provided to pilot program faculty, and EPA assessment tools were developed and used by the pilot programs. Pre- and post-study surveys were given to participating residents, faculty, and program directors to gauge baseline practices and to gather feedback on the EPA implementation experience. Results demonstrated overall good feasibility in implementing EPAs. Faculty acceptance of EPAs varied and was less than that of program directors. Residents reported a significant increase in the frequency with which faculty provided formative assessments that included specific examples of performance and specific ways to improve, as well as increased frequency with which faculty provided summative assessments that included specific ways to improve. EPAs offered the most benefit in setting clear expectations for performance of each task, for providing more specific feedback to residents, and in increasing Program director's understanding of resident strengths abilities and weaknesses.

  PublisherDOI

• A Rare Case of Solitary Fibrous Tumor Involving the Nasolacrimal Duct System in a 12-Year-Old Female: A Case Report and Review of the Literature

  Ophthalmic Plastic and Reconstructive Surgery · 2024-12-19 · 1 citations

  review

  The authors report the youngest case of solitary fibrous tumor (SFT) with extensive involvement of the nasolacrimal duct system and discuss current literature regarding this tumor type. A 12-year-old female presented with a 6-month history of an enlarging right medial orbit mass. CT orbits revealed a well-circumscribed, enhancing lesion adjacent to the right nasolacrimal system. Pathology confirmed SFT (1.2 × 1.1 × 1.1 cm) with spindle cell morphology and a mitotic rate of 5 per 10 high power fields. Immunohistochemistry (IHC) was positive for CD-34 and signal transducer and activator of transcription 6 and negative for S-100, consistent with SFT. Next-generation sequencing confirmed NGFI-A-binding protein 2::signal transducer and activator of transcription 6 gene fusion. To the authors' knowledge, only 17 cases of SFT involving the lacrimal sac have been reported, of which, the average age was 43.5 years. Notably, SFTs with a high mitotic rate carry a heightened risk of malignant transformation. Given this patient's mitotic rate of 5 per 10 high power fields, positive surgical margins, and young age, close follow-up is imperative.

  PublisherDOI

• Melanocytic Nevus of the Superior Conjunctival Fornix: A Case Report

  Case Reports in Ophthalmology · 2024-03-18

  articleOpen access

  Introduction: Conjunctival nevi are benign tumors that are commonly located at the nasal or temporal limbus and rarely in the fornix or tarsus. We report a case of a patient presenting with a solitary compound cystic nevus of the conjunctival fornix in the background of bilateral complexion-associated melanosis. Case Presentation: A 71-year-old African-American female was referred for evaluation of an incidentally noted melanocytic lesion of the right conjunctival fornix. The patient underwent an excisional biopsy, revealing histological features consistent with a compound cystic nevus. Conclusion: This finding is noteworthy due to the rarity of conjunctival nevi originating in the fornix. The case underscores the importance of excisional biopsy in evaluating conjunctival forniceal melanocytic lesions to exclude malignant melanoma, a critical consideration for prognosis.

  PublisherDOI

• Coexisting Biopsy-Diagnosed Dementia and Glioblastoma

  Brain Sciences · 2024-01-30 · 3 citations

  articleOpen access

  Both glioblastoma (GBM) and dementia are devastating diseases with limited treatments that are usually not curative. Having clinically diagnosed dementia with an associated biopsy-proven etiology and a coexisting GBM diagnosis is a rare occurrence. The relationship between the development of neurodegenerative dementia and GBM is unclear, as there are conflicting reports in the literature. We present two cases of simultaneous biopsy-proven dementia, one with Alzheimer's disease (AD) and GBM, and one with cerebral amyloid angiopathy (CAA) and GBM. We discuss how these diseases may be associated. Whether one pathologic process begins first or develops concurrently is unknown, but certain molecular pathways of dementia and GBM appear directly related while others inversely related. Further investigations of these close molecular relationships between dementia and GBM could lead to development of improved diagnostic tools and therapeutic interventions for both diseases.

  PublisherOA PDFDOI

Frequent coauthors

• High Road

  Royal College of Music

  48 shared

• Alan D. Proia

  Duke University Hospital

  33 shared

• Holland Road

  Guildhall School of Music and Drama

  32 shared

• Allan H. Friedman

  Duke Medical Center

  31 shared

• Isaac O. Karikari

  University of Oklahoma

  29 shared

• Christine M. Hulette

  27 shared

• Prithvi Mruthyunjaya

  24 shared

• Roger E. McLendon

  Duke University

  21 shared