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Archives of Pathology & Laboratory... Dec 2019
Review
Topics: Humans; Immunotherapy; Medical Oncology; Neoplasms; Oncologists; Pathologists; Pathology, Clinical
PubMed: 31403333
DOI: 10.5858/arpa.2019-0340-SA -
Annales de Pathologie Jun 2019
Topics: Anaplastic Lymphoma Kinase; Genetic Markers; Humans; Liquid Biopsy; Pathologists; Physician's Role; Protein-Tyrosine Kinases; Proto-Oncogene Proteins; Thoracic Neoplasms; Translocation, Genetic
PubMed: 31160017
DOI: 10.1016/j.annpat.2019.05.002 -
American Journal of Clinical Pathology Mar 2023Hirschsprung disease (HD) is a congenital condition defined by the absence of ganglion cells in the distal-most portion of the gastrointestinal tract. Biopsies and... (Review)
Review
OBJECTIVES
Hirschsprung disease (HD) is a congenital condition defined by the absence of ganglion cells in the distal-most portion of the gastrointestinal tract. Biopsies and resections for HD can be adrenaline inducing for the general surgical pathologist because specimens are infrequent; HD is 1 of only a few neuroanatomic diseases that general surgical pathologists diagnose; numerous preanalytic factors (eg, biopsy adequacy, surgeon sampling protocol, processing artifacts) can affect histologic interpretation; and most importantly, the diagnosis has high stakes.
METHODS
We provide a comprehensive overview of the background, relevant clinical procedures, and pathologic assessment of HD. Grossing and frozen section protocols, an algorithmic approach to diagnosis, and histologic pearls and pitfalls are also discussed.
RESULTS
Evaluation and recognition of the features of HD have evolved significantly in the past 2 decades with the discovery of the value of calretinin immunohistochemistry in the late 2000s and the recent development of straightforward and reproducible histologic criteria for identification of the HD transition zone.
CONCLUSIONS
These advancements have substantially improved the pathologist's ability to reliably evaluate for HD. Nonetheless, as with any high-stakes surgical pathology specimen, clear communication with the clinical team is essential.
Topics: Humans; Infant; Hirschsprung Disease; Pathologists; Rectum; Biopsy; Immunohistochemistry; Calbindin 2
PubMed: 36565211
DOI: 10.1093/ajcp/aqac141 -
Fetal and Pediatric Pathology Dec 2023Costs for sendout genetic testing on in-patients are billed to the hospital. Turnaround times are several weeks, often extending past the inpatient hospitalization. We...
Costs for sendout genetic testing on in-patients are billed to the hospital. Turnaround times are several weeks, often extending past the inpatient hospitalization. We concurrently reviewed all sendout genetic in-patient test requests over an 18-month period, deferring those that could be obtained as an outpatient, directing the tests to less expensive laboratories with complementary testing profiles, and identifying no-charge sponsored tests. Of 121 test requests, 25 were deferred, alternative less expensive laboratories were identified for 8, 16 requests were directed to sponsored tests, for a 42.3% cost saving. Of the 96 tests sent, 18 (18.8%) identified an explanatory genetic abnormality. Approximately 40% of the sendout genetic testing costs were reduced with prior test review. Deferment, alternative laboratories, and sponsored tests contributed to cost savings. Efficiency of diagnostic inpatient genetic testing was approximately 20%.
Topics: Child; Humans; Genetic Testing; Hospitalization; Laboratories; Pathologists; Pediatrics; Inpatients
PubMed: 37787107
DOI: 10.1080/15513815.2023.2263790 -
Nederlands Tijdschrift Voor Geneeskunde Jul 2022For many patients the pathology report plays a key role in diagnosis and treatment planning. The report is traditionally addressed to the clinician and not to the...
For many patients the pathology report plays a key role in diagnosis and treatment planning. The report is traditionally addressed to the clinician and not to the patient. Although nowadays the patient can read the report, the complex content most often is incomprehensible to him/her. In an era of shared decision-making in which the patient must be fully informed, direct communication between patient and pathologist could be of added value for successful therapeutic management. Some successful initiatives have been reported. However, in the Netherlands direct interaction between the pathologist and the patient is still rare. This article is a plea to view the pathology report from a patient's perspective and to investigate how the communication of the content can be optimized. This article discusses possibilities for practical implementation, potential benefits and bottlenecks, as a basis for starting a discussion with practitioners, pathologists and patients in the Netherlands.
Topics: Communication; Female; Humans; Male; Netherlands; Pathologists
PubMed: 35899713
DOI: No ID Found -
Der Pathologe Dec 2019The label cancer in itself leads to complex psychological reactions in patients that are closely related to previous experiences and self-image. A cancer diagnosis can... (Review)
Review
The label cancer in itself leads to complex psychological reactions in patients that are closely related to previous experiences and self-image. A cancer diagnosis can lead to increased distress and subsequent mental comorbidity such as depression or anxiety disorders. The responsibility of the pathologist, as the person who first uses the label cancer, is high. The pathologist must be conscious and focus not only on the accuracy of the anatomical pathology, but also on the potential influences the wording may have on the mental health of the patient. The word "carcinoma" should only be used in the case of tumors with the respective biological behavior. The example of non-invasive follicular thyroid neoplasm with papillary-like nuclear features shows that changing a label can lead to an improvement in distress and quality of life.
Topics: Adaptation, Psychological; Humans; Mental Health; Neoplasms; Pathologists; Professional-Patient Relations; Psycho-Oncology; Quality of Life; Stress, Psychological
PubMed: 31705241
DOI: 10.1007/s00292-019-00687-6 -
Kidney International May 2020
Topics: Agriculture; Drug-Related Side Effects and Adverse Reactions; Humans; Nephritis, Interstitial; Pathologists; Renal Insufficiency
PubMed: 32331583
DOI: 10.1016/j.kint.2020.01.023 -
Annals of Diagnostic Pathology Oct 2019Beyond squamous carcinoma, a variety of diagnostically challenging neoplasms arise within various head and neck sites. This is particularly the situation with neoplasms... (Review)
Review
CONTEXT
Beyond squamous carcinoma, a variety of diagnostically challenging neoplasms arise within various head and neck sites. This is particularly the situation with neoplasms where little cellular cytoplasm is present to assist the pathologist in categorizing such lesions.
OBJECTIVE
To highlight diagnostic pitfalls that accompanying neoplasms composed primarily of 'cytoplasmically-poor' cells. These pitfalls include morphologic and immunohistochemical traps that emerge from this class of neoplasms.
DATA SOURCES
Selection of pathologic specimens from the author's personal files, and literature review.
CONCLUSIONS
Interpretative pitfalls regarding the histopathology and immunophenotype of small 'cytoplasmically-poor' neoplasms are a diagnostic hazard in head and neck surgical pathology practice, and require knowledge of histomorphologic plasticity and aberrant immunophenotyping.
Topics: Head and Neck Neoplasms; Humans; Pathologists; Pathology, Clinical
PubMed: 31382078
DOI: 10.1016/j.anndiagpath.2019.07.005 -
Pathologica Oct 2023The crucial role of pathologists in enhancing our understanding of SARS-CoV-2-related disease, from initial pneumonia manifestations to persistent long COVID lung... (Review)
Review
The crucial role of pathologists in enhancing our understanding of SARS-CoV-2-related disease, from initial pneumonia manifestations to persistent long COVID lung symptoms, is the focus of this review. Pathological explorations have offered unprecedented insights into the early stages of severe COVID-19, shedding light on the interplay between the virus and subsequent complications, thereby shaping clinical approaches. Growing interest is directed to residual lung abnormalities of COVID-19 survivors. Although various radiological studies reported long-lasting pulmonary changes (e.g., ground glass opacities, reticulations, and bronchiectasis), the true incidence of pulmonary fibrosis and corresponding pathological findings in these patients remains largely unknown. There are a few high-impact and knowledgeable works on late complications in COVID-19 survivors, several coming from explant or autopsy cases, and rare cases from in vivo sampling. The study of biopsy samples has further deepened our knowledge of the aftermath of COVID-19 on lung tissue, uncovering alterations at the cellular level and shifts in vascular and epithelial dynamics. Despite the substantial progress made, future research is needed to devise a uniform strategy for interpreting lung biopsies, with a focus on leveraging advanced tools such as molecular and digital pathology techniques, along with artificial intelligence.
Topics: Humans; COVID-19; Post-Acute COVID-19 Syndrome; Artificial Intelligence; Pathologists; SARS-CoV-2; Pneumonia; Lung
PubMed: 38054902
DOI: 10.32074/1591-951X-906 -
Virchows Archiv : An International... Jun 2018In recent decades, various highly qualified individuals have increasingly performed tasks that have historically been handled by physicians with the aim of reducing... (Review)
Review
In recent decades, various highly qualified individuals have increasingly performed tasks that have historically been handled by physicians with the aim of reducing their workload. Over time, however, these "physician assistants" or "physician extenders" have gained more and more responsibilities, showing that specific tasks can be performed equally skilfully by specialised health care professionals. The pathologist's assistant (PathA) is a highly qualified technician who works alongside the pathologist and is responsible for the grossing and autopsies. This profession was developed in the USA, with formal training programmes starting in 1970 when Dr. Kinney, director of the Department of Pathology of Duke University, Durham, NC, started the first dedicated course. Most institutes in the USA and Canada currently employ these technical personnel for grossing, and numerous papers published over the years demonstrate the quality of the assistance provided by the PathA, which is equal to or sometimes even better than the performance of pathologists. The PathA can be employed to carry out a wide range of tasks to assist the pathologist, such as grossing (the description and reduction of surgical specimens), judicial autopsies and administrative and supervisory practices within the laboratory or assistance in research, although the diagnosis is always the pathologist's responsibility. Since this role has already been consolidated in North America, part of the relevant literature is altogether out of date. However, the situation is different in Europe, where there is an increasing interest in PathA, mainly because of the benefits of their inclusion in anatomic pathology laboratories. In the UK, biomedical scientists (BMS, the British equivalent of PathA) are involved in many tasks both in surgical pathology and in cytopathology, which are generally performed by medically trained staff. Several papers have been recently published to highlight the role of BMS with the broader public. This report aimed to conduct a systematic review of all the articles published about the PathA/BMS and to perform a narrative synthesis. The results may contribute to the evidence for including the PAthA/BMS within a surgical pathology laboratory organisation.
Topics: Autopsy; Europe; Humans; Laboratories; Pathologists; Pathology, Surgical; Workforce; Workload
PubMed: 29380127
DOI: 10.1007/s00428-018-2300-x