Abstract:
Diagnoses of hematolymphoid malignancies result from multidisciplinary participation and comprehensive analyses; this includes clinical data, imaging studies, pathology and various esoteric tests. For the last twenty years, because of advances in tumor biology, various novel modalities of anti-cancer treatments especially with targeted anti-cancer drugs, and new technology, classification of hematolymphoid malignancies has become more and more complex; at the same time, the diagnoses and treatment modalities have been trending towards greater sophistication and precision. In addition to the initial diagnosis, nowadays, a modern pathology and laboratory service center must have abilities to provide multiple tests of increasing sensitivity and complexity for the purposes of, for example, prognosis and risk stratification, targeted therapy, treatment effect monitoring, disease monitoring after remission, target gene mutation monitoring, prognosis reassessment after chemotherapy, and treatment re-adjustment. Therefore, pathology and laboratory service have become an imperative component of modern medicine. Morphology alone or using any single test simply cannot meet the hematology-oncology needs. In fact, multi-test modalities, comprehensive analyses and integrated reporting, are standard practice along with their training programs throughout the health systems in the North America. At the turn of the century, technologies including immunohistochemistry, flow cytometry, cytogenetics, and later, molecular diagnostics have been adopted for the diagnoses of hematolymphoid malignancies in China. This article further discusses comprehensive approaches to the diagnoses of hematolymphoid malignancies, their organizational structures, and multidiscipline-oriented subspecialty training programs for hematopathologists. The approaches are characterized by emphasizing that hematopathologists must have comprehensive subspecialty-required multidiscipline analytical skill, must have abilities to provide integrated diagnoses based on the disease classification or comprehensive clinical-relevant interpretation of multi-test results, rather than provide technical results only, and must deliver integrated hematopathology reports.
Key words:
Hematopathology,
Lymphoma,
Comprehensive diagnostic modalities,
Pathology,
Laboratory medicine
Xiaolong S. Liu. What approaches should be taken to the diagnostics of hematolymphoid malignancies?[J]. Chinese Journal of Clinical Laboratory Management(Electronic Edition), 2016, 04(02): 99-109.