A panegyric on Lauren Vedder Ackerman

Dr Anuj ParkashWritten by | HISTORICAL INSIGHTS

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Lauren V. Ackerman, MD(1905-1993), was an American physician and greatest surgical pathologist of mid-20th century, first graduated with a bachelors degree in mechanical engineering in 1927 and doctorate in medicine in 1932.

The modern era of surgical pathology at Barnes Hospital and Washington University School of Medicine in St. Louis began with the arrival of Dr. Ackerman in 1948. By early 1960, surgical pathology as a distinct subspecialty of anatomic pathology was defined and the role of the surgical pathologist on matters of the “pathology of the living” was established.

A very experienced surgeon came to see Dr. Ackerman with an invitation: “Lauren, would you please come to the Clinic to see a patient with a lesion in the oral cavity that you keep calling leukoplakia?” “Tell me, Lauren” said the surgeon, “what kind of leukoplakia is this?” He replied: “It is the bad kind.” At that moment, the entity of verrucous carcinoma was born, aka “Ackerman’s tumor”.

 

Dr. Ackerman authored his first book, Cancer: Diagnosis, Treatment, and Prognosis, with Juan Del Regato, a radiotherapist which was to have a major effect on the management of patients with malignant neoplasms.

 

 

Dr. Ackerman felt that the standard radical mastectomy was probably excessive therapy for most invasive carcinomas of the breast, and was very critical of the so-called super-radical mastectomy, which had come into vogue in the late 1950s and early 1960s. It was Dr. Ackerman’s opinion that radiation therapy with total or simple mastectomy was adequate treatment in most cases.

 

Dr. Ackerman published first edition of his influential textbook with the title Surgical Pathology in 1953, post retirement he assigned editorship to Dr. Juan Rosai, who continued to oversee Rosai & Ackerman’s Surgical Pathology through its 11thedition.

 

Dr. Ackerman loved to travel and was known by some of the surgeons at Washington University as the “TWA professor,” “Travel with Ackerman”. He was a visiting professor to the world.

Another notable observation of Dr. Ackerman was delineation of the zonation phenomenon in myositis ossificans one of the critical differentiating features from osteosarcoma.

One of the few conclusions from his many studies that have not withstood the test of time was his premise that there was no direct relationship between the adenomatous polyp (tubular adenoma) and colonic carcinoma.

Dr. Ackerman underwent a right hemicolectomy for an undifferentiated carcinoma of the cecum with neuroendocrine features. When Dr. Juan Rosai asked him how he felt, he said “Not too well. The left colon now has to do the things that the right colon used to do, and he does not like it.” He died 2 months later.

Juan Rosai in: Lauren V. Ackerman: a wit, a rogue, a giant: selected anecdotes, mentioned:

“If there was an individual in surgical pathology who can be accurately described as a “character,” that was Dr. Ackerman”

His Fernandel-like looks, his ever present sardonic smile, and his inimitable quips all contributed to make him the unchallenged star of any pathology gathering”

Compiled by: Dr. Divya Bansal

Disclaimer: The pictures used in this blog is for education purpose only with no commercial usage.
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Last modified: 01/06/2021

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