The importance of surgical pathology
The field of “surgical pathology” emerged from the groundwork laid by Velpeau, a Professor of Surgery, from the University of Paris and his early work was published in 1853. In the 1870’s, Carl Rouge and his associates at the University of Berlin first introduced the concept of “surgical biopsy” as a necessary tool. William Halstead was the first American surgeon to start the Division of Surgical Pathology at Johns Hopkins Hospital (USA). He made Joseph Bloodgood the first full-fledged American surgical pathologist.
Thereafter, significant contributions to the field of surgical pathology from USA came from other pioneers such as Arthur Purdy Stout (Columbia University, New York), Raffaele Lattes, James Ewing and Fred Stewart (Memorial Hospital, New York), Malcolm Dockerty (Mayo Clinic, Rochester) and Lauren Ackerman (St. Louis). Other key pioneers who contributed from other prestigious institutions from around the world include Pierre Masson in France and British oncologist Sir Rupert Willis.
It was the introduction of newer textbooks and publications that also helped the development and progress of surgical pathology. Activities such as the “Surgical Pathology and Tumour” seminars organized by various national, international, and regional societies further spread the knowledge.
Today, the advancement in the fields of technology with more sophisticated techniques have led to superior imaging modalities coupled with the clinical, surgical, and gross appearance that helps the surgical pathologist to conclude to an accurate diagnosis. The exponential growth of knowledge in the field of pathology has led to sub-specializations and super specializations within this field over the last several decades.
Biopsy specimen materials, blocks and slides are also utilized to detect new molecular and genetic targets as identified in the burgeoning field of molecular biology, which is often dictating the treatment. With these novel, molecular and gene-targeting therapies, it is the presence (or absence) of certain genetic/molecular targets such as receptors, that are directing the treatment.
Hence, surgical pathology plays a crucial role in current day management of medical diseases, with the clinician, surgeon, and pathologist collaborating together. In this issue, we bring to you several such instances where the pathology diagnosis played a crucial role.
Dr. R.G. Wiseman Pinto