The Origin and Nature of Pathology
Jeremy R. Jass in Understanding Pathology, 2020
It took several decades for pathologists to take up diagnostic work at the microscopic level, the autopsy being perceived as the only legitimate pursuit. In Europe and America, surgeons began to appreciate the value of an accurate diagnosis before undertaking a potentially dangerous procedure and learned the technique of microscopic examination of biopsies. This, however, did not become widespread practice until well into the twentieth century. Up until 1910 surgeons at the Glasgow Royal Infirmary did not value preoperative biopsy, being content for pathologists to confirm or correct the diagnosis of cancer following mastectomy (Jacyna, 1988). Surgeons also began to appreciate the importance of examining operative specimens as a means of evaluating the procedure. By the early twentieth century, laboratory examination and diagnosis of tissue samples was largely the province of the pathologist and has remained so to this day. Nonetheless, anatomical pathology or histopathology has continued to play a prominent role in surgical training and research and the discipline is still sometimes described as surgical pathology, particularly in America. In Japan, surgeons have maintained the tradition of dissecting their own surgical specimens, a fact which emphasises that anatomical pathology is very much part of the process of patient management and not simply a screening or monitoring service.
Nonclinical Safety Evaluation of Drugs
Pritam S. Sahota, James A. Popp, Jerry F. Hardisty, Chirukandath Gopinath, Page R. Bouchard in Toxicologic Pathology, 2018
Histopathology is the study of the structural manifestation of disease at the light microscopic level; it is largely a descriptive and interpretive science. The trained and experienced toxicologic pathologist must be able to distinguish normal variation and spontaneous disease processes from those changes resulting from the administration of a test article (Crissman et al. 2004). Histopathology results are one of the most important parts of the nonclinical safety assessment process. In toxicologic pathology, the goal is to determine if the test article produces changes through a comparison of treated animals with control animal data (both concurrent and historic controls). It is important, therefore, that microscopic observations be recorded in a consistent, objective manner that readily allows tabulation and comparison of group effects. In this setting, the use of descriptive, rather than diagnostic, terminology is preferred (Greaves 2012). A disease or etiologic diagnosis implies a particular pathogenesis or impact on organ function on the basis of what is known about that disease process; this would be misleading in the experimental setting of a toxicity study. Consistently using descriptive rather than diagnostic terminology in tabulating anatomic pathology data will decrease confusion and misconceptions.
Biomedical Applications in Probing Deep Tissue Using Mid-Infrared Supercontinuum Optical Biopsy
Lingyan Shi, Robert R. Alfano in Deep Imaging in Tissue and Biomedical Materials, 2017
For external (skin) cancer diagnosis, initially a visual examination of the skin is carried out by an experienced consultant dermatologist; this may be dermoscope-assisted—a dermoscope is a hand-held ∼×10 magnification optical microscope. If deemed necessary, this examination is followed up by the “Gold Standard” comprising excision (removal) of a small-tissue section for histopathology (literally—study of diseased tissue). Histopathology to date refers to high-resolution optical- microscopic study of the morphology of dye-stained (hematoxylin and eosin (H&E) dyes) excised tissue, or shed cells, by a clinician (medical professional interacting directly with patients) to discover disease. The current skin cancer diagnostic process is time-consuming and dependent on human judgment. Moreover, you had to have it cut out, to know. MIR remote, in vivo, spectroscopic-imaging could offer assistance in skin cancer diagnosis that is fast, objective, non-invasive, sensitive (minimal false negatives [14]) and specific (minimal false positives [14]).
A tale of subcutaneous nodules of the hands
Published in Scandinavian Journal of Rheumatology, 2023
A Chamli, C Massaoudi, R Frioui, E Ben Brahim, A Debbiche, S Fenniche, H Hammami, A Zaouak
In the medical literature, fewer than 100 cases of subcutaneous sarcoidosis have been reported to date since its first description in 1904 by Darier and Roussy (3). It is mainly described in women, most often in their fifth or sixth decade, as in our case; and heralds systemic involvement in 80% of cases (4). Given its association with disease activity, identifying the disease at an early stage is important (3–5). Clinically, subcutaneous sarcoidosis is characterized by asymptomatic, firm, mobile, skin-coloured nodules, commonly located on the upper extremities (3, 5–7). Its location on the dorsum of the hands and fingers, as in our patient, has been rarely reported in the literature (7, 8). In fact, this clinical presentation can be misleading and may mimic other causes of multiple subcutaneous nodules with firm consistency, such as rheumatoid nodules, multiple lipomas, subcutaneous granuloma annulare, calcinosis, and cutaneous metastasis (9). However, in our patient, these diagnoses were ruled out by histopathology. Indeed, a skin biopsy is mandatory to make an accurate diagnosis and to exclude differential diagnoses showing an inflammatory infiltrate composed of non-caseating granulomas involving fat lobules. The granulomas are small, uniform in size, and mainly composed of epithelioid cells, with a discrete amount of multinucleated giant cells and minor lymphocytic component. In some cases, discrete small foci of necrosis may be observed in the histopathological examination of skin biopsy, as in our case, which raises the differential diagnoses to that of tuberculosis (4).
A rare case of orbital angioleiomyoma
Published in Orbit, 2021
Shiao Wei Wong, James Laybourne, Luciane Irion, Anne Cook
Histopathology is key for diagnosis. Henderson and Harrison4 and Wolter2 reported the earliest cases of angioleiomyoma which predates the Morimoto1 classifications. However more recent reports have described the morphological features of the orbital angioleiomyomas excised. The cavernous type was the most commonly reported (which includes our case), followed by the venous type and then the solid type (Table 1). On immunohistochemistry the lesion shows positivity for alpha smooth muscle actin (Figure 5), vimentin, desmin, calponin and h-caldesmon. CD31 and CD34 highlight the endothelial component (Figure 4a,4b). Angioleiomyoma lacks expression for HMB45 and oestrogen receptors. Histopathology and immunohistochemistry therefore help to differentiate angioleiomyoma from closely related lesions such as leiomyoma, angiomyoma, angiomyofibroma and angiomyolipoma.9,13,13
Pancreatic cancer subtypes: a roadmap for precision medicine
Published in Annals of Medicine, 2018
Carolina Torres, Paul J. Grippo
PDAC is a heterogeneous and molecularly complex disease with significant differences observed in outcomes among individual patients. Hence, there is a need towards tailored therapies specific for genetic, even biomolecular characteristics of individual tumours, including PDAC and other cancers [31]. In clinic, cancer typically is identified by histopathological analysis or by different, well-established imaging modalities including computer tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), X-ray and ultrasound (US). Histological analysis is the gold standard for clinical diagnosis of cancers and for contributions to prognosis, identification of disease stage and potential therapeutic targets [32]. Histopathology requires tissue biopsies and subsequent examination by a pathologist(s), which still remains somewhat subjective. In more recent years, a reshuffling of PDAC classifications has been underway, from the histopathologic subtypes (which traditionally define PanIN or cystic-derived PDAC) to the molecular subtypes determined from various high-throughput profiling techniques previously described in this review.