A conversation with Dr. Annika Windon, Assistant Professor of Pathology and Laboratory Medicine at Weill Cornell Medicine
Q: You received board certification in anatomic and clinical pathology after completing your residency at the Hospital of the University of Pennsylvania and developed an expertise in gastrointestinal, pancreas, and liver pathology. What drew you to those fields, and what do you find engaging or challenging about them today?
A: Initially, I was drawn to GI pathology because of my mentor in residency. She was an exceptional GI pathologist, and she introduced me to the breadth and complexity of the field during case sign out and at the gross bench. Her passion and skill as an educator were so compelling that I was immediately drawn in—largely because of how she introduced the specialty to me.
Annika Windon, M.D.
Assistant Professor of Pathology and Laboratory Medicine
As I gained more exposure, I really enjoyed the intellectual challenge of complex cases, and I became intrigued by the focused, yet diverse scope of the field. We deal with such a broad spectrum of entities—everything from inflammatory to neoplastic conditions. It’s a field that really demands a strong foundation in clinical medicine and a deep understanding of the human body as a whole. Every case is different and can serve as an opportunity to learn, which keeps me engaged.
I am especially fascinated, and at the same time humbled, by liver pathology, which is arguably one of the more challenging areas of GI pathology. To interpret a liver biopsy accurately, you need to consider the entire clinical picture—history, lab work, medication history, imaging, and sometimes operative findings. The comprehensive, detective-like approach is what I find so interesting and satisfying. While some may assume GI pathology primarily consists evaluating polyps all day, that perception is far from the truth. Many of our patients are critically ill or have complex conditions that require integration of the clinical presentation with the histology. We need to understand all of the information in order to deliver a meaningful diagnosis. I also appreciate any opportunity to learn from my clinical colleagues, especially during interdisciplinary conferences. Oftentimes those cases are the more complex and challenging.
Q: Many pathologists don’t interact with patients. Have you had any direct contact with them?
A: That’s a great question—and I love that you asked me. Personally, I haven’t met my patients face-to-face. There was one individual who reached out to thank me via email after I published an article describing microscopic colitis in the pediatric population, and she appreciated the research I had conducted on this entity because she had lymphocytic colitis (a form of microscopic colitis), but that’s the closest I’ve come.
Having said that, I’m excited about incorporating more exposure to clinical medicine into my work moving forward—possibly by shadowing or collaborating more closely with my gastroenterology and hepatology colleagues. I want to go beyond what I see under the microscope and better understand the whole patient. Recently, I have been thinking of how can we make pathology reports easier to understand for clinicians and patients and how the understanding of my reports impacts subsequent steps in the clinical management of the patient. It’s something I plan to prioritize in the next phase of my career.
I try to encourage this perspective in trainees, reminding them that behind every glass slide is a real person: someone’s parent, child, or sibling. It’s so important not to lose sight of that human connection. Even though we’re not the ones delivering the diagnosis directly to the patient, the weight of what we do really matters. Putting your full effort into each case isn’t just professional—it’s a privilege.
Q: Some of your academic interests have included exploring pre-neoplastic conditions like Barrett’s esophagus and distinguishing pre-neoplastic from reactive lesions in the biliary tree. How do you explain such a technical specialty to those outside the field?
A: I usually start by explaining that I am interested in studying subtle changes that occur in the tissue before the cancer develops. For example, in Barrett’s esophagus (a precursor lesion for esophageal cancer), the lining of the esophagus changes from one cell type to another and can potentially become cancerous. My interest focuses on identifying those subtle changes early—before cancer forms.
Even among GI pathologists, classifying reactive versus dysplastic Barrett’s can be tricky. Some patients with these abnormal changes will never develop cancer. So, I’m interested in studying how we can use morphology—what we see under the microscope—alongside molecular studies and other endoscopic techniques to better risk stratify these patients and guide screening strategies.
In the pancreaticobiliary system, the same dilemma occurs. These cases are diagnostically challenging with sometimes significant histologic overlap, and the resulting surgeries are can be complex with high morbidity. Distinguishing reactive from dysplastic changes in the bile ducts, for example, takes a lot of experience and a deep understanding of morphologic nuances. These are challenging areas within GI pathology but I love it—I enjoy pushing myself to keep learning, sharpening my eye, and staying current with the latest ancillary studies.
Q: Do you use AI in your work? And what are your thoughts on its future in pathology?
A: I don’t currently use it in my work, but I am actively trying to learn about all of its applications. I do think there is a role for it, but there is a need for close human oversight. I believe we may be able to ultimately leverage AI in various capacities, including using it as an ancillary tool to assist with pattern-based recognition. However, it’s critical that trainees and those in practice continue to develop and hone their skills in the fundamentals of histology, and avoid complete reliance on AI. The power of human interpretation is still important, especially when you need to integrate complex clinical data and factors that can be critical to a case.
Q: You’ve been very involved in national pathology societies like CAP and USCAP, and resident education. Why is that work important to you?
A: I’ve had mentors and teachers who really invested in me and helped me grow, so I’m passionate about paying that forward. I want to train the next generation of pathologists to push themselves and be the best diagnosticians and physicians they can be. The only way to accomplish this goal is to be fully invested in resident and fellow education.
Being active in national committees helps you stay connected to the broader pathology community. I’m currently on the Journal Watch committee for GIPS (Rodger C. Haggitt Gastrointestinal Pathology Society), which keeps me up-to-date on both clinical and pathologic literature. I have the opportunity to share interesting articles that I think will help my colleagues in practice. I encourage trainees to get involved too—not just for the knowledge, but for the networking, the professional development, and the exposure to how guidelines and consensus statements are developed.
Mentorship, especially, is absolutely critical. It’s been a driving force in my own career. And I think institutions like Weill Cornell Medicine do a really great job of fostering those relationships, encouraging both formal and informal mentorship as well as sponsorship—creating opportunities and exposure for younger faculty.
Q: How did you end up at Weill Cornell Medicine in New York?
A: I ultimately wanted to be somewhere that emphasized academic work and teaching. Cornell aligned with that vision, so I applied. The interview process confirmed that it was the right place for me.
I’ve always admired New York City, and quickly adapted to living here. The energy of the city, the diversity, the welcoming environment, all helped me realize this was the right fit. There’s something for everyone, and I never feel out of place.
Q: What advice would you give someone interested in a pathology career?
A: First, don’t be afraid of your interests. Pathology hasn’t always been presented in the most attractive way in medical school—people think it consists of just autopsies and lab work, which are valuable areas within medicine, but it’s so much more than that. Surgical pathology, for example, is highly interactive. In my field, I work closely with surgeons, gastroenterologists, hepatologists, and other clinicians.
I’d encourage students to spend some time in pathology departments. For example, go to the gross room, observe the pressure of a frozen section/ intraoperative consultation when the surgical team is waiting for the diagnosis as the patient is under anesthesia on the operating table. That’s when the specialty comes alive. And don’t believe the stereotype that pathologists are antisocial or just work isolated in the basement of a hospital. I talk to people all day—clinicians, residents, lab staff. Communication skills matter here too.
Q: When you were considering pathology, did people question your interest because you’re a “people person”?
A: Absolutely. People said, “You’re so outgoing—why would you go into pathology?” But for me, pathology was the perfect fit. I care deeply about patients, and I enjoy having a role in their care through a diagnostic branch of medicine. I love having the ability to potentially provide an answer in difficult cases and visualizing disease under the microscope. I think others might feel the same way, but they hesitate because of how pathology is presented. I’d say—don’t be afraid. Explore it. Be curious.
Q: Is there anything else you’d like to share about your journey?
A: Yes—don’t give up. If you don’t get the fellowship or the job you want the first time, keep going. My journey is a testament to persistence. It has not been easy. Keep pushing yourself to improve—get sharper, stronger, better. There’s always a next step.
Q: I found a Golfweek article from 2006 about you and your siblings becoming serious golfers at a young age. Did that experience shape your professional life in any way?
A: Absolutely. Golf has been a huge influence in my life. It started with my dad—my brothers and I went to the driving range with him one day, and once I picked up a club, I was hooked. I played high school and collegiate golf, competing in many national and international tournaments.
Golf teaches discipline, focus, and accountability. It’s an individual sport, and just like in pathology, no one else can do it for you. You’re responsible for your performance. I’m very methodical by nature, and the mechanics of the golf swing require precision—just like studying patterns of injury under the microscope.
So yes, there’s a strong connection between golf and pathology for me. Both are about focus, patience, and constant self-improvement.
Q: Do you still play?
A: Oh yes! I try to play every weekend when the weather is warm. I recently played the Bethpage Black Course, where they will host the Ryder Cup in September—it was tough, but I like a challenge. My favorite course of all time is probably Pine Valley. It’s incredibly difficult, but also incredibly rewarding. Just like the field of pathology.
Q: Final question—what’s something people might be surprised to learn about you?
A: Honestly, I’m pretty much an open book. What you see is what you get. But one thing I’ll say is this: I will fight hard for every patient. It’s truly an honor and a privilege to do what I do.