About

K. Brannock, MD, is a staff hematopathologist and Director of Hematopathology at Nationwide Children’s Hospital and a Clinical Assistant Professor at The Ohio State University College of Medicine. She has been practicing since 2008, initially as a surgical pathologist, and has been practicing as a fellowship-trained, board-certified academic hematopathologist since 2017. Her special interests include acute leukemia, chronic myeloid malignancies, benign hematology, and laboratory management. During her career, she has served on many departmental and hospital committees and in several laboratory directorship roles, including numerous quality improvement initiatives. She has also been extensively involved in teaching medical students, residents, and fellows.

Research topics

• Pathology
• Immunology
• Medicine

Selected publications

• Bone Marrow Morphology in Hereditary Thrombocytosis May Show Features of Myeloproliferative Neoplasms: A Case Report of a Child with Homozygous <i>MPL</i> Baltimore Germline Variant and Review of Literature

  Pediatric and Developmental Pathology · 2026-03-21

  article

  Hereditary thrombocytosis (HT) is a rare cause of elevated platelet counts in children, most commonly resulting from germline variants in THPO or MPL . We report the first description of bone marrow morphology in a pediatric patient with germline homozygous MPL Baltimore (K39N) variant, a functional polymorphism resulting in HT. The patient had persistent thrombocytosis from infancy without bleeding or thrombotic complications. Bone marrow biopsy demonstrated mild hypocellularity, increased megakaryocytes forming small clusters, and megakaryocytic atypia partially overlapping with the morphologic features of myeloproliferative neoplasms (MPN). However, a somatic cytogenetic or molecular abnormality was not identified and it was determined that the thrombocytosis and bone marrow morphology were driven by the homozygous germline MPL Baltimore variant. Literature review found reports of bone marrow morphology in HT showing varying degrees of megakaryocytic proliferation and atypia with differences seen between specific germline variants. Cases with germline MPL P106L variant have similar morphology as this homozygous MPL Baltimore case. While cases of germline MPL S550N are nearly identical to MPN with more severe megakaryocytic atypia and frequent development of marrow fibrosis. This case underscores the importance of considering HT in children with unexplained thrombocytosis and highlights the diagnostic pitfall of misclassifying HT as MPN.

  PublisherDOI

• A Rare Case of Early T-Precursor Lymphoblastic Lymphoma (ETP-LBL) in a Child With Nijmegen Breakage Syndrome

  Pediatric and Developmental Pathology · 2024-05-25 · 1 citations

  article1st authorCorresponding

  Lymphoblastic lymphoma (LBL) with an early T-cell precursor phenotype has only been rarely reported. Nijmegen breakage syndrome (NBS) is an inherited chromosomal instability disorder with known predisposition to malignancies that is very rare as well. We report a case of early T-precursor LBL (ETP-LBL) in a patient with NBS, a rare combination that has not been reported. We raise the question of whether a chromosomal instability disorder such as NBS increases the propensity for early T-precursor acute lymphoblastic leukemia/lymphoma (ETP-ALL/LBL), given that ETP-ALL has been shown to have increased genomic instability compared to T-ALL.

  PublisherDOI

• Interfollicular Classic Hodgkin Lymphoma: Report of a Case and a Brief Review of Literature

  Pediatric and Developmental Pathology · 2024 · 1 citations

  1st authorCorresponding
  • Pathology
  • Medicine
  • Immunology

  Interfollicular Hodgkin lymphoma (IHL) has been rarely reported in the literature and is recognized by the WHO Classification as a morphologic pattern sometimes seen in mixed cellularity classic Hodgkin lymphoma (CHL). The changes may be subtle due to preservation of architecture. We report a case of a 9-year-old male with IHL showing preserved follicular architecture but with the presence of interfollicular infiltrates consisting of eosinophils, plasma cells, and Hodgkin-Reed-Sternberg (HRS) cells. Immunophenotyping confirmed the morphologic suspicion for IHL. A discussion and review of the literature are offered. We conclude that IHL is a variant that requires a high index of suspicion, as it may be easily missed due to the subtle morphologic features and preserved architecture seen in most cases. We further emphasize that unexplained interfollicular infiltrates of eosinophils may be clues that should prompt a search of HRS cells and consideration of immunohistochemical staining if needed.

  PublisherDOI

• Differentiating fulminant EBV infection complicated by HLH from Lymphoma: report of a case and a brief literature review

  Diagnostic Pathology · 2023 · 6 citations

  • Pathology
  • Medicine
  • Immunology

  Epstein-Barr virus (EBV) infection may present with fulminant constitutional symptoms, cytopenia(s), and systemic lymphadenopathy, raising clinical suspicion for lymphoma and prompting lymph node and bone marrow biopsies. At the microscopic level, the histopathologic findings in cases of acute EBV lymphadenitis may mimic certain lymphoid neoplasms, creating a range of differential diagnoses and diagnostic pitfalls.We present a case of fulminant EBV infection in an adolescent whose clinical and radiographic findings led to lymph node and bone marrow biopsies to rule out lymphoma. One week after being diagnosed with acute EBV infection (infectious mononucleosis), a 17-year-old Caucasian male presented with worsening symptoms including persistent fever, progressive, painful lymphadenopathy, and splenomegaly. A peripheral blood smear showed lymphocytosis with many reactive lymphocytes, anemia, and thrombocytopenia. Laboratory studies showed elevated ferritin, triglycerides, and soluble IL-2/CD25. A cervical lymph node biopsy demonstrated an EBV-positive, reactive B-immunoblast proliferation with large atypical lymphoid cells mimicking Reed-Sternberg cells of Hodgkin lymphoma, in addition to patchy vasculitis, coagulative necrosis, and prominent hemophagocytic activity. Bilateral bone marrow biopsies showed a hypercellular marrow with patchy infiltrates of similar EBV-positive, large atypical lymphoid cells, as well as prominent hemophagocytic activity. The diagnosis of acute EBV associated lymphoproliferation with concurrent hemophagocytic lymphohistiocytosis (HLH) was rendered.Recognition of common and uncommon clinical presentations of acute EBV infection is essential, particularly when histopathologic findings raise suspicion for a possible hematolymphoid neoplasm. Both the lymph node architectural and viral cytopathic changes observed in EBV lymphadenitis exhibit significant morphologic overlap with classic Hodgkin lymphoma (cHL) and several other lymphomas, including anaplastic large cell lymphoma, diffuse large B cell lymphoma, and angioimmunoblastic T cell lymphoma. Recognition of immunohistochemical staining patterns in EBV lymphadenitis is critical to avoid misdiagnosis. Conversely, bona fide lymphoma, particularly cHL, can masquerade as EBV infection. We provide a concise discussion and tables of the histopathologic differential diagnosis of EBV lymphadenitis, including cHL and other lymphomas. Pathologists should include acute EBV infection within the differential diagnosis when confronted with clinical and pathologic findings concerning for lymphoma, particularly in adolescents and young adults.

  PublisherOA PDFDOI

• Standardization of Schistocyte Identification and Quantitation for the Diagnosis of Thrombotic Microangiopathic Anemia at University of Cincinnati Medical Center

  Blood · 2019-11-13 · 1 citations

  articleSenior author

  Background: Thrombotic microangiopathic anemia (TMA) is a hematological emergency that requires prompt review of a peripheral blood smear for the presence of schistocytes. Within our institution, we had concern for lack of consistency in identifying schistocytes, lack of consistency in reporting methods, possible variation in schistocyte quantitation due to microscope differences, and the threshold for which our laboratory had been reporting increased schistocytes. The objective of our quality improvement project was to implement published practice standards for morphological identification, quantitation, and reporting of schistocytes across different groups at the University of Cincinnati Medical Center (UCMC). Methods: The International Council for Standardization in Haematology (ICSH) recommendations for the identification, diagnostic value, and quantitation of schistocytes (Zini et. al. International Journal of Laboratory Hematology 2012) were reviewed prior to designing this project. We next conducted a survey of groups that were reviewing peripheral blood smears for schistocytes on a routine basis: medical technologists (n=9), pathology residents (n=10) and hematology-oncology fellows (n=13). The survey included questions about schistocytes, including desire for standardization and normal reference values, desire for pathologist instruction, and reporting patterns. One question included 8 images of various red cell morphologies, and participants were asked to select ones they would classify as schistocytes. The microscopes were compared for objective and field diameter measurements. Six (6) peripheral blood smears with previously reported schistocytes were re-reviewed. Schistocytes were identified per ICSH guidelines and counted as a percentage (%) of 1000 total red blood cells using a Miller optical disc and also as an average number per field for a total of 10 high power fields. The results were plotted on a linear X-Y axis graph (Fig 1) and compared to the ICSH guidelines (Fig 2) and the policy for reporting schistocytes in our laboratory. Results: Survey results showed that the majority of each group desired standardization, normal reference values, and pathologist instruction. For reporting of schistocytes, residents answered present/absent (50%) or average per high power field (HPF) (50%), whereas 92% of fellows answered average per HPF. No participants reported a percentage of 1000 red blood cells, the current ICSH recommendation. For the morphological identification, 50% of residents, 62% of fellows and 67% of technologists correctly identified keratocytes as schistocytes. Fifteen (15%) of fellows misidentified bite cells as schistocytes, whereas one fellow (8%) and one technologist (11%) misidentified acanthocytes as schistocytes. Only 70% of technologists correctly identified helmet cells as schistocytes, whereas all residents and fellows chose them correctly. Almost all participants failed to recognize microspherocytes as schistocytes. The microscopes all showed the same objective and field diameter measurements. The schistocyte percentage plotted versus the number of schistocytes per HPF showed a 0.99% correlation co-efficient (R=0.99%) (Fig 1). The results were compared to the ICSH threshold of 1%, above which the ICSH reports is a robust morphologic indicator for the diagnosis of TMA (Fig 2), and to the current reporting policy at UCMC. Two (2) schistocytes per HPF correlated with 1% schistocytes on the linear plot. At UCMC, policy had been to report 2-8 schistocytes per HPF as present and &gt;8 per HPF as increased. These findings indicated that the threshold for reporting increased schistocytes should be lowered from &gt;8 per HPF to &gt;2 per HPF. The above data were reviewed with each survey group. A process was also initiated to change the laboratory schistocyte reporting policy. Conclusion: All survey groups needed and desired education on schistocyte identification and reporting per ICSH guidelines. All microscopes showed the same measurements and were therefore expected to produce the same quantitation results. Schistocyte percentage correlated with the number of schistocytes per HPF. By implementing the ICSH guidelines, we aimed to decrease inter-observer bias and to standardize the quantitation and reporting of schistocytes at UCMC, thereby assisting in timely and accurate diagnosis of thrombotic microangiopathic anemia. Disclosures No relevant conflicts of interest to declare.

  PublisherDOI

• Castleman Disease Presenting as a Parapharyngeal Mass: A Case Report and Review of the Literature

  Clinical Medicine Insights Case Reports · 2019-01-01 · 8 citations

  articleOpen access

  OBJECTIVES: Masses in the parapharyngeal space often pose a diagnostic and therapeutic challenge due to an inaccessible location for biopsy and proximity to critical neurovascular structures of the neck. The aims of this study are to describe a rare case of Castleman disease (CD) presenting in the parapharyngeal space. METHODS: Case report of a 38-year-old male presenting to a tertiary care center and literature review. RESULTS & CONCLUSIONS: The parapharyngeal space is an unusual location for CD. Surgeons, radiologists, and pathologists must be aware of this disease entity within the differential diagnosis to provide appropriate perioperative counseling for patients.

  PublisherOA PDFDOI

• A Case Report of a Breast Implant–Associated Plasmacytoma and Literature Review of Non-ALCL Breast Implant–Associated Neoplasms

  Aesthetic Surgery Journal · 2018-11-24 · 8 citations

  review

  Lymphomas associated with breast implants are rare, with the most common being anaplastic large cell lymphoma (ALCL). Non-ALCL breast implant-associated lymphomas are even more rare, with only a small handful of such neoplasms reported to date. Given the need to better understand these pathologies as well as the increasing clinical and media attention being paid to these diseases, we review the available literature of hematolymphoid neoplasms other than ALCL associated with breast implants and describe the first case of a patient diagnosed with a primary breast implant-associated plasmacytoma.

  PublisherDOI

Frequent coauthors

• Samir B. Kahwash

  9 shared

• Fernando Ovalle

  University of Alabama at Birmingham

  4 shared

• Ahmed Beydoun

  Medical College of Wisconsin

  4 shared

• Pooja Agarwal

  Advanced Numerical Research and Analysis Group

  4 shared

• Rafiullah Khan

  University of Cincinnati

  4 shared

• Ryan M. Gobble

  University of Cincinnati

  4 shared

• Alice L. Tang

  University of Cincinnati Medical Center

  1 shared

• Rebecca Wyma

  The Ohio State University

  1 shared

Awards & honors

• Medical Leadership Program, Nationwide Children's Hospital,…
• Member, Society for Hematopathology Research