About

Virginia A. LiVolsi, M.D., is a Staff Pathologist at the Hospital of the University of Pennsylvania within the Department of Pathology and Laboratory Medicine. She serves as the Director of Endocrine and ENT Subspecialty at the same hospital. Dr. LiVolsi's educational background includes a B.S. in Chemistry from the College of Mount Saint Vincent, New York, earned in 1965, and an M.D. from Columbia University College of Physicians and Surgeons in 1969. Her research expertise focuses on the pathogenesis of thyroid neoplasms, and her clinical expertise encompasses thyroid, parathyroid pathology, gynecological pathology, and head and neck pathology, including salivary glands. Dr. LiVolsi has contributed to the understanding of thyroid tumor differentiation and has published on topics such as immunohistochemical differentiation of adrenal tumors, follicular-patterned thyroid lesions, and microdissection of thyroid tumors. Her work has advanced the diagnostic and research approaches in endocrine pathology, particularly related to thyroid neoplasms.

Research topics

• Medicine
• Surgery
• General surgery
• Intensive care medicine
• Internal medicine

Selected publications

• Performance of a multigene genomic classifier and clinical parameters in predicting malignancy in a Southeast Asian cohort of patients with cytologically indeterminate thyroid nodules

  Cancer Cytopathology · 2024-02-06 · 5 citations

  articleOpen access

  BACKGROUND: Most thyroid nodules are benign. It is important to determine the likelihood of malignancy in such nodules to avoid unnecessary surgery. The primary objective of this study was to characterize the genetic landscape and the performance of a multigene genomic classifier in fine-needle aspiration (FNA) biopsies of cytologically indeterminate thyroid nodules in a Southeast Asian cohort. The secondary objective was to assess the predictive contribution of clinical characteristics to thyroid malignancy. METHODS: This prospective, multicenter, blinded study included 132 patients with 134 nodules. Molecular testing (MT) with ThyroSeq v3 was performed on clinical or ex-vivo FNA samples. Centralized pathology review also was performed. RESULTS: Of 134 nodules, consisting of 61% Bethesda category III, 20% category IV, and 19% category V cytology, and 56% were histologically malignant. ThyroSeq yielded negative results in 37.3% of all FNA samples and in 42% of Bethesda category III-IV cytology nodules. Most positive samples had RAS-like (41.7%), followed by BRAF-like (22.6%), and high-risk (17.9%) alterations. Compared with North American patients, the authors observed a higher proportion of RAS-like mutations, specifically NRAS, in Bethesda categories III and IV and more BRAF-like mutations in Bethesda category III. The test had sensitivity, specificity, negative predictive value, and positive predictive value of 89.6%, 73.7%, 84.0%, and 82.1%, respectively. The risk of malignancy was predicted by positive MT and high-suspicion ultrasound characteristics according to American Thyroid Association criteria. CONCLUSIONS: Even in the current Southeast Asian cohort with nodules that had a high pretest cancer probability, MT could lead to potential avoidance of diagnostic surgery in 42% of patients with Bethesda category III-IV nodules. MT positivity was a stronger predictor of malignancy than clinical parameters.

  PublisherOA PDFDOI

• A comparison of the histopathologic features of thyroid carcinomas with NTRK fusions to those with other malignant fusions

  Human Pathology · 2024-06-09 · 3 citations

  article
  PublisherDOI

• Seven years of Non-invasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features (NIFTP): Rate of Acceptance and Variation of Diagnostic Approaches Across Different Continents

  The Journal of Clinical Endocrinology & Metabolism · 2024-06-12 · 8 citations

  articleOpen access

  CONTEXT: Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) was introduced as a new entity replacing the diagnosis of noninvasive encapsulated follicular variant of papillary thyroid carcinoma (PTC). Significant variability in the incidence of NIFTP diagnosed in different world regions has been reported. OBJECTIVE: To investigate the rate of adoption of NIFTP, change in practice patterns, and uniformity in applying diagnostic criteria among pathologists practicing in different regions. METHODS: Two surveys distributed to pathologists of the International Endocrine Pathology Discussion Group with multiple-choice questions on NIFTP adoption into pathology practice and whole slide images of 5 tumors to collect information on nuclear score and diagnosis. Forty-eight endocrine pathologists, including 24 from North America, 8 from Europe, and 16 from Asia/Oceania completed the first survey and 38 the second survey. RESULTS: A 94% adoption rate of NIFTP by the pathologists was found. Yet, the frequency of rendering NIFTP diagnosis was significantly higher in North America than in other regions (P = .009). While the highest concordance was found in diagnosing lesions with mildly or well-developed PTC-like nuclei, there was significant variability in nuclear scoring and diagnosing NIFTP for tumors with moderate nuclear changes (nuclear score 2) (case 2, P < .05). Pathologists practicing in North America and Europe showed a tendency for lower thresholds for PTC-like nuclei and NIFTP than those practicing in Asia/Oceania. CONCLUSION: Despite a high adoption rate of NIFTP across geographic regions, NIFTP is diagnosed more often by pathologists in North America. Significant differences remain in diagnosing intermediate PTC-like nuclei and respectively NIFTP, with more conservative nuclear scoring in Asia/Oceania, which may explain the geographic differences in NIFTP incidence.

  PublisherOA PDFDOI

• Differentiated high grade thyroid carcinomas: Diagnostic consideration and clinical features

  Human Pathology · 2024-01-18 · 24 citations

  review
  PublisherDOI

• Issue Information

  Head & Neck · 2023-06-07

  paratextOpen access

  Rest of World), €2555 (Europe), £2021 (UK)

  PublisherOA PDFDOI

• Update on Sinonasal Tract Malignancies: Advances in Diagnostic Modalities

  Archives of Pathology & Laboratory Medicine · 2023-03-15

  reviewOpen access

  CONTEXT.—: Sinonasal tract malignancies are rare cancers with frequent morphologic overlap. Given the similar histologic profiles seen in many of these entities, they often present a diagnostic challenge to the practicing pathologist. OBJECTIVE.—: To provide a streamlined algorithm using histologic clues, immunohistochemical profiles, and molecular assays to aid in diagnosis of these lesions. DATA SOURCES.—: Sources were the World Health Organization Tumor Classification, literature review, and institutional experience. CONCLUSIONS.—: Although many sinonasal tract malignancies show similar histology, distinct immunohistochemical and molecular profiles can help parse out differences, thereby facilitating diagnosis for the pathologist.

  PublisherDOI

• Faculty Opinions recommendation of New biology of pheochromocytoma and paraganglioma.

  Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature · 2023-01-11

  dataset1st authorCorresponding
  PublisherDOI

• Brain metastases of papillary thyroid carcinoma origin are derived from aggressive histologic variants and demonstrate similar adverse morphology in the metastatic lesion

  Clinical Neurology and Neurosurgery · 2023-02-24 · 7 citations

  reviewSenior author
  PublisherDOI

• The Cooperative Human Tissue Network of the National Cancer Institute: Supporting Cancer Research for 35 Years

  Molecular Cancer Therapeutics · 2023-07-31 · 4 citations

  articleOpen accessSenior author

  The Cooperative Human Tissue Network was created by the NCI in 1987 to support a coordinated national effort to collect and distribute high quality, pathologist-validated human tissues for cancer research. Since then, the network has expanded to provide different types of tissue samples, blood and body fluid samples, immunohistologic and molecular sample preparations, tissue microarrays, and clinical datasets inclusive of biomarkers and molecular testing. From inception through the end of 2021, the network has distributed 1,375,041 biospecimens. It served 889 active investigators in 2021. The network has also taken steps to begin to optimize the representation of diverse communities among the distributed biospecimens. In this article, the authors review the 35-year history of this network, describe changes to the program over the last 15 years, and provide operational and scientific highlights from each of the divisions. Readers will learn how to engage with the network and about the continued evolution of the program for the future.

  PublisherOA PDFDOI

• Insights Obtained from the Nontumorous Glandular Tissue in Patients with Endocrine Tumors

  Endocrine Pathology · 2023-03-21 · 8 citations

  review
  PublisherDOI

Recent grants

• NIH Grant U01CA044974

  NIH · $21.9M · 2014

• COLLABORATIVE HUMAN TISSUE NETWORK EASTERN DIVISION

  NIH · $5.0M · 2014–2019

Frequent coauthors

• Zubair Baloch

  Philadelphia University

  509 shared

• Laura C. Collins

  Hadassah Medical Center

  246 shared

• Nicholas Knoblauch

  University of Chicago

  242 shared

• Rendi Dintzis

  Kyung Hee University

  242 shared

• Liang Cheng

  242 shared

• Kristin Post

  242 shared

• Laila Mahmoud Montaser

  242 shared

• L Wong

  Kyung Hee University

  242 shared

Labs

• Pathology and Laboratory MedicinePI