Dr. Ronald F. Dorfman, a broadly experienced and knowledgeable surgical pathologist and an Emeritus Professor of Pathology at Stanford University, is best recognized world-wide for his expertise in hematopathology. His prolific publications, his invaluable contributions as a consultant on problematic cases and his teaching and lecturing in numerous countries have qualified him eminently for the many awards that he has received.
Dr. Dorfman was born in Johannesburg, South Africa in 1923. He graduated from the University of Witwatersrand and Medical School in Johannesburg, from which he received the MBBch in 1948. His medical school training was interrupted for two years (1944-1946), by his military service in Egypt and Italy during the second World War. After serving as a rotating intern in medicine and surgery and as a resident physician at Johannesburg General Hospital, he was elected in 1951 to attend the Royal Postgraduate Medical School of London, with the intention of obtaining a degree in internal medicine. Subsequently, he served as senior resident physician at the Royal Victoria Hospital in Edinburgh, Scotland. At this stage he made the prescient decision to switch to pathology, which he started in London. He then returned to South Africa and in 1955 entered the pathology training program at the South African Institute for Medical Research (SAIMR) in Johannesburg.
After completion of his residency, he joined the SAIMR as an Associate Pathologist in 1955 and was appointed a Fellow of the National Cancer Institute of South Africa in 1960. Dr. George Oettlé, director of the Cancer Institute, stimulated his early and intense interest in diseases of the lymphoid system. In addition to being a pioneer in utilizing the classification of lymphomas introduced in 1956 by Dr. Henry Rappaport, considered at that time to be the doyen of U.S. hematopathologists, Dorfman promptly produced an impressive series of independent original contributions. In 1961 he was invited to present a paper on “The Enzyme Histochemistry of Kaposi’s Sarcoma” at an international meeting sponsored by the International Union Against Cancer in Kampala, Uganda. It was at this meeting that he first met (and greatly impressed) Dr. Lauren V. Ackerman, one of the leading pathologists in the U.S. and Professor of Surgical Pathology at Washington University School of Medicine in St. Louis, Missouri. Between 1961 and 1964 Dorfman published several papers based on studies performed at the SAIMR, centering on morphologic and enzyme histochemical studies of Hodgkin’s disease, non-Hodgkins’ lymphomas, hyperplastic lymphoreticular diseases and Kaposi’s sarcoma. Based on these studies he next appeared on the international scene through an invitation to attend (in Paris, France in 1963) a Symposium on Lymphoreticular Tumors in Africa, the proceedings of which were published in 1964.
Not surprisingly, Professor Ackerman offered Dr. Dorfman a faculty appointment and in 1963 he and his family (wife Zelma and three young daughters, Erica, aged 7, Anne (3) and Carol (1) emigrated to the United States to begin what would be a five year period of impressive productivity in the Division of Surgical Pathology at Washington University School of Medicine and Barnes Hospital in St. Louis.
In 1960, at the SAIMR, Ronald Dorfman had encountered his first two cases of a unique disorder of which he was shown two additional examples during his five years at Washington University, by Dr. Juan Rosai, then a surgical pathology fellow at Barnes Hospital. Rosai was urged to work up these four cases following which their first paper on the now world-recognized condition initially termed “Sinus Histiocytosis with Massive Lymphadenopathy” (SHML) and later “Rosai-Dorfman Disease”, was published in 1969. This and a second report in 1972 entitled “Sinus Histiocytosis with Massive Lymphadenopathy: A Pseudolymphomatous Benign Disorder. Analysis of 34 cases”, published in the journal Cancer, served to establish SHML as a distinct entity. The establishment of a registry of cases of SHML, subsequently maintained by Dr. Rosai, who by then had relocated to Yale University as head of Anatomic Pathology, resulted in an accumulation over the ensuing years, of hundreds of cases from many parts of the world, highlighting the broad clinical spectrum of this disorder and emphasizing the extranodal manifestations of the disease. This in turn resulted in a prolific number of publications on Rosai-Dorfman disease, authored by many of Dr. Rosai’s fellows, in particular, Dr. Elliot Foucar.
At the instigation of Dr. Dennis Wright (later to become internationally recognized for his work on Burkitt’s tumor), Dorfman was responsible for the review of a case in St. Louis, which he presented during a clinicopathologic conference at Washington University and which was subsequently published in The American Journal of Medicine in 1965. This constituted the first example of Burkitt’s lymphoma reported outside of Africa. A subsequent retrospective review of possible cases at Barnes Hospital culminated in Dr. Dorfman’s report in the journal Cancer (1965) of a series of cases in St. Louis, clinically and histologically resembling Burkitt’s African Lymphoma.
In the ensuing years Ronald Dorfman played a leading role in the emerging specialty of hematopathology around the world. In 1966 he was invited by Dr. Henry Rappaport to be one of the initial members of the Pathology Panel for Lymphoma Clinical Trials under the sponsorship of the U.S. National Cancer Institute. He subsequently served for more than a decade as pathology consultant to the Southeast Cancer Chemotherapy Group. In 1967 he participated in an invited workshop in Bethesda, Maryland, organized by the World Health Organization (WHO) and the National Cancer Institute to define criteria for the diagnosis of Burkitt’s tumor (published by the WHO in 1969). Also in 1967 in Bethesda and in 1971 in Nagoya, Japan, Dorfman was a major contributor to meetings with expert Japanese hematopathologists under the auspices of the United States National Science Foundation and the Japanese Society for the Promotion of Science. From its inception in 1968 he was a faculty member for the Tutorial on Neoplastic Hematopathology, founded and directed for many years by Dr. Henry Rappaport and still offered annually under the able leadership of Dr. Daniel Knowles of Cornell University.
In 1968 Ronald Dorfman was offered a tenured appointment in the Department of Pathology at Stanford University Medical Center where, for approximately 35 years he co-directed the Laboratory of Surgical Pathology with Dr. Richard L Kempson. At Dorfman’s instigation the lymphoma classification of Rappaport was adopted at Stanford in 1968, leading to a series of major clinicopathologic studies with his clinical colleagues Drs. Henry Kaplan, Saul Rosenberg and others, over the years to follow. In 1970 he applied for and was awarded a grant of $250,000 by the John A Hartford Foundation to carry out research studies on Hodgkin’s disease. Five years later this grant was renewed. In 1974 he was appointed a Member of the Royal College of Pathologists of England, becoming a Fellow of the College in 1980. From 1976 to 1980 he served as one of six expert hematopathologists involved in the massive project which eventuated in the publication by the National Cancer Institute of the Working Formulation of Non-Hodgkin Lymphomas for Clinical Usage. In 1985 he was awarded a Senior Visiting Research Fellowship by St. John’s College, Oxford University, which enabled him to carry out immunohistochemical studies of Hodgkin’s disease, in collaboration with Drs. David Mason and Kevin Gatter at the Radcliffe Hospital, Oxford. Sadly, he learned that David Mason had died this year (2008) at the premature age of 66, from post-operative complications after the removal of a benign tumor of the pancreas. Mason was recognized internationally as the outstanding authority on the application of monoclonal antibodies (many produced in his own laboratory) to biopsy specimens, in the diagnosis of hematological malignancies.
In addition to his approximately 170 original publications in peer-reviewed journals, Ronald Dorfman has contributed to more than a dozen book chapters and books and he helped to prepare a new fascicle on Tumors of the Lymph Nodes and Spleen for the Third Series of the Atlas of Tumor Pathology, published in 1995. For five years he presented a course on the pathology of lymph node diseases at the annual meetings of the U.S. and Canadian Academy of Pathology, later serving as the first moderator of the evening hematopathology specialty conference. He made additional major contributions to the Academy through his membership on the Education Committee and later the Council. In 1981 he co-founded, with Dr. Costan W. Berard, the Society for Hematopathology, now a long-standing companion society of the Academy. They are both pleased that in recent years, the Society has combined with the European Association of Haematopathology to sponsor joint meetings. Dr. Dorfman participated in the Academy’s Long Course on “The Reticuloendothelial System” in 1974 and in 1986 co-directed with Dr. Berard the Long Course on “Malignant Lymphomas, Leukemia and the Immune System.”
Ronald Dorfman has presented innumerable lectures and seminars at distinguished academic institutions and international symposia the world over. He has served on major editorial boards and has participated in a broad array of professional organizations and scientific and academic committees. In later years at Stanford University Medical Center he had no choice but to concentrate solely on hematopathology and in particular, his consultations, which numbered 1500-2000 difficult cases a year. In 1981, with the help of generous donors from the San Francisco bay area and southern California he established a special fellowship program for young pathologists from Israel (The Mount Zion-Stanford-Israel-Hematopathology Fellowship Program), which lasted 13 years. He has over the years educated and influenced directly and indirectly more than a generation of hematopathologists and surgical pathologists in a wide spectrum of subspecialties.
In 1993 the U.S. and Canadian Academy honored him by appointing him the 36th Maude Abbott Lecturer. His lecture, given at the 82nd annual meeting of the Academy in 1993, was entitled: “Hematopathology: A Crescendo of Scholarly Activity”. That same year he was forced to retire at the age of 70, but was recalled to work part time, concentrating solely on his consultations, which he reviewed together with the hematopathology and surgical pathology fellows.
After Ronald Dorfman’s final retirement in 2001, Dr. Stephen Galli the chairman of the pathology department at Stanford University Medical Center, announced that the department had endowed a chair (Professorship of Hematopathology) in Dr. Dorfman’s name. Moreover Dorfman was delighted when one of his younger colleagues, Dr. Roger Warnke, who he had always regarded as his protégé, was appointed as the first holder of the Ronald F. Dorfman, MBBch, FRCPath Professorship of Hematopathology.