Lester Layfield, MD

Professor and Chair


Pathology and Anatomical Sciences


E-mail


573-882-8915


Education

  • B.S., Magna Cum Laude University of California, Irvine, California
  • M.D. University of California, Los Angeles, California

Additional Study

  • Resident in Pathology – University of Washington, 1979-1980
  • Resident in Pathology – University of California Los Angeles, 1980-1983
  • Chief Resident in Pathology – University of California Los Angeles, 1983-1984

Certification

Anatomic and Clinical Pathology; Cytopathology

Academic Appointments

  • 1983-84 Adjunct Professor of Pathology; University of California at Los Angeles, California
  • 1984-89 Assistant Professor, Department of Pathology; University of California at Los Angeles, California
  • 1984-90 Children’s Cancer Study Group Pathology; University of California at Los Angeles, California
  • 1984-90 Director of Fine Needle Aspiration Service; University of California at Los Angeles, California
  • 1989-90 Associate Professor, Department of Pathology; University of California at Los Angeles, California
  • 1990-92 Associate Professor, Department of Pathology; University of Iowa Hospitals and Clinics, Iowa City, Iowa
  • 1990-92 Co-Director of Cytology; University of Iowa Hospitals and Clinics, Iowa City, Iowa
  • 1992-96 Associate Professor, Department of Pathology; Duke University Medical Center, Durham, North Carolina
  • 1992-97 Director of FNA Service (2100 specimens per year). Department of Pathology; Duke University Medical Center, Durham, North Carolina
  • 1992-97 Director of Image Analysis Laboratory (2000 tests per year). Department of Pathology; Duke University Medical Center, Durham, North Carolina
  • 1993-97 Head, Section of Surgical Pathology; Department of Pathology, Duke University Medical Center, Durham, North Carolina
  • 1996-97 Professor, Department of Pathology; Duke University Medical Center, Durham, North Carolina
  • 1997-2012 Director, Surgical Pathology, Department of Pathology; University of Utah Health Sciences Center Vice President for Anatomic Pathology, ARUP Laboratories
  • 2000–2012 Director, Anatomic Molecular Diagnostics Laboratory, ARUP Institute for Clinical and Experimental Pathology
  • 2012-present Chairman, Pathology and Anatomical Sciences, University of Missouri, Columbia, Missouri
  • 2012-present Professor, Pathology and Anatomical Sciences, University of Missouri, Columbia, Missouri

Research Description

Development of molecular diagnostic testing in oncologic pathology.

Interests

  • Glycated hemoglobin (HbA1c) methodology and Interferences
  • Standardization of HbA1c, insulin, and c-peptide measurements
  • Use of HbA1c and glycated plasma protein measurements for diabetes screening

Representative Publications

  1. Levitt S, Cheng L, Du Puis MH, Layfield LJ. Fine needle aspiration diagnosis of malignant lymphoma with confirmation by immunoperoxidase staining. Acta Cytol 29:895- 902, 1985.
  2. Layfield LJ, Anders K, Glasgow BJ, Mirra JM. Fine needle aspiration cytology of primary soft tissue tumors. Arch Pathol Lab Med 110:420-424, 1986.
  3. Layfield LJ, Anders K, Glasgow BJ, Mirra JM. Fine needle aspiration cytology of primary bone lesions. Acta Cytol 31: 177-184, 1987
  4. Layfield LJ, Tan P, Glasgow B. Fine needle aspiration accuracy and pitfalls in the diagnosis of salivary gland lesions. Arch Pathol Lab Med 11: 346-333, 1987.
  5. Layfield LJ, Hilborne L, Glasgow BJ, Mukamel E, DeKernion J. Utilization of fine needle aspiration cytology in grading of prostatic carcinoma. J Urol 138: 798-800, 1987.
  6. Layfield LJ, Hilborne LH, Ljung, BM, Feig S, Ehrich RM. Use of fine needle aspiration cytology for the diagnosis of testicular relapse in patients with acute lymphoblastic leukemia. J Urol 139: 1020-1022, 1988.
  7. Ritchie AWS, Layfield LJ, Turcillo P, de Kerion JB. The significance of atypia in fine needle aspiration cytology of the prostate. J Urol 110: 761-765, 1988.
  8. Layfield LJ, Glasgow BJ, Cramer H. Fine needle aspiration in the management of breast masses. In Pathology Annual 1989 Part II, PP Rosen, RE Fechner (eds). Appleton-Century-Crofts, Norwalk, CT 1989, 23-62.
  9. Layfield LJ, Ostrzega N. Fine needle aspiration smear morphology of metastatic melanoma. Acta Cytol 33: 606-612, 1989.
  10. Layfield LJ, Ritchie AWS, Ehrlich R. The relationship of DNA content to conventional prognostic factors in Wilms’ tumor. J Urol 142: 1040-1043, 1989.
  11. Layfield LJ, Hart J, Neuwirth H, Bohman R. Relationships between DNA ploidy and clinical behavior of phyllodes tumors. Cancer 64: 1486-1489, 1989.
  12. Layfield LJ, Reichman A. Fine-needle aspiration cytology: Utilization in pediatric pathology. Dis Markers 8:301-315, 1990.
  13. Layfield LJ, Glasgow BJ. Diagnosis of salivary gland tumors by fine needle aspiration cytology. A review of clinical utility and pitfalls. Diagn Cytopathol 7:267-272, 1991.
  14. Kerns BJ, Jordan PA, Huper G, Marks JR, Iglehart JD, Layfield LJ. Assessment of c-erb-B-2 amplification by immunohistochemistry in paraffin-embedded breast cancer. Mod Pathol 6:673-678, 1993.
  15. Kerns BJ, Jordan PA, Faerman LL, Berchuck A, Bast RC, Layfield LJ. Determination of proliferation index with MIB-1 in advanced ovarian cancer using quantitative image analysis. Am J Clin Pathol 101:192-197; 1994.
  16. Kerns BJ, Jordan PA, Faerman LL, Berchuck A, Bast RC, Layfield LJ. Determination of proliferation index with MIB-1 in advanced ovarian cancer using quantitative image analysis. Am J Clin Pathol 101:192-197; 1994.
  17. Layfield LJ, Thompson JK, Dodge RK, Kerns BJ. Prognostic indicators for neuroblastoma; stage, grade, DNA ploidy, MIB-1 proliferation index, p53, Her-2/neu and EGFr. A survival study. J Surg Oncol 59:21-27, 1995.
  18. Layfield LJ, Wax TD, Lee JG, Cotton, PB. Accuracy and morphologic aspects of pancreation biliary duct brushings. Acta Cytol 39:11-18, 1995.
  19. Lee JG, Leung JW, Baillie J, Layfield LJ, Cotton PB. Benign, dysplastic or malignant – making sense of endoscopic bile duct brush cytology: Results of 149 consecutive patients. Am J Gastroenterol 90:722-726, 1995.
  20. Layfield LJ, Kerns BJ, Conlon DH, Iglehart JD, Marks JR, Dodge RK. Determination of proliferation index by MIB-1 in early stage breast cancer using quantitative image analysis. Breast J 1:362-371, 1995.
  21. Layfield LJ, Saria E., Conlon DH, Kerns BJ. Estrogen and progesterone receptor status determined by the Ventana ES 320TM automated immunohistochemical stainer and the CAS 200TM image analyzer in 236 early stage breast carcinomas: Prognostic significance. J Surg Oncol 61:177-184, 1996.
  22. Layfield LJ, Dodd LG. Cytologically low grade malignancies. An important interpretative pitfall responsible for false negative diagnoses in fine needle aspiration of the breast. Diagn Cytopathol 15:250-259, 1996.
  23. Mooney EE, Dodd LG, Layfield LJ. Squamous cells in fine-needle aspiration biopsies of salivary gland lesions: potential pitfalls in cytologic diagnosis. Diagn Cytopathol 15:447-452, 1996.
  24. Layfield LJ. Aspiration cytologic diagnosis of bone tumors: Morphology and clinical-radiologic correlates. Cytopathology Annual. ASCP Press 1:129-157, 1996.
  25. McDonagh DP, Liu J, Gaffey MJ, Layfield LJ, Azumi N, Traweek ST. Detection of Kaposi’s sarcoma-associated herpesvirus-like DNA sequences in angiosarcoma. Am J Pathol 149:1363-1368, 1996.
  26. Moffatt EJ, Kerns BJ, Madden JM, Layfield LJ. Prognostic factors for fibromatoses: A correlation of proliferation index, estrogen receptor, p53, retinoblastoma and SARC gene products and clinical features with outcome. J Surg Oncol, 1997.
  27. Layfield LJ, Saria E, Mooney EE, Link, Dodge RR. Tissue heterogeneity of immunohistochemically detected estrogen receptor: implications for image analysis quantification. AJCP 11):758-764, 1998.
  28. Layfield LJ, Lenel JC, Crim JR, et al. Bone tumor radiograph review by pathologists prior to pathologic diagnosis. A receiver operator curve analysis of diagnostic utility. Oncology Reports 5:949-953, 1998.
  29. Berend KR, Toth AP, Harrelson JM, Layfield LJ, et al. Association between ratio of matrix metalloproteinase-1 to tissue inhibitor of metalloproteinase-1 and local recurrence, metastasis and survival in human chondrosarcoma. JBJS 80A:11-17, 1998.
  30. Standards of practice task force Papanicolaou society. Guidelines of the Papanicolaou society of cytopathology for the examination of cytologic specimens obtained from the respiratory tract. (Published simultaneously by Mod Path and Diagn Cytopathol.) Diagn Cytopathol 21:61-69; 1999.
  31. Gupta D, Shidham V, Holden J, Layfield LJ. Prognostic value of immunohistochemical expression of topoisomerase alpha II, MIB-1, p53, E-cadherin, Rb gene protein product and Her-2/Neu in adrenal and extra-adrenal pheochromocytomas. Applied Immunohistochem and Molecular Pathol 8:267-274; 2000.
  32. Goldstein NS, Bassi D, Watts JC, Layfield LJ, Gown A. E-cadherin reactivity of non-invasive ductal and lobular lesions of the breast: Implications for the interpretation of problematic lesions. Am J Clin Pathol 2001; 115:534-542.
  33. Cessna MH, Zhou H, Perkins SL, Tripp SR, Layfield LJ, Daines C, Coffin CM. Are myogenin and MyoD1 expression specific for rhabdomyosarcoma (RMS)? A study of 150 cases with emphasis on spindle cell mimics. Am J Surg Path 25:1150-1152, 2001.
  34. Layfield LJ, Jones C, Gopez EV. Institutional review of outside cytology materials: A retrospective analysis of two institutions’ experiences. Diagn Cytopathol 26:45-48, 2002.
  35. Willmore C, Holden JA, Zhou L, Tripp S, Wittwer CT, Layfield LJ. Detection of c-kit activating mutations in gastrointestinal stromal tumors by high resolution amplicon melting analysis. Am J Clin Pathol 2004; 122:206-216.
  36. Layfield LJ, Willmore C, Tripp S, Jones C, Jensen RL. Epidermal growth factor receptor (EGFR) gene amplification and protein expression in glioblastoma multiforme: prognostic significance and relationship to other prognostic factors. App Immuno Molec Morph 2006; 14:91-96.
  37. Layfield LJ, Willmore-Payne C, Shimada H, Holden, JA. Assessment of NMYC amplification: A comparison of FISH, LightCycler PCR monoplexing and traditional blotting methods used with formalin-fixed, paraffin-embedded neuroblastomas. Anal Quant Cytol Histol 2005; 27:5-14.
  38. Willmore-Payne C, Holden JA, Tripp S, Layfield LJ. Human malignant melanoma: Detection of BRAF and C-KIT activating mutations by high resolution amplicon melting analysis. Human Pathol 2005; 36:486-493.
  39. Willmore-Payne C, Holden JA, Layfield LJ. Detection of epidermal growth factor receptor and human epidermal growth factor receptor-2 activating mutations in lung adenocarcinoma by high resolution melting amplicon analysis: Correlation with gene copy number, protein expression and hormone receptor expression. Hum Pathol. 2006; 37:755-763.
  40. Willmore-Payne C, Holden J, Turner KC, Proia A, Layfield, LJ. Translocations and amplifications of chromosome 12 in liposarcoma demonstrated by the LSI® CHOP breakapart rearrangement probe. Arch Pathol & Lab Med. 2008 Jun; 132(6):952-957.
  41. Layfield LJ, Abrams J, Cochand-Priollet B, Evans D, Gharib H, Greenspan F, Henry M, LiVolsi V, Merino M, Michael CW, Wang H, Wells S. NCI State of the Science Conference: Post thyroid FNA testing and treatment options. Diagn Cytopathol. 2008 Jun; 36(6):442-448.
  42. Chadwick B, Willmore-Payne C, Tripp S, Layfield LJ, Hirschowitz S, Holden J. Histologic, Immunohistochemical and Molecular Classifications of 52 IPMNs of the Pancreas. Applied Immunohistochemistry & Molecular Morphology. 2009 Jan;17(1):31-9.
  43. Layfield LJ, Cibas ES, Gharib H, Mandel SJ. Thyroid Aspiration Cytology: Current Status. CA. 2009 Mar/Apr; 59(2):99-110.
  44. Willmore-Payne C, Holden JA, Wittwer CT, Layfield LJ. The use of EGFR exon 19 and 21 unlabeled DNA probes to screen for activating mutations in non-small cell lung cancer. J Biomol Tech. 2008 Jul;19(3):217-224.
  45. Layfield LJ, Morton MJ, Cramer HM, Hirschowitz S. Implications of the Proposed Thyroid FNA Category of “Follicular Lesion of Undetermined Significance”, (FLUS): A Five Year Multi-Institutional Analysis. Diagn Cytopathol. 2009 Oct;37(10):710-714.
  46. Wallander ML, Layfield LJ, Emerson LL, Mamalis N, Davis D, Tripp S, Holden JA. KIT Mutations in Ocular Melanoma: Frequency and Anatomic Distribution. Modern Pathology. 2011 Apr 8. [Epub ahead of print]
  47. Layfield LJ, Witt BL, Metzger KG, Anderson GM. Extraneous Tissue: A potential source for diagnostic error in surgical pathology. Am J Clin Pathol. Am J Clin Pathol. 2011 Nov;136(5):767-772.
  48. Wallander ML, Geiersbach KB, Tripp SR, Layfield LJ. Comparison of RT-PCR, Immunohistochemistry and Fluorescence in situ Hybridization Methodologies for Detection of EML4-ALK Fusion Positive Non-Small Cell Lung Carcinoma: Implications for Optimal Clinical Testing. Archives of Pathology and Laboratory Medicine. 2011 (in press).
  49. Layfield LJ, Schmidt RL. HER2/neu Gene Amplification Heterogeneity: The Significance of Cells With a 3:1 HER/CEP17 Ratio. Appl Immunohistochem Mol Morphol. 2012 Apr 10. [Epub ahead of print].