Gallstone-related disease comprises a spectrum of conditions resulting from biliary stone formation, leading to obstruction and inflammatory complications. These can significantly impact patient quality of life and carry high morbidity if not accurately detected. Appropriate imaging is essential for evaluating the extent of gallstone disease and assuring appropriate clinical management. Magnetic Resonance Imaging (MRI) techniques (including Magnetic Resonance Cholangiopancreatography (MRCP) are increasingly used for diagnosis of gallstone disease and its complications and provide high contrast resolution and facilitate tissue-level assessment of gallstone disease processes. In this review we seek to delve deep into the spectrum of MR imaging in diagnose of gallstone-related disease within the gallbladder and complications related to migration of the gallstones to the gall bladder neck or cystic duct, common hepatic duct or bile duct (choledocholithiasis) and beyond, including gallstone pancreatitis, gallstone ileus, Bouveret syndrome, and dropped gallstones, by offering key examples from our practice. Furthermore, we will specifically highlight the crucial role of MRI and MRCP for enhancing diagnostic accuracy and improving patient outcomes in gallstone-related disease and showcase relevant surgical pathology specimens of various gallstone related complications.

BACKGROUND: The gold standard for diagnosis of cardiac tumours is histopathological examination. Cardiovascular magnetic resonance (CMR) is a valuable non-invasive, radiation-free tool for identifying and characterizing cardiac tumours. Our aim is to understand CMR diagnosis of cardiac tumours by distinguishing benign vs. malignant tumours compared to the gold standard.
METHODS: A systematic search was performed in the PubMed, Web of Science, and Scopus databases up to December 2022, and the results were reviewed by 2 independent investigators. Studies reporting CMR diagnosis were included in a meta-analysis, and pooled measures were obtained. The risk of bias was assessed using the Quality Assessment Tools from the National Institutes of Health.
RESULTS: A total of 2,321 results was obtained; 10 studies were eligible, including one identified by citation search. Eight studies were included in the meta-analysis, which presented a pooled sensitivity of 93% and specificity of 94%, a diagnostic odds ratio of 185, and an area under the curve of 0.98 for CMR diagnosis of benign vs. malignant tumours. Additionally, 4 studies evaluated whether CMR diagnosis of cardiac tumours matched specific histopathological subtypes, with 73.6% achieving the correct diagnosis.
CONCLUSIONS: To the best of our knowledge, this is the first published systematic review on CMR diagnosis of cardiac tumours. Compared to histopathological results, the ability to discriminate benign from malignant tumours was good but not outstanding. However, significant heterogeneity may have had an impact on our findings.

UNASSIGNED: Solid pseudopapillary neoplasm, or Frantz-Gruber tumor, is a diagnostic challenge for the surgical pathologist. It is classified by the WHO as a malignant epithelial tumor of the pancreas, its prevalence is low, it occurs in only 1 to 2% of all malignant tumors of the pancreas, it usually affects mainly young women, its origin is still unclear, it is generally It presents as a solitary, encapsulated lesion, without invasion of peripancreatic tissues with rare cases of metastasis, which is why it is considered a low-grade malignant tumor by the WHO. The objective of this article is to present three clinical cases and to evaluate the epidemiology, clinical manifestations, morphology and immunohistochemical expression of the tumor in a review of the bibliography, as well as to compare it with the cases already reported on the subject.
UNASSIGNED: Three cases of Frantz tumor were diagnosed by the pathology department of a tertiary hospital are presented, which correspond to two women aged 17 and 34, as well as a 52-year-old man whose presentation by age and sex is rare.
UNASSIGNED: After the bibliographical review and the analysis of the cases presented, we verified the difficulty to make a correct diagnosis, since its presence is rare in the daily practice of the surgical pathologist. The morphological patterns of the solid pseudopapillary tumor are varied and can often be reminiscent of neuroendocrine tumors of the pancreas, whose presentation rate is higher.

There is emerging use of artificial intelligence (AI) models to aid diagnostic imaging. This review examined and critically appraised the application of AI models to identify surgical pathology from radiological images of the abdominopelvic cavity, to identify current limitations and inform future research.
Systematic review.
Systematic database searches (Medline, EMBASE, Cochrane Central Register of Controlled Trials) were performed. Date limitations (January 2012 to July 2021) were applied.
Primary research studies were considered for eligibility using the PIRT (participants, index test(s), reference standard and target condition) framework. Only publications in the English language were eligible for inclusion in the review.
Study characteristics, descriptions of AI models and outcomes assessing diagnostic performance were extracted by independent reviewers. A narrative synthesis was performed in accordance with the Synthesis Without Meta-analysis guidelines. Risk of bias was assessed (Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2)).
Fifteen retrospective studies were included. Studies were diverse in surgical specialty, the intention of the AI applications and the models used. AI training and test sets comprised a median of 130 (range: 5-2440) and 37 (range: 10-1045) patients, respectively. Diagnostic performance of models varied (range: 70%-95% sensitivity, 53%-98% specificity). Only four studies compared the AI model with human performance. Reporting of studies was unstandardised and often lacking in detail. Most studies (n=14) were judged as having overall high risk of bias with concerns regarding applicability.
AI application in this field is diverse. Adherence to reporting guidelines is warranted. With finite healthcare resources, future endeavours may benefit from targeting areas where radiological expertise is in high demand to provide greater efficiency in clinical care. Translation to clinical practice and adoption of a multidisciplinary approach should be of high priority.
CRD42021237249.

Gross-only examination policies vary widely across pathology departments. Several studies-particularly a College of American Pathologists\' Q-Probes study-have looked at the variations in gross-only policies, and even more studies have addressed the (in)appropriateness of certain specimen types for gross-only examination. Few, if any, studies have tackled the important task of how to revise and safely implement a new gross-only examination protocol, especially in collaboration with clinical colleagues.
We reviewed the grossing protocols from three anatomic pathology centers to identify common gross-only specimen types. We compiled an inclusive list of any specimen types that appeared on one or more centers\' lists. We performed a retrospective review of the gross and microscopic diagnoses for those specimen types to determine if any diagnoses of significance would have been missed had that specimen been processed as a gross-only.
We reviewed 940 cases among 13 specimen types. For 7 specimen types, the gross diagnoses provided equivalent information to the microscopic diagnoses. For 6 specimen types, microscopic diagnoses provided clinically meaningful information beyond what was captured in the gross diagnoses.
To improve the value of care provided, pathology departments should conduct internal reviews and consider transitioning specimen types to gross-only when safe.

OBJECTIVE: Second-opinion pathology review identifies clinically significant diagnostic discrepancies for some patients. Discrepancy rates and laboratory-specific costs in a single health care system for patients referred from regional affiliates to a comprehensive cancer center (\"main campus\") have not been reported.
METHODS: Main campus second-opinion pathology cases for 740 patients from eight affiliated hospitals during 2016 to 2018 were reviewed. Chart review was performed to identify changes in care due to pathology review. To assess costs of pathology interpretation, reimbursement rates for consultation Current Procedural Terminology billing codes were compared with codes that would have been used had the cases originated at the main campus.
RESULTS: Diagnostic discrepancies were identified in 104 (14.1%) patients, 30 (4.1%) of which resulted in a change in care. In aggregate, reimbursement for affiliate cases was 65.6% of the reimbursement for the same cases had they originated at the main campus. High-volume organ systems with low relative consultation reimbursement included gynecologic, breast, and thoracic.
CONCLUSIONS: Preventable diagnostic errors are reduced by pathology review for patients referred within a single health care system. Although the resulting changes in care potentially lead to overall cost savings, the financial value of referral pathology review could be improved.

OBJECTIVE: Histopathological Evaluation of surgical margins of a resected tumour specimen can give an insight about the extent of tumour spread. Errors in proper identification and orientation of resected tumour margins can lead to treatment failure and poor prognosis. Inking of resected margins is the most reliable and safe method. The aim of this study is to systematically review the studies which compares various materials used for inking of surgically resected specimen.
METHODS: Articles searched from PubMed, Cochrane, Google search, manual search using key words - inking, tissue marking dyes, surgical margin, tumour margin, surgical pathology, grossing, gross specimens and back references of the articles, yielded three articles. Three articles with a total sample size of 1325 and compares properties of India ink, Acrylic colours and Tissue Marking Dyes were considered in this review.
RESULTS: Both India ink and acrylic colours are good with respect to the Ease of application, visibility on paraffin wax blocks, Visibility on naked eye examination of slides and Visibility on microscope. Acrylic colours have less drying time than India ink. India ink do not result in contamination of tissue processing fluids, Interference with cellular and nuclear details and penetration in to tissues when compared with acrylic colours.
CONCLUSIONS: India Ink will continue to dominate as the best surgical ink when comparing all the parameters till newer studies are available for acrylic colours or other dyes. Acrylic colours have the potential to be widely used as a tissue marking dyes except for the few disadvantages.
UNASSIGNED: Гистопатологическая оценка хирургического края резектированного образца опухоли может дать представление о степени распространения опухоли. Ошибки в правильной идентификации и ориентации резектированных краев опухоли могут привести к неудачному лечению и плохому прогнозу. Подкраска краев резекции является наиболее надежным и безопасным методом. Целью данного исследования является систематический обзор исследований, в которых сравниваются различные материалы, используемые для нанесения краски на резектированные образцы.
UNASSIGNED: Поиск статей в PubMed, Cochrane, Google, ручной поиск по ключевым словам — чернила, краски для маркировки тканей, хирургические поля, опухолевые поля, хирургическая патология, брутто, брутто-образец и обратные ссылки статей, дал три статьи. В данном обзоре были рассмотрены три статьи с общим размером выборки 1325 и сравнением свойств индийских чернил, акриловых красок и красок для маркировки тканей.
UNASSIGNED: Как индийская тушь, так и акриловые краски хороши с точки зрения простоты нанесения, видимости на парафиновых восковых блоках, видимости на невооружённом глазу при осмотре слайдов и видимости на микроскопе. Акриловые краски имеют меньшее время высыхания, чем индийские чернила. По сравнению с акриловыми красками индийские чернила не приводят к загрязнению тканевых технологических жидкостей, вмешательству в клеточные и ядерные детали и проникновению в ткани.
UNASSIGNED: Индийские чернила будут продолжать доминировать в качестве лучших хирургических чернил при сравнении всех параметров до тех пор, пока не будут доступны новые исследования для акриловых красок или других красителей. Акриловые краски могут быть широко использованы в качестве красителей для маркировки тканей, за исключением нескольких недостатков.

BACKGROUND: Systematic review of amended reports in surgical pathology has been recommended as a valuable exercise in promoting quality assurance and improvement. Examination of report amendments can identify defects in the surgical pathology process and inspire new approaches to decreasing error rates and improving overall patient care.
METHODS: We performed a retrospective review of all amended dermatopathology reports over a 1.5-year period at a large academic institution.
RESULTS: During the study period, 86 amended reports out of a total 7950 skin-specific reports were issued (1.08%). Of these amended reports, about 59% (51/86) were because of non-interpretative errors (eg, wrong site, chin vs shin, etc.) while 41% (35/86) were diagnostic misinterpretations. Of these 35, 24 were considered major diagnostic changes while six were minor. Five amendments provided additional diagnostic information. Of those amended reports with diagnostic misinterpretations, 14/35 involved melanocytic lesions, 8/35 involved non-melanoma skin cancers or keratinocyte atypia, 10/35 were inflammatory lesions and 3/35 involved other tumors.
CONCLUSIONS: Our review points to several quality improvement areas that can be targeted to potentially avoid diagnostic errors in dermatopathology, including standardizing certain anatomic sites to prevent misidentification and seeking out clinicopathologic correlation in challenging melanocytic cases.

Remote digital pathology allows healthcare systems to maintain pathology operations during public health emergencies. Existing Clinical Laboratory Improvement Amendments regulations require pathologists to electronically verify patient reports from a certified facility. During the 2019 pandemic of COVID-19 disease, caused by the SAR-CoV-2 virus, this requirement potentially exposes pathologists, their colleagues, and household members to the risk of becoming infected. Relaxation of government enforcement of this regulation allows pathologists to review and report pathology specimens from a remote, non-CLIA certified facility. The availability of digital pathology systems can facilitate remote microscopic diagnosis, although formal comprehensive (case-based) validation of remote digital diagnosis has not been reported. All glass slides representing routine clinical signout workload in surgical pathology subspecialties at Memorial Sloan Kettering Cancer Center were scanned on an Aperio GT450 at ×40 equivalent resolution (0.26 µm/pixel). Twelve pathologists from nine surgical pathology subspecialties remotely reviewed and reported complete pathology cases using a digital pathology system from a non-CLIA certified facility through a secure connection. Whole slide images were integrated to and launched within the laboratory information system to a custom vendor-agnostic, whole slide image viewer. Remote signouts utilized consumer-grade computers and monitors (monitor size, 13.3-42 in.; resolution, 1280 × 800-3840 × 2160 pixels) connecting to an institution clinical workstation via secure virtual private network. Pathologists subsequently reviewed all corresponding glass slides using a light microscope within the CLIA-certified department. Intraobserver concordance metrics included reporting elements of top-line diagnosis, margin status, lymphovascular and/or perineural invasion, pathology stage, and ancillary testing. The median whole slide image file size was 1.3 GB; scan time/slide averaged 90 s; and scanned tissue area averaged 612 mm2. Signout sessions included a total of 108 cases, comprised of 254 individual parts and 1196 slides. Major diagnostic equivalency was 100% between digital and glass slide diagnoses; and overall concordance was 98.8% (251/254). This study reports validation of primary diagnostic review and reporting of complete pathology cases from a remote site during a public health emergency. Our experience shows high (100%) intraobserver digital to glass slide major diagnostic concordance when reporting from a remote site. This randomized, prospective study successfully validated remote use of a digital pathology system including operational feasibility supporting remote review and reporting of pathology specimens, and evaluation of remote access performance and usability for remote signout.

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