Perinatal and Paediatric Pathology Special Theme Issue

Abstract

Fetuses and children are not ‘little adults’. Their diseases frequently require additional knowledge to that used in adult pathology and also a multidisciplinary approach in their diagnosis. This special theme issue of Pathology provides an update on uncommon and common, but troublesome, aspects of perinatal and paediatric pathology. The senior authors in this issue are recognised experts in their area both from Australasia and overseas and we would like to thank them for agreeing to write for this special theme edition knowing they are already very heavily committed in so many ways. The breadth of topics shows the vibrancy of pathology. Galambos and deMello, for example, describe the molecular processes in pulmonary development and how dysregulation can lead to clinical manifestations. Pathology is global. Peres and his colleagues have written on their experience of infectious diseases in a developing country. They rightly warn that while pathologists in developing countries are aware of these diseases, those in industrialised countries may not be but should be ready to expect the unexpected with increased tourism and immigration. That pathology is medicine is amply demonstrated by the following reviews: Mackay and Monagle illustrate the key role that pathologists play in the diagnosis and management of perinatal and early childhood stroke. In the paper on eosinophilic oesophagitis, Chow and his colleagues show the importance of pathology in refining a clinical entity and in triaging management. Lam and Ng show the cross-over between disciplines with the use of biochemical markers for diagnosing neonatal sepsis. Timely diagnosis reduces antimicrobial therapy and neonatal intensive care costs. The cost burden of inheritable diseases is immense and Wilcken and Wiley outline how newborn screening has reduced this burden and hint at the use of new technologies in the future to expand screening further. The unexplained stillbirth remains a diagnostic challenge and Rawlinson and colleagues pose the question, and the veracity of the evidence, of the role of viruses and other infections in stillbirth. In documenting the pathology of paediatric renal tumours, Vujanic and Charles show the interplay between pathology and oncology. They outline clearly the current differences between the North American and European approaches to initial treatment and diagnosis. Vlychou and Athanasou provide a comprehensive review of bone tumours in children, with valuable radiological-pathological correlation. If there are still those who doubt the value of autopsies, Encha-Ravazi and her colleagues show that neuropathological evaluation, including the use of molecular probes, is important for genetic counselling. The importance of effective communication with our clinical colleagues is discussed by Gordijn and her colleagues in relation to placental lesions that may recur in a subsequent pregnancy. Our sincere thanks to the reviewers who provided detailed and constructive comments which made our editorial task so much easier. Thank you to Soon Lee, Editor of Pathology, for the opportunity to produce this special theme issue. Finally, we thank Belinda Neill in the Editorial Office at the College for keeping us on target. Her efficiency and organisational skill need to be acknowledged.