[Telepathology in diagnostic consultations for controversial neoplastic growths in the lung--personal experience].
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Date
2001-12-04
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Abstract
The authors assessed the diagnostic accuracy of the static telepathology sTP for practical consultations in the controversial pulmonary oncology cases The short characteristics of the diagnostic cases is included We reported the results of 6 difficult clinico pathological cases submitted to Dept Quantitative Pathology DQP for consultations 5F and 1M age 26 68 yrs Digital images of histological or cytological samples were captured at DQP and transmitted to telepathologist TPat in Thoraxklinik Heidelberg or AFIP Washington DC Simultaneously the same slides or with a paraffin block were mailed to TPats for re evaluation with the conventional microscope dgn zwPat The controversial cases presented 2 types of diagnostic problems 1 rare entities 2 common difficulties in the routine work of pathologist but with indefinitely proved diagnosis The first group encounters TPat diagnoses as follows case A pulmonary plasma cell granuloma with lymphoidal interstitial infiltrates LIP preleukemia case B microfoci of early metastases of benign uterine leiomyoma case D small cell carcinoma spreading along pleura The second group included case C invasive epidermoidal carcinoma in bronchus case E probably metastatic adenocarcinoma of colon case F synchronous or metastasising 2 lung tumours sharing NE morphology or NE immunohistochemical features There was very high concordance between referring pathologist ref Pat diagnoses and TPat diagnoses as well as a consensus in zw TPat diagnoses In 2 cases the conceptual problem was solved by TPat Telepathology offered a support or improved the quality of the final diagnosis The implementation of sTP remarkably reduced the time of consultations and allowed to present the diagnostic problems to the international group of experts