Colazioni Istochimiche Mito o Realtà

Dr. Sílvia Bagué MD Consultant Pathologist | Pathology Department | Hospital de la Santa Creu i Sant Pau | Universitat Autònoma de Barcelona, Spain

MD, PhD | Head of the Pathology Laboratory of IPATIMUP | Researcher at i3S | Affiliated Professor of Medical Faculty of Porto University | Vice-President of the Portuguese Society of Anatomic Pathology - Porto University, Portugal

APOF - Pathologists Beyond Borders - Experiences by volunteers
Non-Governmental Organisation for preventive medicine and oncological diagnosis in the South of the World

Dr. Sebastian Mignacca | Veterinary Research Officer | Pathology Division | Department of Agriculture, Food and the Marine | Backweston Campus | Celbridge, Ireland

Stromal prostatic tumor is a rare lesion thaspan a spectrum from monophasic to biphasic (phyllodes type) tumors, with controversial terminology and pathology, whose most accepted terminology is Prostatic stromal tumors with uncertain malignant potential (STUMP); they generally have good prognosis, although may have recur, invade locally or metastasize. Owing to the rarity of this tumor, there is not yet a consensus on appropriate management.

We report a case of a 81 year old man with lower urinary tract symptoms, abnormal digital rectal examination, and high PSA level. Three nodular pieces of prostate were resected by open surgery (370 grams) When cut, they are solid, with an increased consistency, a whitish color and a trabeculated appearance. Microscopically, there is proliferation of spindle cells, arranged in irregular and random bundles, surrounded by abundant collagenous stroma, with slight focal atypia. A panel of ancillary techniques of IHC was carried out, which confirmed the diagnosis, and ruled out differential diagnoses. We highlight this pathology for its low frequency and the value of accurate histopathological diagnosis differentiating it from other pathologies.

This lecture will cover the key diagnostic features of high-grade CGIN / AIS and the diagnostic pitfalls that may be encountered in cervical cytology.

Small, blue, round cell tumors (SBRCT) is a group of highly heterogeneous malignant and aggressive tumors, which can occur at any age.
Tumors in this group are sharing similar morphological appearance, and characterized by small, round nuclei and a narrow cytoplasm, thus gaining more blue color in H&E stained slides.
The tumors of this group, which more commonly encountered in children include lymphoblastic lymphoma, Ewing’s sarcoma, rhabdomyosarcoma, nephroblastoma, neuroblastoma, medulloblastoma, retinoblastoma, and hepatoblastoma.
Other tumors, such as small cell carcinoma, Merkel cell carcinoma, non-Hodgkin lymphoma, synovial sarcoma, desmoplastic round cell tumor, mesenchymal chondrosarcoma, small cell osteosarcoma and olfactory neuroblastoma are traditionally accepted to be more common in adults.
Differential diagnosis of these tumors is difficult and sometimes challenging for pediatric pathologists. Despite the similar immunohistochemical expression patterns of some antigens (CD56, CD99), we discuss and present our insight of this problem.

The diagnosis of heavily pigmented melanocytic lesions is problematic. This is often compounded by lack of visibility of nuclear detail of tumour cells due to physical masking by melanin pigment. Similarly there can be colour merging of chromogenic final reaction products with melanin, making evidence of antigenic localisation problematic.

Paraffin blocks containing several tissues have become a major tool in surgical pathology. As multi-tissue blocks, they usually consist of few rather large samples and as tissue micro-arrays they may contain up to several hundred small sized tissue cores. This makes carrier-based multi-tissue blocks (CBMTBs) an ideal approach when exact orientation of layers is important, for example in normal GIT tissues. The carrier tissue approach can also be used for few large sized sample tissues or to generate classical TMAs with sample cores of <1mm. Since the newly generated carrier-based multi-tissue block (CBMBT) or carrier-based TMA (CBTMAs) is completely re-embedded after assembling, sectioning of CBMTBs is comparable to sectioning a normal solid tissue block producing virtually no sample loss and requiring minimal trimming and consequently vastly increasing yield.

The Anatomic Pathology laboratory has profoundly changed in the last decade with the introduction of traceability and FISH and Molecular Biology techniques. Technology has certainly supported all stages of sample preparation from acceptance of the material to delivery of the preparation (traceability). Microscopy and the morphological approach remain, however, the basis from which the entire diagnostic process starts.During the webinar, the cost-benefits of this "methodological transition" will be assessed according to an approach that starts from automation to reach innovation.

The "digital pathology" has been used successfully in South Tyrol for the performance of intraoperative examinations in the three peripheral hospitals of Merano, Bressanone and Brunico. Being devoid of pathological anatomy, originally the execution of intraoperative examinations in those locations required a pathologist and a technician from the Bolzano hospital to go there in person with a portable freezer. Since 2003, the development of a project has begun for the use of a digital platform that would allow the reading of extemporaneous preparations to the freezer remotely, avoiding the transfer of staff from the Anatomic Pathology of Bolzano. The project took shape in 2008, with the resolution of various structural and organizational problems and the collaboration of technicians, surgeons and pathologists. The path for the realization of the project, the validation studies carried out, and the remote intraoperative diagnostic activity carried out in recent years are illustrated.

Talking about "lean management" in Healthcare in a pandemic era might seem to most a mere philosophical exercise from a cultural circle useful for distracting attention on the current problem.In reality, as I hope will be evident at the end of my attribute, having a managerial / organizational tool such as the "Lean" methodology available would also help to explain some of the many situations of unpreparedness for this emergency, the effects of which we are all well known. In "lean management" and therefore in the "lean" methodology or "lean thinking", deep cultural roots are recognized at the base that are rooted in Japanese culture which is very observant of rules and attention to quality.

Besides patients safety, around which all histopathology activities are centered, staff safety is crucial in our departments, where exposure to chemical and biological hazards is constant. It is important to know about the chemicals we deal with in our daily work. Understanding the labels can help identifying the more hazardous chemicals, what the risks are and how to avoid them. This webinar will provide familiarity with the symbols of the CLP (classification, labelling and packaging) system, internationally adopted since 2018 . The environmental safety can be safeguarded with the reduction of toxics use by substitution and with the minimization and identification of those chemicals that can be disposed of safely in normal trash from other chemicals that must be placed in appropriate containers to be picked up by safety services.