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Archives of Pathology & Laboratory... Jun 2024
Topics: Humans; Pathologists; Pathology; Pathology, Clinical
PubMed: 38411264
DOI: 10.5858/arpa.2023-0572-ED -
Gastroenterology Clinics of North... Mar 2019Celiac disease is a common immune-mediated disorder that occurs in individuals with permissive genetics (HLA-DQ2/DQ8 genotype) following exposure to certain wheat... (Review)
Review
Celiac disease is a common immune-mediated disorder that occurs in individuals with permissive genetics (HLA-DQ2/DQ8 genotype) following exposure to certain wheat proteins. The histopathologic manifestations of small intestinal mucosal injury (villus atrophy, crypt hyperplasia, and intraepithelial lymphocytosis) are well recognized. However, these findings are not specific for celiac disease, because they are observed in other small intestinal disorders. These mimics include common and rare entities, the list of which continues to grow. This article discusses the histopathology and differential diagnosis of celiac disease and provides the pathologist's perspective on biopsy adequacy, evaluation, and reporting in light of current knowledge.
Topics: Biopsy; Celiac Disease; Gastroenterologists; Humans; Interdisciplinary Communication; Intestine, Small; Pathologists
PubMed: 30711210
DOI: 10.1016/j.gtc.2018.09.003 -
American Journal of Clinical Pathology Apr 2023Multidisciplinary cancer conferences (MCCs) are important tools in the treatment of patients with complex health issues, helping clinicians achieve optimal outcomes in... (Review)
Review
OBJECTIVES
Multidisciplinary cancer conferences (MCCs) are important tools in the treatment of patients with complex health issues, helping clinicians achieve optimal outcomes in oncological practice. To explore the role of pathologists at MCCs, we conducted a review of prior research on this topic.
METHODS
We conducted a scoping review by searching MEDLINE, EMBASE, and the Cochrane Library for English-language qualitative, quantitative, or multiple/mixed methods studies on the role and impact of pathologists on MCCs. We used Microsoft Excel to extract data.
RESULTS
Of 76 research results, we included only 3 studies that involved review of cancer cases by pathologists for MCCs. All 3 studies showed that expert pathology review improved the accuracy of diagnosis and refined disease staging, leading to changes in the management of melanoma, breast cancer, and gynecologic cancer. No studies explored the barriers to pathologists participating in MCCs or the strategies or interventions employed to promote or support pathologist involvement.
CONCLUSIONS
We identified a paucity of studies on the role of pathologists in MCCs. Given the positive impact of MCCs involving pathologists on the accuracy of diagnosis and optimization of treatment, future research is warranted to further establish the role and impact of pathologists in MCCs and how to promote or support pathologists' involvement.
Topics: Humans; Female; Pathologists; Breast Neoplasms; Patient Care; Melanoma; Genital Neoplasms, Female
PubMed: 36749312
DOI: 10.1093/ajcp/aqac164 -
Veterinary Pathology May 2020High-throughput in vitro models lack human-relevant complexity, which undermines their ability to accurately mimic in vivo biologic and pathologic responses. The...
High-throughput in vitro models lack human-relevant complexity, which undermines their ability to accurately mimic in vivo biologic and pathologic responses. The emergence of microphysiological systems (MPS) presents an opportunity to revolutionize in vitro modeling for both basic biomedical research and applied drug discovery. The MPS platform has been an area of interdisciplinary collaboration to develop new, predictive, and reliable in vitro methods for regulatory acceptance. The current MPS models have been developed to recapitulate an organ or tissue on a smaller scale. However, the complexity of these models (ie, including all cell types present in the in vivo tissue) with appropriate structural, functional, and biochemical attributes are often not fully characterized. Here, we provide an overview of the capabilities and limitations of the microfluidic MPS model (aka organs-on-chips) within the scope of drug development. We recommend the engagement of pathologists early in the MPS design, characterization, and validation phases, because this will enable development of more robust and comprehensive MPS models that can accurately replicate normal biology and pathophysiology and hence be more predictive of human responses.
Topics: Animals; Biomarkers; Cell Culture Techniques; Communicable Diseases; Drug Discovery; In Vitro Techniques; Models, Biological; Neoplasms; Pathologists; Pluripotent Stem Cells; Tissue Culture Techniques
PubMed: 32180532
DOI: 10.1177/0300985820908794 -
Surgical Pathology Clinics Jun 2021Although clinicians often put vasculitis and microvascular occlusion in the same differential diagnosis, biopsy findings often are either vasculitis or occlusion.... (Review)
Review
Although clinicians often put vasculitis and microvascular occlusion in the same differential diagnosis, biopsy findings often are either vasculitis or occlusion. However, both vasculitis and occlusion are present in some cases of levamisole-associated vasculopathy and certain infections. Depth of dermal involvement and vessel size should be reported, because superficial and deep small vessel leukocytoclastic vasculitis and/or involvement of medium-sized vessels may be associated with systemic disease. Microvascular occlusion of vessels in the fat should prompt consideration of calciphylaxis. Clues to ultimate clinical diagnosis can be garnered from depth of involvement, size of vessels affected, and presence of both vasculitis and occlusion.
Topics: Diagnosis, Differential; Humans; Pathologists; Vasculitis; Vasculitis, Leukocytoclastic, Cutaneous
PubMed: 34023108
DOI: 10.1016/j.path.2021.01.006 -
Archives of Pathology & Laboratory... Feb 2019In this era of minimally invasive procedures for diagnosis, prognosis, and treatment, pathologists are at the forefront of analyzing specimens and are expected to make... (Review)
Review
CONTEXT.—
In this era of minimally invasive procedures for diagnosis, prognosis, and treatment, pathologists are at the forefront of analyzing specimens and are expected to make more specific diagnoses, providing additional information from the material they receive.
OBJECTIVE.—
To familiarize pathologists with the essential components of surgical pathology reports for colorectal liver metastases (CRLM) resections.
DATA SOURCES.—
Colorectal cancer is the third most common cancer in the world and the liver is the most frequent site of metastases. Not all patients are candidates for surgery initially and may be treated with neoadjuvant chemotherapy, most commonly with FOLFOX (5-fluorouracil/leucovorin and oxaliplatin) and FOLFIRI (5-fluorouracil/leucovorin and irinotecan), after which they may become surgical candidates. When CRLM resections are received post neoadjuvant, the pathologist needs to not only report margin status but also report details regarding the tumor's response to treatment, and should evaluate the nonneoplastic parenchyma for chemotherapy-related injury, such as sinusoidal obstruction syndrome and/or steatohepatitis that may be caused by treatment. If ancillary tests, such as molecular studies (eg, KRAS, BRAF, NRAS, and microsatellite instability), have been previously conducted, these results should be included in the report. If not, they should be ordered for the resection specimen.
CONCLUSIONS.—
In this review, we will describe strategies and practical approaches to maximize the information gained from CRLM resections. A checklist is provided that may be used while signing out these cases to remind pathologists of additional components they may wish to include in their reports to best guide patient management.
Topics: Colorectal Neoplasms; Humans; Liver Neoplasms; Pathologists; Pathology, Surgical; Patient Care
PubMed: 29790787
DOI: 10.5858/arpa.2017-0505-RA -
Der Pathologe Sep 2021Diagnostic radiology and diagnostic pathology are medical disciplines that use a variety of morphological analyses with different macroscopic and microscopic... (Review)
Review
Diagnostic radiology and diagnostic pathology are medical disciplines that use a variety of morphological analyses with different macroscopic and microscopic resolutions for diagnosis and staging of cancers. In the clinical setting, radiology and pathology departments are often spatially separated. However, there are examples of increasingly tight cooperation and convergence, for example in the setting of multidisciplinary tumor boards. This article focuses exemplarily on the correlations of radiological and histopathological diagnostics in pancreatic cancer.
Topics: Humans; Magnetic Resonance Imaging; Pancreatic Neoplasms; Pathologists; Radiography; Radiologists; Radiology
PubMed: 33956172
DOI: 10.1007/s00292-021-00949-2 -
Cardiovascular Pathology : the Official... 2022This article stems from the intersection of the author's long-standing interests in science, medicine, pathology and oenology. A discussion is provided of selected... (Review)
Review
This article stems from the intersection of the author's long-standing interests in science, medicine, pathology and oenology. A discussion is provided of selected aspects of the science of viticulture and wine production as well as qualities of the finished product crafted by the art of the wine maker. The case for health benefits of moderate consumption of wine and other alcoholic beverages also is discussed. Based on the "French paradox," an analysis is presented of the evidence for the special effects of red wine consumption, particularly as part of the Mediterranean diet and lifestyle. A concluding perspective is given in support of wine as a promoter of civility and social engagement.
Topics: Alcohol Drinking; Cardiovascular System; Humans; Pathologists; Wine
PubMed: 35654336
DOI: 10.1016/j.carpath.2022.107446 -
Seminars in Diagnostic Pathology Nov 2022Ultrasound-guided fine needle aspiration (USG-FNA) biopsies have traditionally been performed in the radiology department, with radiologists performing the procurement... (Review)
Review
Ultrasound-guided fine needle aspiration (USG-FNA) biopsies have traditionally been performed in the radiology department, with radiologists performing the procurement with or without on-site cytotechnologists or pathologists to provide adequacy or diagnostic evaluation of the specimen. However, more recently, these image-guided biopsies have been performed by endocrinologists and now cytopathologists. Starting an USG-FNA service is a big task that requires consideration of multiple factors, including training, certification, privileges, equipment, documentation, information technology (IT) issues, and the overall business plan or financial component. In this review, the issues confronted when bringing on an USG-FNA service are discussed in detail in an effort to highlight the issues and challenges that many cytopathology laboratories are facing when implementing this new service.
Topics: Humans; Biopsy, Fine-Needle; Pathologists; Image-Guided Biopsy; Laboratories; Ultrasonography, Interventional
PubMed: 35718580
DOI: 10.1053/j.semdp.2022.06.007 -
Archives of Pathology & Laboratory... Jul 2017- Transbronchial cryobiopsy has recently been proposed as an alternative to surgical biopsy in the diagnosis of diffuse lung disease. (Review)
Review
CONTEXT
- Transbronchial cryobiopsy has recently been proposed as an alternative to surgical biopsy in the diagnosis of diffuse lung disease.
OBJECTIVE
- To familiarize pathologists with transbronchial cryobiopsy, including what it is, how it is performed, how it compares to other techniques of lung biopsy in diffuse lung disease, what are the technical issues relating to it, what the complications are, how cryobiopsies should be interpreted, and the clinical usefulness of cryobiopsy.
DATA SOURCES
- All the available literature on cryobiopsy in diffuse lung disease through May 2016, primarily in the last 5 years, was reviewed, and some unpublished data known to the authors were included.
CONCLUSIONS
- Cryobiopsies are considerably larger than forceps biopsies and allow pattern recognition approaching that of a surgical lung biopsy in many cases. Artifacts associated with cryobiopsy are minimal. In comparison with surgical lung biopsies, the diagnosis rate with cryobiopsies is lower, in the neighborhood of 80%, versus higher than 90% for surgical lung biopsies. Cryobiopsy is proposed as an alternative to surgical lung biopsy and a technique that may appreciably decrease the number of patients who require surgical lung biopsy for diagnosis. This is important because the mortality from cryobiopsy is very small (0.1% to date) compared with surgical lung biopsy (1.7% for elective procedures and considerably higher for nonelective procedures).
Topics: Biopsy; Cryosurgery; Humans; Lung; Lung Diseases; Pathologists
PubMed: 27588334
DOI: 10.5858/arpa.2016-0233-RA