{"title":"[Introduction to renal pathology].","authors":"Maike Büttner-Herold, Kerstin Amann","doi":"10.1007/s00292-024-01310-z","DOIUrl":"10.1007/s00292-024-01310-z","url":null,"abstract":"<p><p>In recent decades, nephropathology has developed worldwide as a subspeciality of pathology, which requires special methodological and technical equipment to process the material and specific clinical and pathological expertise to interpret the findings. These special requirements mean that nephropathology is not available at all pathology institutes, but is carried out on a large scale in a few highly specialised centres. The history of nephropathology, or in a narrower sense the specialised histopathological examination of kidney biopsies, began in 1958 with the first use or performance of a kidney biopsy [1]. It thus replaced the practice of urinalysis, which had been common since the Middle Ages, as a diagnostic tool for kidney diseases. Specialised techniques such as immunofluorescence or immunohistology but also electron microscopy are required to assess specific renal changes, for which the examination of renal biopsies is one of the few remaining routine applications today. In Germany and German-speaking countries, the discipline developed thanks to the work of outstanding people in the field of pathology who were primarily involved in this discipline and had the necessary technical and human resources in their laboratories to ensure that these biopsies could be analysed.</p>","PeriodicalId":74402,"journal":{"name":"Pathologie (Heidelberg, Germany)","volume":" ","pages":"241-245"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140186502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Mitteilungen der Deutschen Gesellschaft für Pathologie.","authors":"","doi":"10.1007/s00292-024-01323-8","DOIUrl":"https://doi.org/10.1007/s00292-024-01323-8","url":null,"abstract":"","PeriodicalId":74402,"journal":{"name":"Pathologie (Heidelberg, Germany)","volume":"45 3","pages":"233-234"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wolfgang Saeger, Andreas M Luebke, S T Mekoula, Jörg-Michael Pahnke
{"title":"[Xanthogranulomatous adrenalitis : A rare and difficult differential diagnosis of adrenal gland tumors].","authors":"Wolfgang Saeger, Andreas M Luebke, S T Mekoula, Jörg-Michael Pahnke","doi":"10.1007/s00292-024-01312-x","DOIUrl":"10.1007/s00292-024-01312-x","url":null,"abstract":"<p><p>A radiologically diagnosed tumor in a 29-year-old woman with a fever of around 39 °C was operated on under the suspicion of cholecystitis or a liver abscess. A solid tumor was found in the adrenal gland and resected. The frozen section findings did not reveal a clear diagnosis of entity and assignment. Histologically, the tumor was found to consist of densely clustered large histiocyte-like cells with expression of vimentin, CD68, and CD163 as well as negativity for keratin, langerin, and SMA. We diagnosed xanthogranulomatous adrenalitis and discussed the differential diagnoses (Langerhans cell histiocytosis, Rosai-Dorfman disease, malakoplakia, Erdheim-Chester disease).</p>","PeriodicalId":74402,"journal":{"name":"Pathologie (Heidelberg, Germany)","volume":" ","pages":"218-222"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11045564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140112391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andreas G Loth, Anne Fassl, Felix K H Chun, Jens Köllermann, Sylvia Hartmann, Steffen Gretser, Paul K Ziegler, Nadine Flinner, Falko Schulze, Peter J Wild, Maximilian N Kinzler
{"title":"[Fluorescence confocal microscopy-complete digitization of pathology].","authors":"Andreas G Loth, Anne Fassl, Felix K H Chun, Jens Köllermann, Sylvia Hartmann, Steffen Gretser, Paul K Ziegler, Nadine Flinner, Falko Schulze, Peter J Wild, Maximilian N Kinzler","doi":"10.1007/s00292-024-01311-y","DOIUrl":"10.1007/s00292-024-01311-y","url":null,"abstract":"<p><strong>Background: </strong>Fluorescence-based confocal microscopy (FCM) can be used to create virtual H&E sections in real time. So far, FCM has been used in dermato-, uro-, and gynecopathology. FCM allows the creation of a completely digitized frozen section, which could potentially replace conventional frozen sections in the future.</p><p><strong>Objective: </strong>The aim of the current work is to implement FCM technology as a component of fully digitized processes in the pathological workflow. For this purpose, the current use of FCM in liver transplant pathology will be extended to other disciplines such as urology and otorhinolaryngology.</p><p><strong>Materials and methods: </strong>The FCM technique continues to be used prospectively on native tissue samples from potential donor livers. Conventional frozen sections are used comparatively to virtual FCM scans.</p><p><strong>Results: </strong>The data show a nearly perfect agreement for the detection of cholangitis, fibrosis, and malignancy, and a high level of agreement for, e.g., macrovesicular steatosis, inflammation, steatohepatitis, and necrosis between virtual FCM scans and conventional routine diagnostic frozen sections.</p><p><strong>Conclusion: </strong>Since the availability of time- and cost-intensive frozen section diagnostics in the context of transplant pathology in continuous operation (24/7) is now only established at very few university centers in Germany due to an increasing shortage of specialists, the use of FCM could be an important building block in the current process leading towards a fully digitized pathology workflow and should thus be extended to various disciplines.</p>","PeriodicalId":74402,"journal":{"name":"Pathologie (Heidelberg, Germany)","volume":" ","pages":"211-217"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11045597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140041149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Adenoid cystic carcinoma of the ceruminous glands].","authors":"Stephanie Strobl, Matthias M Gaida","doi":"10.1007/s00292-024-01309-6","DOIUrl":"10.1007/s00292-024-01309-6","url":null,"abstract":"","PeriodicalId":74402,"journal":{"name":"Pathologie (Heidelberg, Germany)","volume":" ","pages":"162-163"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139901123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Svenja Windeck, Kristina Allgoewer, Saskia von Stillfried, Lucas Triefenbach, Ulrike Nienaber, Roman David Bülow, Rainer Röhrig, Benjamin Ondruschka, Peter Boor
{"title":"[Development and progress of the National Autopsy Network (NATON)].","authors":"Svenja Windeck, Kristina Allgoewer, Saskia von Stillfried, Lucas Triefenbach, Ulrike Nienaber, Roman David Bülow, Rainer Röhrig, Benjamin Ondruschka, Peter Boor","doi":"10.1007/s00292-024-01307-8","DOIUrl":"10.1007/s00292-024-01307-8","url":null,"abstract":"<p><strong>Background: </strong>Autopsies have long been considered the gold standard for quality assurance in medicine, yet their significance in basic research has been relatively overlooked. The COVID-19 pandemic underscored the potential of autopsies in understanding pathophysiology, therapy, and disease management. In response, the German Registry for COVID-19 Autopsies (DeRegCOVID) was established in April 2020, followed by the DEFEAT PANDEMIcs consortium (2020-2021), which evolved into the National Autopsy Network (NATON).</p><p><strong>Deregcovid: </strong>DeRegCOVID collected and analyzed autopsy data from COVID-19 deceased in Germany over three years, serving as the largest national multicenter autopsy study. Results identified crucial factors in severe/fatal cases, such as pulmonary vascular thromboemboli and the intricate virus-immune interplay. DeRegCOVID served as a central hub for data analysis, research inquiries, and public communication, playing a vital role in informing policy changes and responding to health authorities.</p><p><strong>Naton: </strong>Initiated by the Network University Medicine (NUM), NATON emerged as a sustainable infrastructure for autopsy-based research. NATON aims to provide a data and method platform, fostering collaboration across pathology, neuropathology, and legal medicine. Its structure supports a swift feedback loop between research, patient care, and pandemic management.</p><p><strong>Conclusion: </strong>DeRegCOVID has significantly contributed to understanding COVID-19 pathophysiology, leading to the establishment of NATON. The National Autopsy Registry (NAREG), as its successor, embodies a modular and adaptable approach, aiming to enhance autopsy-based research collaboration nationally and, potentially, internationally.</p>","PeriodicalId":74402,"journal":{"name":"Pathologie (Heidelberg, Germany)","volume":" ","pages":"203-210"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11045591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139998432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Artificial intelligence for pathology-how, where, and why?]","authors":"Peter Schüffler, Katja Steiger, Carolin Mogler","doi":"10.1007/s00292-024-01314-9","DOIUrl":"10.1007/s00292-024-01314-9","url":null,"abstract":"<p><p>Artificial intelligence promises many innovations and simplifications in pathology, but also raises just as many questions and uncertainties. In this article, we provide a brief overview of the current status, the goals already achieved by existing algorithms, and the remaining challenges.</p>","PeriodicalId":74402,"journal":{"name":"Pathologie (Heidelberg, Germany)","volume":" ","pages":"198-202"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11045628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140112356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Leander Schwaibold, Sven Mattern, Markus Mählmann, Leon Lobert, Thomas Breunig, Christian M Schürch
{"title":"[Effects of upstream laboratory processes on the digitization of histological slides].","authors":"Leander Schwaibold, Sven Mattern, Markus Mählmann, Leon Lobert, Thomas Breunig, Christian M Schürch","doi":"10.1007/s00292-024-01303-y","DOIUrl":"10.1007/s00292-024-01303-y","url":null,"abstract":"<p><strong>Background: </strong>Several factors in glass slide (GS) preparation affect the quality and data volume of a digitized histological slide. In particular, reducing contamination and selecting the appropriate coverslip have the potential to significantly reduce scan time and data volume.</p><p><strong>Goals: </strong>To objectify observations from our institute's digitization process to determine the impact of laboratory processes on the quality of digital histology slides.</p><p><strong>Materials and methods: </strong>Experiment 1: Scanning the GS before and after installation of a central console in the microtomy area to reduce dirt and statistical analysis of the determined parameters. Experiment 2: Re-coverslipping the GS (post diagnostics) with glass and film. Scanning the GS and statistical analysis of the collected parameters.</p><p><strong>Conclusion: </strong>The targeted restructuring in the laboratory process leads to a reduction of GS contamination. This causes a significant reduction in the amount of data generated and scanning time required for the digitized sections. Film as a coverslip material minimizes processing errors in contrast to glass. According to our estimation, all the above-mentioned points lead to considerable cost savings.</p>","PeriodicalId":74402,"journal":{"name":"Pathologie (Heidelberg, Germany)","volume":" ","pages":"90-97"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10901962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139934589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alexandra K Stoll, Florestan J Koll, Markus Eckstein, Henning Reis, Nadine Flinner, Peter J Wild, Jochen Triesch
{"title":"[Histomolecular classification of urothelial carcinoma of the urinary bladder : From histological phenotype to genotype and back].","authors":"Alexandra K Stoll, Florestan J Koll, Markus Eckstein, Henning Reis, Nadine Flinner, Peter J Wild, Jochen Triesch","doi":"10.1007/s00292-024-01305-w","DOIUrl":"10.1007/s00292-024-01305-w","url":null,"abstract":"<p><strong>Background: </strong>Of all urothelial carcinomas (UCs), 25% are muscle invasive and associated with a 5-year overall survival rate of 50%. Findings regarding the molecular classification of muscle-invasive urothelial carcinomas (MIUCs) have not yet found their way into clinical practice.</p><p><strong>Objectives: </strong>Prediction of molecular consensus subtypes in MIUCs with artificial intelligence (AI) based on histologic hematoxylin-eosin (HE) sections.</p><p><strong>Methods: </strong>Pathologic review and annotation of The Cancer Genome Atlas (TCGA) Bladder Cancer (BLCA) Cohort (N = 412) and the Dr. Senckenberg Institute of Pathology (SIP) BLCA Cohort (N = 181). An AI model for the prediction of molecular subtypes based on annotated histomorphology was trained.</p><p><strong>Results: </strong>For a five-fold cross-validation with TCGA cases (N = 274), an internal TCGA test set (N = 18) and an external SIP test set (N = 27), we reached mean area under the receiver operating characteristic curve (AUROC) scores of 0.73, 0.8 and 0.75 for the classification of the used molecular subtypes \"luminal\", \"basal/squamous\" and \"stroma-rich\". By training on correlations to individual molecular subtypes, rather than training on one subtype assignment per case, the AI prediction of subtypes could be significantly improved.</p><p><strong>Discussion: </strong>Follow-up studies with RNA extraction from various areas of AI-predicted molecular heterogeneity may improve molecular classifications and thereby AI algorithms trained on these classifications.</p>","PeriodicalId":74402,"journal":{"name":"Pathologie (Heidelberg, Germany)","volume":" ","pages":"106-114"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10901926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139572255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Frederick Klauschen, Jonas Dippel, Philipp Keyl, Philipp Jurmeister, Michael Bockmayr, Andreas Mock, Oliver Buchstab, Maximilian Alber, Lukas Ruff, Grégoire Montavon, Klaus-Robert Müller
{"title":"[Explainable artificial intelligence in pathology].","authors":"Frederick Klauschen, Jonas Dippel, Philipp Keyl, Philipp Jurmeister, Michael Bockmayr, Andreas Mock, Oliver Buchstab, Maximilian Alber, Lukas Ruff, Grégoire Montavon, Klaus-Robert Müller","doi":"10.1007/s00292-024-01308-7","DOIUrl":"10.1007/s00292-024-01308-7","url":null,"abstract":"<p><p>With the advancements in precision medicine, the demands on pathological diagnostics have increased, requiring standardized, quantitative, and integrated assessments of histomorphological and molecular pathological data. Great hopes are placed in artificial intelligence (AI) methods, which have demonstrated the ability to analyze complex clinical, histological, and molecular data for disease classification, biomarker quantification, and prognosis estimation. This paper provides an overview of the latest developments in pathology AI, discusses the limitations, particularly concerning the black box character of AI, and describes solutions to make decision processes more transparent using methods of so-called explainable AI (XAI).</p>","PeriodicalId":74402,"journal":{"name":"Pathologie (Heidelberg, Germany)","volume":" ","pages":"133-139"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139693697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}