The editors are back with the next issue. This issue brings together a few cases wherein pathological correlation with clinical features sprung up some interesting surprises. Such surprises makes clinical practice challenging and encourages a dialogue between the clinician and the pathologist. Clinical medicine when correlated with histopathological results improves the overall diagnostic and management outcomes. It gives direction to the clinician and helps in making the final diagnosis.
Clinicopathological correlation is a term that defines the relationship between the clinical and the pathological findings of a patient. It is not an etiological cause of the disease. A consultation between the clinician and the pathologist allows the objective review of symptoms, signs, laboratory investigations, imaging techniques and histopathology, results of the disease condition and its course. Clinicians reach a provisional diagnosis when they evaluate the patient’s history, and examination findings. This diagnosis is then confirmed or refuted, by the laboratory results, imaging techniques, the histopathologic examination and finally the autopsy results in the event of the death of the patient. This correlation is a positive correlation wherein the clinical and the pathological findings sync with each other. However, when they don't correlate then it is negative clinicopathological correlation. This is all the more important as the clinical dilemmas can be resolved.
It is gratifying to the clinician when the pathologist collaborates his clinical diagnosis.
There is a case of a pregnant patient with a dysgerminoma. The preoperative clinical and MRI diagnosis was that of a subserosal fibroid uterus. Surgery revealed it to be an ovarian neoplasm and the gross and typical round or polygonal tumor cells arranged in nests, sheets and cords with pleomorphic hyperchromatic nuclei, thick nuclear membrane, prominent eosinophilic nucleoli and moderate vacuolated cytoplasm within these cells clinched the diagnosis of a dysgerminoma.
The pathologist needs to review the clinician’s notes and then correlate the histopathology or the autopsy findings prior to writing his report. This clinicopathological summary report should be presented in a concise, simple, and easy to understand language detailing the positive and the relevant negative relationship between the clinical and the pathological findings. These reports aid in constructing the sequence of the disease process in an individual, especially when this is the summary report of an autopsy. Unrelated findings should also be highlighted. This will update the knowledge of the clinician and aid in improving the quality of healthcare.When the clinician and the pathologist join hands then the patient, the medical world and academia all stand to benefit. I have great pleasure in presenting the May issue of our journal to our readers who are ever willing to learn from others’ experiences.