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The Dermatopathology Unit at the Massachusetts General Hospital, led by Dr. Lyn McDivitt Duncan, is a world leader in diagnostic dermatopathology, dermatopathology training and investigative dermatology.
The Dermatopathology Unit is responsible for diagnosing skin biopsies from a variety of sources, including Mass General inpatients, patients seen in outpatient clinics at the Mass General and in the Boston metropolitan area, and patients who have had initial diagnoses that we are asked to review in consultation. These specimens include routine histology, immunofluorescence, immunohistochemistry and in situ hybridization studies.
The Dermatopathology Unit has a long history of being a leader in clinicopathological studies of melanocytic tumors. Current projects range from comparative histomorphology to transcriptional genomic profiling. Recent reports from the Mass General Dermatopathology Unit include morphologic descriptions of benign versus malignant melanocytic proliferations including dysplastic nevi, Spitz’s nevi, lentigo maligna, desmoplastic melanoma, animal type melanoma, nevoid melanoma, and a protocol for sentinel node biopsies in melanoma. In addition, we have reported studies of prognostic factors in melanoma, particularly the evaluation of tumor infiltrating lymphocytes in melanoma and the value of a unique melanocyte specific gene, TRPM1 (MLSN/melastatin).
Academic and Research Accomplishments
Dr. Duncan's research activities focus on cutaneous oncology, specifically cutaneous lymphoma and malignant melanoma. She serves as the Scientific Co-Chair of the cooperative group trial CALGB 500105, and as the Mass GeneralMass General Principal Investigator of the Harvard Skin SPORE (Specialized Program of Research Excellence). Dr. Duncan and colleagues, including Dr. Nancy Harris and Dr. Judith Ferry, described a previously under recognized form of cutaneous lymphoma that has provided insight into the clinical and histologic heterogeneity of cutaneous B-cell lymphomas. Marginal zone B-cell lymphoma mimics a benign reactive process, and is now recognized as the second most common form of primary cutaneous B-cell lymphoma.
In a collaborative effort with Dr. F. Stephen Hodi at the Dana-Farber Cancer Institute, Dr. Duncan is evaluating the combined impact of TRPM1 and sentinel lymph node status in predicting the outcome in melanoma patients in the CALGB 500105 cooperative group trial entitled "Prospective Study of Melastatin Expression in Predicting the Risk for Developing Local Regional Metastases of Primary Melanoma."
As the Mass General Co-Principal Investigator of the Harvard Skin Cancer SPORE, Dr. Duncan is leading investigation on melanoma biomarkers in cohorts of clinically annotated melanoma tissue specimens and in the Skin SPORE collaborative melanocytic tumor progression Tissue Microarray (TMA). This TMA work is a collaborative effort led by Dr. Duncan with Dr. David Rimm, Dr. David Elder, Dr. Victor Prieto and Dr. George Murphy of the Univ. of Pennsylvania, Yale University, MD Anderson and Harvard Skin SPOREs, respectively.
Dr. Hoang's research focuses on the diagnostic utility of immunohistochemistry in cutaneous neoplasms and the development of educational platforms using the latest technology.
Dr. Nazarian's research is focused on elucidating the pathophysiologic mechanisms of fibrosing disorders of the skin, with particular interest in nephrogenic systemic fibrosis.
Dr. Duncan serves on the Advisory Board of the Harvard/MIT Health Sciences and Technology Program Dr. Duncan is also the Mass General Co-Director of the Harvard Dermatopathology Training Program, after a decade of service as the Harvard Dermatopathology Training Program Director. All members of the Dermatopathology Unit actively teach Residents in Pathology and Dermatology and Dermatopathology Fellows during daily dermatopathology signout. There are three dermatopathology services, with full signout activities each day in a recently designed interactive signout facility that includes two 40 inch plasma screen monitors linked by camera to a multi-headed microscope and by ethernet to the electronic medical record, e-textbooks, and via the internet, Medline and Pubmed.
In addition to this teaching there are numerous teaching conferences specific to Dermatopathology including:
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