Autopsy Service

Autopsy Service

The Autopsy Service performs autopsies on patients who die at Massachusetts General Hospital and patients who die outside of the hospital who have had some Mass General care. The service also performs autopsies for patients at Cambridge Hospital, several community hospitals and occasionally on patients from other hospitals. The service performs approximately 350 cases per year. This constitutes approximately 13% of hospital deaths. The Office of Decedent Affairs is a central resource for questions while making final arrangements, including requesting an autopsy, autopsy reports, finding a funeral home, filling out paperwork and answering any additional concerns.

Faculty

Mass General

• James R. Stone, MD, PhD - Subspecialty Head, Autopsy Service
• Rex Neal Smith, MD, PhD
• Abner Louissaint, Jr., MD, PhD
• Vanda Torous, MD
• Derek Oakley, MD, PhD
• Katelyn Dannheim, MD
• CHA Faculty (8-9 weeks)

Cambridge Hospital

• Julie M. Braza, MD
• John Grabbe, MD
• Rebecca Osgood, MD
• Eva Patalas, MD
• Elizabeth Zulinska, MD

Clinical Autopsy Program

Autopsies at Mass General cover the full spectrum of diseases and all organ systems, drawing on specialists in all areas of study in the department.

Autopsies are presented to the pathology staff and attending physicians at a weekly autopsy conference. Histologic sections are expedited for the conference to enhance the teaching value of the gross pathology. Autopsy residents and staff participate in a weekly autopsy consensus conference. The autopsy service provides for a provisional anatomic the day after the case is complete and attempts to complete the sign-out of the case in 60 days.

Special procedures are used for autopsies of organ transplantation (heart, lung, liver, kidney) to archive data for the many clinical transplantation protocols. Study of complications of therapy and degrees of rejection are an important part of these autopsies.

Residents rotate for two weeks through the Office of the Chief Medical Examiner (OCME) of the Commonwealth and perform prosections at that office. The off-site rotations include the opportunity for crime scene investigation.  Dr. Drucilla Roberts serves as consultant to OCME for cases of obstetric pathology. A series of lectures by the OCME is delivered through the academic year.

The neuropathology service examines brain, spinal cord, and muscles. Cases of neurodegenerative disease and dementia are referred to the Department through the Alzheimer Disease Research Center. The general autopsy service and neuropathology autopsy service perform autopsies on patients who have lived 100 years or more as part of a clinicopathologic study on centenarians.

Perinatal Autopsy Service

The perinatal autopsy service, under the direction of Dr. Drucilla Roberts, includes the full range of perinatal pathology services, including placental pathology, perinatal neuropathology, and cytogenetics. Perinatal autopsies include fetal and pediatric autopsies from 20 weeks gestational age to 3 months of life. The service performs approximately 50 perinatal autopsies per year, generally providing each resident with experience of 5-10 perinatal autopsies during their 3-5 year training period.

The perinatal autopsy service also performs all fetopsies (intact fetal abortal examinations less than 24 weeks gestational age, generally considered as surgical specimens) using the same complete autopsy procedure. Most perinatal autopsies are presented to clinical conferences including pediatric, obstetric and surgical services.

Educational Autopsy Activities

The autopsy service provides clinicopathological correlations and didactic teaching at the following conferences:

• Medical Service Morbidity and Mortality conference
• Surgical Grand Rounds
• Pediatric and Obstetrics Clinical Conferences
• Medical and Surgical Subspecialties
• Critical Care Unit conferences
• Transplantation Morbidity & Mortality Conference
• Neurology and neuropathology clinical and pathological conferences

Medical students who rotate through the department for one month or longer are assigned in part to the autopsy service. The student observes autopsies on their first few days in the department and then serve as the prosector on a case during the end of their first week. During their fourth week, they complete the histologic study, the clinicopathologic correlation, and the final written document with the attending staff pathologist. They may present an enlarged version of their findings at a small lecture at the conclusion of their rotation.

Facility

The autopsy suite underwent a one million dollar renovation in 2006. There are two L-shaped dissecting tables with continuous water cleansing and surgical lighting. There is a shower area in the autopsy suite. A separate conference has a large computer monitor. There is a large viewing window from the conference room into the dissecting area for viewing autopsies in progress.