Chapter 11 Tissue and Molecular Diagnosis

Pre-nineteenth century tissue diagnosis depended on naked eye examination of autopsy material and of a small selection of surgical specimens. Tissue analysis is now an integral and routine element of clinical practice. It is heavily dependent on microscopic assessment, although newer methods of tissue analysis will increasingly provide additional information. Developments and changes in cellular pathology are continuous. The location of a modern cellular pathology department is usually within or near a medium-sized or large hospital or in a purpose-built off-site centre. Molecular pathological analysis of cancer tissue increasingly contributes to management, including diagnostic categorisation, prognostic predictions and selection of drug therapy. Neoplasia is a broad term that includes benign and malignant tumours and precursors of malignancy.

Advanced Learning Content
Chapter 11: Tissue and Molecular Diagnosis
Multiple Choice Questions
Weblinks

Journal articles

Early pathology

https://link.springer.com/article/10.1007%2Fs00428-011-1075-0/ (paid)

This paper revisits the story of the alleged failure of a famous nineteenth century German pathologist to diagnose laryngeal cancer in a biopsy from the Kaiser. The death of the Kaiser from cancer after the negative result apparently led to scepticism in Europe about the value of histopathology.

Mismatch repair deficiency

https://pubmed.ncbi.nlm.nih.gov/34837268/ (paid)

This review provides practical information on clinical testing and the interpretation of microsatellite instability/mismatch repair testing.

Digital/AI

https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S1470204519301548?returnurl=https:%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS1470204519301548%3Fshowall%3Dtrue&referrer=https:%2F%2Fdiagnosticpathology.biomedcentral.com%2F/ (paid)

In modern clinical practice, digital pathology is playing an increasingly important role. Rapid technological advancements are likely to enable improved diagnosis and clinical care. This review article discusses these important advances in digital pathology and artificial intelligence.

General/molecular

https://www.esp-pathology.org/_Resources/Persistent/c8aea6fb029803c787160deaba164e82f82c4f75/ESP%20Position%20Paper.pdf (free)

This position paper from the European Society of Pathology describes the integral role of diagnostic pathology in molecular test performance and molecular interpretations.

Book chapters

https://www.ncbi.nlm.nih.gov/books/NBK525286/

Pathology has a crucial role in the accessibility and delivery of quality health care. This is because the field of pathology is responsible for diagnosis and is the most common diagnostic gold standard. This chapter reviews the essential minimal requirements to provide access to pathology services.

Guidelines

Colorectal cancer

https://www.rcpath.org/uploads/assets/c8b61ba0-ae3f-43f1-85ffd3ab9f17cfe6/G049-Dataset-for-histopathological-reporting-of-colorectal-cancer.pdf

This guideline describes the minimum requirements for colorectal carcinoma pathological evaluation and reporting.

Non-neoplastic gastrointestinal pathology

https://www.rcpath.org/uploads/assets/4593f557-d75c-4ca6-9307a9d688e02a2d/g085-tp-giandp-jan16.pdf

This guideline describes the typical workflows by which digestive system biopsies and resections are managed and important recommendations for handling.

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