The Hematopathology group provides diagnostic services for patients at MGH and consultation services for US and international pathologists.

Hematopathology

The Hematopathology group, led by Dr Harris since 1980 and by Dr. Ferry since January, 2010, provides diagnostic services for patients at MGH and consultation services for US and international pathologists. The group has focused on the careful morphologic, immunophenotypic, and genetic characterization of lymphoid and myeloid neoplasms, in order to develop criteria for diagnosis and to better define clinically relevant hematologic diseases. The group works closely with hematologists and oncologists to provide optimal patient care. A major mission of the group is also to train future leaders in the field of hematopathology.

Faculty

Clinical Program

The Hematopathology group provides diagnostic services for patients with hematologic disorders at MGH and for US and international pathologists. The group reports approximately 1200 bone marrow and 700 lymph node and other tissue biopsy specimens, including thymomas, annually. Approximately 1000 additional outside cases are submitted in consultation to the Hematopathology faculty. The group also works with other pathology services at MGH in the diagnosis of hematologic disorders involving extranodal sites and in Cytopathology specimens. The Hematopathology service provides an integrated interpretation on hematologic disorders, including flow cytometry, immunohistochemistry, cytogenetics, molecular genetics, and appropriate clinical and laboratory findings from the medical record.

Academic and Research Accomplishments

The Hematopathology group has been interested in using a combination of morphology, immunophenotype, and genetic features to characterize lymphoid and myeloid disorders, to improve the diagnosis and classification of these diseases. Characterizing small B-cell neoplasms, diffuse large B-cell lymphomas, extranodal lymphomas, reactive proliferations that may mimic lymphomas, acute leukemias, and myelodysplastic syndromes have been particular interests. Dr. Harris is a founding member of the International Lymphoma Study Group, and led the development of the Revised European-American Classification of Lymphoid Neoplasms (REAL classification), published in 1994, and was an editor of the World Health Organization classification of tumors of the hematopoietic and lymphoid tissues, published in 2001 and 2008. Members of the MGH Hematopathology group contributed to chapters on several neoplasms. The research interests of individual faculty are listed on the profiles listed above.

Teaching and Educational Activities

Educational Interactions with Other Departments
Hematopathology attendings and fellows participate in a number of weekly, biweekly or monthly multidisciplinary conferences with the Hematology/Oncology service during which pathology of active patient cases is shown and discussed, including Lymphoma Conference, Leukemia Conference, Lymphoma/Myeloma Clinicopathologic Conference, Leukemia/Bone Marrow Transplant Clinicopathologic Conference, and the Hematology Interdisciplinary Seminar.  In addition, the Hematopathology attendings, fellows and current rotating residents meet weekly to review and discuss interesting and challenging cases around the microscope (Interesting Case Conference) or to discuss a relevant article of interest (Journal Club).  Residents and fellows present cases with interesting and instructive cytogenetic findings at the monthly Hematopathology/Cytogenetics Conference, which is attended by cytogeneticists from Brigham and Women's Hospital.  Hematology/Oncology fellows from the combined Dana Farber-MGH Fellowship with interest in hematology participate in Hematopathology signout during a rotation in their second year of training.

Education of MGH Pathology Residents
Residents spend 2 months (AP) or 2.5 months (CP or AP/CP) on Hematopathology, where they are primarily responsible for bone marrow, peripheral blood, lymph node, and other specimens involved by hematologic disorders. Daily signout occurs as two separate services (Bone Marrow and Lymph Node), each with a faculty member, at multiheaded microscopes. There is usually also a fellow at each signout, as well as often visitors from other departments or institutions. Residents are responsible for reporting all diagnostic modalities on their cases: for example, bone marrow biopsy, aspirate smear, peripheral blood smear, flow cytometry, and immunohistochemistry are reviewed together by one resident-faculty-fellow team, reinforcing the importance of integrated reporting of hematologic neoplasms. The resident also receives reports of cytogenetics and molecular tests and works with the faculty member to incorporate this information into the final diagnosis. The Hematopathology faculty give didactic lectures to the residents during their Hematopathology rotation, including an intensive series of practically-oriented lectures and slide review sessions during the first week of each rotation.

Education of Hematopathology Fellows
The MGH Hematopathology Fellowship is accredited by the ACGME for two positions.  The two fellows supervise the residents in bone marrow and lymph node diagnosis.  The fellows also handle the complex consultation cases referred to the Hematopathology faculty.  The fellows participate in research projects during the fellowship and have produced a large number of research publications.

 

Previous and Current Fellows

Fellow Site of Residency Grad Year Current Position
Abner Louissaint Jr., MD, PhD MGH 2010 Current fellow
       
Ha Nishino, MD Baylor and MGH 2010 Current fellow
       
Julia Turbiner Geyer, MD MGH 2009 Hematopathologist, Cornell-Weill Medical Center
       
Michael Kluk, MD, PhD Yale 2009 Molecular Pathology Fellow, Harvard Program
       
Graham Slack, MD University of Alberta 2008 Hematopathologist, University of British Columbia
       
Chad Soupir, MD MGH 2008 Pathologist, Ridgeview Medical Center, MN
       
Aliyah R. Sohani, MD MGH 2007 Hematopathologist, MGH
       
Rania Seliem, MD Baystate and MGH 2006 Hematopathologist, Rashid Hospital, Dubai, UAE
       
Sa A Wang, MD Yale 2005 Hematopathologist, MD Anderson Cancer Center
       
Zoe Tang, MD MGH 2004 Hematopathologist, Kaiser Permanente, San Francisco Medical Center
       
Wen Jing, MD MGH 2004 Hematopathologist, Kaiser Permanente, San Francisco Medical Center
       
Lan Wang, MD MGH 2003 Pathologist, Chilton Memorial Hospital, NJ
       
Souhad Younes, MD MGH 2002 Pathologist, Sutter Davis Hospital, CA
       
Mohammed Mahmoud, MD Maimonides 1999 Hematopathologist Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
       
Henry Y. Dong, MD MGH 1998 Director of Hematopathology and Molecular Diagnostics, Genzyme Genetics/IMPATH, New York, NY

 

Medical Students
Medical students from Harvard Medical School (HMS) and other institutions performing elective rotations in pathology are typically assigned to one week of Hematopathology, during which they participate in the signouts.  Dr. Hasserjian teaches second-year medical students in the HMS Hematology course and Dr. Sohani teaches first-year medical students in the HMS Pathology course. Dr. Sohani and Dr. Hasserjian also participate in didactic case discussions with third-year medical students rotating at MGH during their Longitudinal Patient Care clerkship.

Post-Graduate Courses
Drs. Harris, Ferry, Hasserjian, and Sohani lecture on hematopathology topics at the annual MGH Current Concepts in Surgical Pathology course, which routinely draws over 200 participants. The Hematopathology faculty participate in several US and International Postgraduate courses in pathology, including courses sponsored by the American Society of Clinical Pathology, the United States and Canadian Academy of Pathology and Harvard Medical School. Dr. Harris is a faculty member of the Tutorial on Neoplastic Hematopathology under the direction of Dr Daniel Knowles (Cornell-Weill Medical Center).