The Pathologist

Earlier this year, we invited The Pathologist community to reflect on how they are meeting the demands of modern medicine – and turning creativity, leadership, innovation, and fresh thinking into meaningful change. Judged blind by a panel of peers, the entries produced a list of 50 remarkable people spanning five continents.

Dana Powell Baker. Credit: The Association of Public Health Laboratories Between 2012 and 2013 was the first time my thyroid health came into question. After a routine visit with my primary care physician, I was referred to my initial consult with an endocrinologist for further evaluation of my thyroid. Interestingly, I did not have any abnormal diagnostic laboratory test results.

Researchers have shown that Escherichia coli RNA polymerase can transcribe an expanded genetic alphabet containing eight nucleotide letters instead of the four found in natural DNA. The study, published in Nature Communications, also identified a way to reduce errors involving one of the synthetic bases. Natural DNA stores information using four bases: adenine, thymine, cytosine, and guanine.

Russ Lebovitz For years, the goal in neurodegenerative disease has been to find a definitive test that can identify what is wrong, predict what will happen next, and guide treatment. That ambition is understandable, but a single test is unlikely to provide all these answers. Biomarkers have transformed the study of neurodegenerative disease. We can now detect biological changes that were once visible only after death.

Credit: Stockport NHS Foundation Trust Walking into the pathology department at the Stockport National Health Service (NHS) Foundation Trust feels a little like stepping back in time. In an unassuming corner of the northwest of England, this single story, red brick building dates back to the early 1900s. In the cramped corridors and poky rooms, "storage" amounts to piles of boxes stacked among the analyzers and equipment.

The College of American Pathologists (CAP) has updated 14 Cancer Protocols, including changes to breast cancer biomarker reporting and molecular testing for gastrointestinal stromal tumors. Released September 16, the third-quarter revisions align standardized pathology reporting with updates to World Health Organization classifications, American Joint Committee on Cancer guidance, and developments in precision oncology.

Credit: Adobe Stock A single-cell analysis platform identified bloodstream pathogens and measured their antimicrobial susceptibility within hours in laboratory and clinical-sample testing, according to a study published in Science Advances. The system combined bacterial enrichment, fluorescence-based identification, and phenotypic antimicrobial susceptibility testing (AST).

As AI-only biomarker tests begin to hit the market, the urgency for digitally enabled pathology labs increases. But is the digital infrastructure mature enough to support them? We asked four experts from clinical pathology, digital pathology, and AI development to share their insights on the AI-readiness of labs today. Part two of their discussion reveals what can go wrong when data quality is poor, how to build scalable systems, and why stakeholder collaboration will be the key to digital success.

A hybrid artificial intelligence system ranked previously identified disease-causing variants among its top three candidates in more than 90 percent of retrospectively assessed rare disease cases, according to a study published in npj Genomic Medicine. The system, called aiDIVA, was developed to reduce the number of variants requiring manual review following exome or genome sequencing.

Alexandra "Ali" Brown trained in anatomic and clinical pathology before completing fellowships in surgical pathology and breast cancer. At MD Anderson Cancer Center in Houston, she became the first pathologist to undertake the Susan G. Komen Interdisciplinary Breast Cancer Fellowship, a program that divided her time between pathology and specialties including surgical oncology, medical oncology, palliative care, and patient advocacy.