Gastrointestinal Pathology

Gastrointestinal Pathology provides comprehensive consultative expertise and services relating to disorders of the gastrointestinal tract, liver, and pancreas. A variety of specialized biomarkers and molecular tests are routinely available.

The focus of gastrointestinal molecular diagnostics at ARUP is on colorectal cancer and other gastrointestinal tumors and polyposis syndromes, including KRAS, BRAF, NRAS and PIK3CA mutational testing in colorectal adenocarcinoma for determination of therapeutic response to EGFR inhibitor therapy, Septin 9 blood testing for colorectal cancer screening, 5-FUchemotherapeutic response and toxicity testing through mutational analysis of DPYD and TYMS,  c-KIT and PDGFRA mutational testing in gastrointestinal stromal tumors, and germline testing for the various polyposis and hereditary gastrointestinal cancer syndromes. An algorithm for Lynch syndrome (hereditary non-polyposis colorectal cancer or HNPCC) testing is available, which includes the rationale for microsatellite instability testing (by PCR and/or immunohistochemistry for the four mismatch repair genes, MLH1, MSH2, MSH6 and PMS2), BRAF mutational testing, and detection of MLH1 methylation. Germline analysis of MLH1, MSH2, MSH6, and PMS2 mutations are also offered as a part of the Lynch syndrome testing algorithm. Tests are available for APC sequencing and MYH mutation testing in familial adenomatous polyposis (FAP) and MYH adenomatous polyposis (MAP). Testing for SMAD4 and BMPR1A alterations in hereditary juvenile polyposis and STK11 alterations in Peutz-Jeghers syndrome are also performed.  ARUP also offers the first blood-based screening test for colorectal cancer, based on methylation alterations of the Septin 9 biomarker. ARUP’s Septin 9 blood test has a reported 90% sensitivity at 90% specificity for detecting colorectal cancer. ARUP is one of only two labs in the US to offer this test. HER2 testing by immunohistochemistry and FISH is available for gastric and pancreatic cancers and SMAD4 immunohistochemical testing in pancreatic cancer is also performed.  Circulating tumor cell counting (Cell Search™) is available for therapeutic monitoring of colorectal cancer patients.

For information concerning consultation, please call (801) 581-2507. Consultations can be sent directly to:

Surgical Pathology Department
Huntsman Cancer Hospital
1950 Circle of Hope, RM N3105
Salt Lake City, UT 84112
Phone: (801) 581-2507 or (801) 584-5078
Fax: (801)581-7035

Please include pertinent clinical history and surgical pathology report(s).
  • Medical Director, Anatomic Pathology
    Dr. Affolter is an assistant professor of pathology at the University of Utah School of Medicine. She received her MD from the University of Kansas School of Medicine while completing her residency in anatomic and clinical pathology and fellowship in gastrointestinal, hepatic, and pancreaticobiliary pathology at the University of Utah School of Medicine. She is certified by the American Board of Pathology in anatomic and clinical pathology and is a member of the United States and Canadian Academy of Pathology, American Society for Clinical Pathology, College of American Pathologists, and the Gastrointestinal Pathology Society, among other professional organizations. Dr. Affolter has research interests that include the serrated pathway of colorectal carcinogenesis and predictive markers in inflammatory bowel disease.
  • Co-Division Chief, Anatomic and Molecular Oncologic Pathology
    Medical Director, Biocomputing
    Dr. Bronner is a Carl R. Kjeldsberg presidential endowed professor of pathology at the University of Utah School of Medicine. Dr. Bronner received her MD from the University of Pennsylvania and completed her pathology residency training and chief residency at the Hospital of the University of Pennsylvania in Philadelphia. Dr. Bronner’s honors include her election as president of the GI Pathology Society, election as council member of the United States and Canadian Academy of Pathology, and, in 2005, the award of the Arthur Purdy Stout Prize, recognizing her work as a surgical pathologist under the age of 45 whose research publications have had a major impact on diagnostic pathology. Dr. Bronner is an editorial journal board member for Human Pathology and Modern Pathology. She has served as an investigator on numerous NIH and foundation grants over the course of her career and has published more than 100 peer-reviewed articles and numerous book chapters.
  • Medical Director, Anatomic Pathology
    Dr. Evason is an assistant professor at the University of Utah School of Medicine and an investigator in the Department of Oncological Sciences at the Huntsman Cancer Institute. She received her MD and PhD through the Medical Scientist Training Program at Washington University in St. Louis. She served a residency and completed fellowship training in anatomic and liver/gastrointestinal pathology at the University of California at San Francisco, followed by a post-doctoral fellowship mentored by Didier Stainier, Andrei Goga, and J. Michael Bishop. Dr. Evason’s research and clinical interests are centered on gastrointestinal and liver pathology, with a specific focus on hepatocellular carcinoma. She is currently investigating molecular pathways and identifying drugs that influence liver tumorigenesis.
  • Medical Director, Solid Tumor Molecular Diagnostics and Histology
    Staff Pathologist, Anatomic Pathology
    Dr. Samowitz is a professor of pathology at the University of Utah School of Medicine. He received his MD from SUNY Downstate, and completed residency training in anatomic pathology at the University of Chicago and fellowships in gastrointestinal pathology at Johns Hopkins Hospital. Specializing in gastrointestinal pathology and the molecular genetics of colorectal cancer, Dr. Samowitz is also the medical director for numerous molecular tests in solid tumor molecular diagnostics, including single-gene assays and next-generation sequencing panels.
  • Medical Director, Anatomic Pathology and Oncology
    Dr. Swanson is an assistant professor of pathology at the University of Utah School of Medicine. He received his MD from Rush University in Chicago and completed pathology residency in anatomic and clinical pathology at the University of California, Los Angeles, where he also served as chief resident. He then went on to complete a fellowship in gastrointestinal and liver pathology at UCLA. Dr. Swanson is a member of the Rodger C. Haggitt Gastrointestinal Pathology Society, United States and Canadian Academy of Pathology, Society for Cardiovascular Pathology, and College of American Pathologists. His research interests include neoplastic and non-neoplastic gastrointestinal diseases and cardiovascular physiology.