Pediatric Pathology: Diagnosis at the Intersection of Genetics, Embryology, and Histology

Abstract

Largely thanks to the genetic revolution, pediatric surgical pathology has been a rapidly evolving field in recent years. As a discipline, pediatric pathology can probably boast requiring the most arcane knowledge about the widest variety of lesions, necessitating a detailed knowledge of genetics and embryology as well as human anatomy and histology. These sciences intersect at the bench of the individual performing surgical pathology on childhood tissues. We have witnessed a gratifying growth in our knowledge of diverse lesions that create pediatric disease, many of which have been previously considered “idiopathic,” “syndromic,” or simply unexplained. However, with this growth has come a need for increasing knowledge of pediatric diseases for diagnosticians who interact with an increasingly savvy group of pediatric subspecialists. Sadly, a concurrent trend has been increasing shortages in manpower to meet these needs. Relatively few new residents decide on a career in pediatric pathology, as rotations typically come late in their training, after fellowship decisions have already been made, and most prefer more lucrative careers in general pathology or larger subspecialties. Our group is getting older and grayer, and the gap promises to widen in the coming years. As a result, more and more general pathologists will be asked to take up