All types of cytologic specimens are routinely received and processed, including gynecologic and non-gynecologic cytology and fine needle aspiration biopsy (both clinician and pathologist performed).

Cytopathology Laboratory

The Cytopathology Laboratory, under the direction of Dr. Martha B. Pitman, MD, occupies the first floor of the Warren Building. The laboratory is staffed by eleven cytopathologists, eight cytotechnologists, three preparatory technologists, and three clerical staff members. Two anatomic pathology residents are always on rotation, and between one and three cytopathology/gynecologic pathology/women's health fellows are present in the laboratory. In terms of clinical services, the laboratory provides comprehensive services to the hospital and its clinicians. All types of cytologic specimens are routinely received and processed including gynecologic and non-gynecologic cytology, and fine needle aspiration biopsy. Both clinicians and pathologists provide their services. The personnel of the laboratory participate fully in the teaching programs of the hospital and medical school. An active clinical research program is distributed among the members of the laboratory.

As the field of cytology is currently in a dynamic state, the laboratory has made significant changes in its methods in the past five years, and has plans to continue this evolution. The goals of the laboratory as it moves forward are to:

  • Maintain the highest quality patient care activities, using the newest and most cost effective technology available. In addition, new modes of ancillary testing for neoplasia detection, prognosis, and classification are being tested and added as appropriate.
  • Provide outstanding teaching to trainees such that they will become tomorrow's leaders in cytology and other anatomic pathology disciplines.
  • Develop and evaluate new methods in, and related to, cytologic specimen procurement; and to foster an environment in which clinical, translational, and basic research can be successfully performed.
  • Provide opportunities for all staff and trainee members of the laboratory to participate in the above activities.

Faculty

Clinical Program

The Cytopathology Laboratory provides comprehensive cytology services to the MGH community. These services include processing and interpretation of all types of gynecologic and non-gynecologic specimens. Under the direction of Dr. Amy Ly, the laboratory maintains an active Fine Needle Aspiration Biopsy Service with preparation, rapid assessment, and final interpretation of both clinician- and pathologist-obtained specimens.

Recent volumes and case mix are:

  • Gyn: 48,826
  • Non-Gyn: 16,876
  • FNA: 5,046

The laboratory has incorporated several major innovations in clinical service delivery in recent years. The most significant are the complete conversion of the gynecologic cytology volume to the new liquid-based collection methods and the implementation of computer-automated cervical cytology screening. The laboratory now uses the most up-to-date clinical instrumentation and continues to test and develop new methods. Other innovations have been in the application of immunologic and molecular diagnostic tests to cytologic specimens. The laboratory offers a full range (via collaboration with the immunopathology service) of ancillary markers on cytologic specimens, in order to make optimal use of limited cytologic specimen material. In addition, the use of flow cytometric analysis for lymphoma workup has become a routine procedure.

Cytology maintains all of its laboratories and most of the faculty offices on Warren 1.

Academic and Research Accomplishments

Dr. Amy Ly's principal clinical interests are in breast pathology and cytopathology.  She has extensive training and experience in performing and interpreting fine needle aspiration biopsies. She is director of the Fine Needle Aspiration Service. Dr. Ly's research interests include adjuvant therapy-induced changes in breast cancer, the utility of cytologic specimens for molecular studies, and circulating tumor cells in breast cancer patients.

Dr. David C. Wilbur is a past Director of Cytopathology. His primary interests are in cytology automation, gynecologic cytology, and digital imaging and telepathology. He is a past-President of the American Society of Cytopathology and has chaired the College of American Pathologists Cytopathology Resource Committee.

Dr. Martha B. Pitman has written and lectured extensively on the clinical utility of fine needle aspiration biopsy, particularly of the liver and pancreas. Her primary research interests center on the role of cytology in the pre-operative diagnosis and management of patients with pancreatic cysts. She is co-author of the 4th series AFIP fascicle on Pancreatic Tumors as well as co-author of pancreas sections on ductal adenocarcinoma and intraductal papillary mucinous neoplasms in the next edition of the WHO Classification of Tumours of the Digestive System. She is the current President of the Papanicolaou Society.

Dr. Rosemary Tambouret Dr. Rosemary Tambouret is the director of the Cytopathology Fellowship at MGH and as such, is active in resident and fellow education. She is currently (2013-2015) the co-chair of the Public Affairs and Advocacy committee of the American Society of Cytopathology (ASC). As co-chair, she is active in promoting cytopathology education initiatives in under-served areas around the world. She is also a member of the MGH Executive Committee on Teaching and Education, as well as the Partners Education Committee and a member of the Cytopathology Resource Committee of the College of American Pathologists. Her academic interests include gynecologic cytology and fine needle aspiration cytology of the kidney.

Dr. William C. Faquin who is Director of ENT Pathology is particularly interested in cytopathology of the head and neck and the application of molecular techniques to the diagnosis and prognostication of head and neck tumors. He is actively involved in research relating to the role of HPV in oropharyngeal squamous cell carcinomas, the FNA diagnosis of Hurthle cell neoplasms of thyroid, Topoisomerase-alpha expression in thyroid neoplasms, and the FNA diagnosis of salivary gland neoplasms, and spindle cell lesions of the head and neck.

Dr. Stephen Black-Schaffer's interests are in pathology graduate medical education and in the organizational and management aspects of pathology practice. He is Associate Chief of Pathology for Training and Education at the Massachusetts General Hospital, where he directs the residency training program in pathology. He is active on committees and councils of the Association of Pathology Chairs (APC), the College of American Pathologists (CAP) and the American Society of Cytopathology (ASC), as well of the Massachusetts General Physicians Organization (MGPO) and Partners Healthcare System (PHS).

Dr. Elena Brachtel is a cytopathologist and breast pathologist. She signs out gynecologic and non-gynecologic cytopathology, gynecological quality assurance, breast pathology and ancillary studies (hormone receptors and HER-2). She is on the faculty of several postgraduate continuing medical education courses and teaches in the areas of breast pathology, gynecologic and non-gynecologic cytopathology. Dr Brachtel's current research interests include involvement of the nipple in breast cancer, role of BTG2 in human breast cancer, digital imaging in breast cancer diagnosis and pathologic changes in breast cancer after neoadjuvant chemotherapy.

Dr. Joseph Misdraji is interested in liver cytology as an extension of his interest in liver pathology and GI pathology. He also takes an active role in teaching residents and fellows FNA techniques and the cytologic diagnosis of endocervical neoplasia in cervical cytology samples.

Dr. Ivan Chebib’s interests include cytopathology and bone and soft tissue pathology. He is board certified in Anatomic Pathology and Cytopathology with the American Board of Pathology, and certified as a fellow of the Royal College of Physicians of Canada.