Pathology Case Study: Two Weeks in Africa

The University of Pittsburgh School of Medicineâs Department of Pathology has compiled a series of case studies to help both students and instructors. In this clinical microbiology case, a 16-year-old male developed symptoms of fatigue, diarrhea, nausea, and vomiting after returning to the United States from a two-week trip to Sudan. Laboratory test results and information from a microscopic examination are included in the case study. Clicking on the âFinal Diagnosisâ section will take you to a detailed discussion of the patientâs condition from the contributing doctor. A list of references, which students could use to get more background information, is also included at the bottom of the section

Pathology Case Study: Rheumatoid Arthritis and Peripheral Leukocytosis

This is a case study presented by the University of Pittsburgh Department of Pathology in which 75-year-old male, with previous history of hypertension and congestive heart failure presented with leukocytosis. Results from a blood cell count, blood smear, and immunohistochemistry are all included in the case study to aid in your understanding of the patientâs diagnosis. The patientâs final diagnosis is found in the âFinal Diagnosisâ section, which also includes a detailed description of the condition from the contributing doctors. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose patientâs conditions. It is also a helpful site for educators to use to introduce or test student learning in hematopatholgy

Pathology Case Study: Cervical Lymphadenopathy

This is a hematopathology case study presented by the University of Pittsburgh Department of Pathology in which a 17-year-old female has cervical lymphadenopathy. Visitors are given both the microscopic and gross descriptions, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using laboratory results to diagnose. It is also a helpful site for educators to use to introduce or test student learning in hematopathology

Experience with CellaVision DM96 for peripheral blood differentials in a large multi-center academic hospital system

Context and Aims: Rapid, accurate peripheral blood differentials are essential to maintain standards of patient care. CellaVision DM96 (CellaVision AB, Lund, Sweden) (CV) is an automated digital morphology and informatics system used to locate, pre-classify, store and transmit images of platelets, red and white blood cells to a trained technologist who confirms or edits CV cell classification. We assessed our experience with CV by evaluating sensitivity, specificity, positive predictive value and negative predictive value for CV in three different patient populations. Materials and Methods: We analyzed classification accuracy of CV for white blood cells, erythroblasts, platelets and artefacts over six months for three different university hospitals using CV. Results: CV classified 211,218 events for the adult cancer center; 51,699 events for the adult general hospital; and 8,009 events for the children′s hospital with accuracy of CV being 93%, 87.3% and 95.4% respectively. Sensitivity and positive predictive value were <80% for immature granulocytes (band neutrophil, promyelocyte, myelocyte and metamyelocytes) (differences usually within one stage of maturation). Cell types comprising a lower frequency of the total events, including blasts, showed lower accuracy at some sites. Conclusions: The reduced immature granulocyte classification accuracy may be due in part to the subjectivity in classification of these cells, length of experience with the system and individual expertise of the technologist. Cells with low sensitivity and positive predictive value comprised a minority of the cells and should not significantly affect the technologist re-classification time. CV serves as a clinically useful instrument in performance of peripheral blood differentials

Pathology Case Study: Intermittent Confusion, Fever of Unknown Origin, and Lower Extremity Weakness

This is a hematopathology case study presented by the University of Pittsburgh Department of Pathology in which a 67-year-old male has intermittent confusion, fever of unknown origin, and lower extremity weakness. Visitors are given microscopic descriptions, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using laboratory results to diagnose. It is also a helpful site for educators to use to introduce or test student learning in hematopathology

Experience with multimodality telepathology at the University of Pittsburgh Medical Center

Several modes of telepathology exist including static (store-and-forward), dynamic (live video streaming or robotic microscopy), and hybrid technology involving whole slide imaging (WSI). Telepathology has been employed at the University of Pittsburgh Medical Center (UPMC) for over a decade at local, national, and international sites. All modes of telepathology have been successfully utilized to exploit our institutions subspecialty expertise and to compete for pathology services. This article discusses the experience garnered at UPMC with each of these teleconsultation methods. Static and WSI telepathology systems have been utilized for many years in transplant pathology using a private network and client-server architecture. Only minor clinically significant differences of opinion were documented. In hematopathology, the CellaVision® system is used to transmit, via email, static images of blood cells in peripheral blood smears for remote interpretation. While live video streaming has remained the mode of choice for providing immediate adequacy assessment of cytology specimens by telecytology, other methods such as robotic microscopy have been validated and shown to be effective. Robotic telepathology has been extensively used to remotely interpret intra-operative neuropathology consultations (frozen sections). Adoption of newer technology and increased pathologist experience has improved accuracy and deferral rates in teleneuropathology. A digital pathology consultation portal (https://pathconsult.upmc.com/) was recently created at our institution to facilitate digital pathology second opinion consults, especially for WSI. The success of this web-based tool is the ability to handle vendor agnostic, large image files of digitized slides, and ongoing user-friendly customization for clients and teleconsultants. It is evident that the practice of telepathology at our institution has evolved in concert with advances in technology and user experience. Early and continued adoption of telepathology has promoted additional digital pathology resources that are now being leveraged for other clinical, educational, and research purposes