A conversation with Dr. Ethel Cesarman, Professor of Pathology and Laboratory Medicine at Weill Cornell Medicine.
Question: You’re trained in anatomic pathology, hematopathology, and molecular pathology, and serve as Assistant Director of the Molecular Hematopathology Lab at NYP and Weill Cornell. Your research focuses on malignancies linked to AIDS and other immunodeficiencies. Is that accurate?
Answer: Yes—except I didn’t do a formal molecular pathology fellowship as those were implemented after my training. But I had experience doing cancer molecular genetics as part of my PhD research.
Ethel Cesarman, M.D., Ph.D.
Professor of Pathology and Laboratory Medicine
Q: What drew you to those fields?
A: I like being in both diagnostics and research—they feed each other. People talk about “physician-scientists;” but I think of myself as a pathologist-scientist: bed to microscope to bench, and back. I’m fascinated by how things happen, why they happen, and what we can do about them. My molecular work bridges how genes and infections cause cancer, and my research is still very microscope oriented.
Q: Any recent discoveries that made you think, “Oh my gosh”?
A: Truly groundbreaking moments are rare, but incremental ones matter too. One big study confirmed the link between Epstein–Barr virus (EBV) and multiple sclerosis—something long suspected. I don’t work on MS, but I do work on EBV, so it was exciting. And progress in cancer therapeutics impresses me—it’s incredibly hard to get even one new drug approved.
Q: Your lab studies how cancer, viruses, and immune dysfunction intersect. Update us?
A: We focus on EBV and Kaposi’s sarcoma herpesvirus (KSHV). For KSHV, we’re studying a viral protein essential for tumor cell survival via the NF-κB pathway. Inhibiting it kills cancer cells. We’ve had success with a peptide-based approach and are now seeking a small-molecule inhibitor. Funding setbacks slowed us, but we have promising leads.
Q: You helped discover the causal agent of Kaposi’s sarcoma (KS). How common is it now in sub-Saharan Africa?
A: With good HIV therapy, KS has declined sharply in the U.S., though it still occurs here—even without HIV. In Africa, the virus is widespread, so KS remains among the most common cancers. Early disease may regress with HIV treatment, but advanced cases require chemotherapy, which can be hard to access in rural areas. I work with the AIDS Malignancy Consortium (AMC) on African clinical trials; paclitaxel works well there, though it’s more toxic than the U.S. gold standard, liposomal doxorubicin.
Q: Has your work taken you to Africa?
A: Yes—Uganda, Kenya, Tanzania, and South Africa. Always meaningful.
Q: This summer you published on a skin-biopsy tool for faster diagnosis. Can you explain the significance of this new tool?
A: Late diagnosis is a huge problem in Africa. Our ultimate goal is to develop a point-of-care test, like a COVID home test, but for KS. The challenge is extracting DNA from skin—it’s thick and connective tissue-rich. If we can make ultra-thin slices, extraction might be simpler and cheaper. We’ve had good results with a small molecular testing device we call “TINY,” developed with Cornell Engineering, but DNA extraction remains the bottleneck which my engineering collaborators are solving.
Q: As leader of the AMC Pathology Core, what’s your role?
A: I ensure accurate, consistent pathology reviews for clinical trials, collaborate internationally, and work with the team to make sure the correct biomarkers are included in clinical trials and apply emerging technologies where feasible, such as multiplex imaging and telepathology to our sites.
Q: Where’s your research headed?
A: Finding a small-molecule inhibitor for the KSHV protein vFLIP is my top goal. I’m also exploring ways to epigenetically expose more viral antigens so the immune system can recognize infected cells. And we continue working on mechanisms of viral pathogenesis and lymphomagenesis.
Q: AI in your work?
A: Not yet. I’ve tried ChatGPT—not a fan of the output. Well-designed machine learning will help pathology, but AI relies on human-generated data; if we stop creating new knowledge, it will just recycle itself.
Q: You were born in Mexico City, trained there, then earned your PhD at NYU. Why New York?
A: I wanted broader research opportunities and an adventure. Pathology wasn’t on my radar until my PhD histology course, when I realized this was what I wanted to do. I loved being able to integrate tissue architecture with function.
Q: Any family influence?
A: Yes—my father was a psychiatrist; his brothers were cardiologists; my mother was an anthropologist turned psychologist.
Q: Advice for new pathologists?
A: It’s an intellectually rich specialty with good work–life balance. At Weill Cornell, if you show initiative, you’ll find amazing opportunities and collaborators.
Q: What do you like about New York?
A: The energy, diversity—and yes, even the subway. I live in Jersey City for more space but still commute by public transit.
Q: Something people might be surprised to know?
A: I knit and crochet—right now for my four upcoming grand-nieces and nephews. During the pandemic, I baked bread and taught myself chair caning from YouTube.
Q: How did COVID affect your work?
A: I stayed productive, signed out molecular cases remotely—a practice we’ve kept—and used the time for writing. Personally, it was a period of reflection and family closeness, even amid its broader devastation.