Clinical journals face a number of important challenges today. Knowledge is accruing in all medical specialties at a breakneck pace, and the figurative distance between the bedside and the research laboratory is widening daily. Balancing the interests of patients, practitioners, and medical scientists in choosing manuscripts for publication becomes an arduous and often thankless job for the editorial staff. The progressive leadership at the Archives has chosen to address this problem, in part, by committing this issue to enhancing the diagnostic skills of its readership.

The special section in this issue of the Archives is dedicated to contemporary diagnostic problems in anatomic pathology. Space constraints limit us to eight topics, which were selected from a sizeable list of potential candidate areas. Although the papers were invited, the authors were advised that their work would be peer reviewed prior to publication. Worthier individuals than I might have chosen different topics (or different authors), but in my defense I tried to maintain a limited set of guiding principles in assembling a group of expert diagnosticians: (1) the authors should be experienced in their subspecialty; (2) the topics should be practical (ie, useful in daily practice); (3) images and tables should be used liberally and with as few restraints as possible; and (4) the authors should rely heavily on their personal experience gained from busy clinical practice.

I would like to introduce these authors and their chosen topics in hopes of enticing readers to invest their valuable time in reading these contributions. The order of presentation here was established by the order in which the manuscripts were received.

Our first contribution is from Drs David Bostwick and Isabelle Meiers on the nuances of interpreting needle core biopsies following nonsurgical therapies for prostatic adenocarcinoma. I have known Dave for many years and have come to appreciate his insight and eloquence. For my own general practice of pathology, his contributions over the years have been as provocative as they are valuable in navigating successfully the often treacherous waters of prostate biopsy interpretation. I think you will find the current work by Drs Bostwick and Meiers to be authoritative and valuable in your daily practice.

Dr Steven Silverberg weighs in next with a foundation article on the surgical pathology of the endometrium. Steve was my first mentor in surgical pathology and cytology, and through his dedication and hard work over the years has established himself as an icon in our specialty. In this exposition he provides characteristically clear advice on managing endometrial biopsies and resected uteri, focusing on proliferative diseases and carcinoma. Since receiving his manuscript, I have benefited already from his advice on numerous occasions in my own practice.

Next, Drs Dinesh Rao and Jonathan Said provide a comprehensive exposé of small lymphocytic proliferations occurring at extranodal sites and their differential diagnosis. Jonathan is an expert hematopathologist and a respected teacher of pathology whom I came to know through the Cell Markers Committee of the College of American Pathologists. Jonathan's straightforward approach to hematopathology is clearly evident in this work. For me, this particular area of hematopathology is always a challenge, and I am happy to say that their manuscript has clarified for me a number of issues that have arisen as recurrent problematic themes.

Drs Ryan Miller and Arie Perry next address the neuropathologic nuances of glioblastoma. For most of us, the brain biopsy is a terrifying prospect in the frozen section suite. Still more daunting is the recognition of morphologic variants of this high-grade tumor, often compounded by the minuscule size of the stereotactic needle biopsy sample. These expert authors provide us with diagnostic insights for managing these specimens, up-to-date details on the classification of glioblastomas, and basic science contributions garnered in the molecular laboratory.

My own contribution focuses on the transbronchial biopsy in contemporary practice. No lung tissue specimen is more common worldwide, yet most pathologists are frustrated by the frequently nondiagnostic results provided by them. Drs James Grudin, James Parish, and Mary Beth Scholand and I present 10 examples of the diagnostic transbronchial biopsies in hopes of underscoring the clinical, radiologic, and pathologic correlation required for success in this area.

Dr Matthew Zarka is a colleague of mine at the Mayo Clinic in Arizona and serves as director of cytopathology at our institution. Matt has a refreshingly unique perspective on fine-needle aspiration cytology based on the architectural patterns produced by cells in a variety of pathologic conditions. His offering on a common pattern observable in fine-needle aspirations of salivary gland lesions provides an enticing sample of concepts soon to be published as a textbook in the series Practical Pathology from Elsevier Science.

Our penultimate contribution comes from Drs DiCaudo, McCalmont, and Wick on selected challenges in dermatopathology. These experienced authors provide a sampling of “wolves in sheep's clothing,” with several examples of sometimes banal-appearing skin lesions that belie their aggressive nature. No surgical pathology library would be complete without a focused exposition of these lesions, and these authors provide a clear compendium of the lesions' salient features and diagnostic pitfalls.

Finally, Drs Li and Burgart address a very contemporary topic in gastrointestinal pathology with their article on serrated adenomas of the lower intestine. In our practice at Mayo Clinic Arizona, we have wrestled with the nuances of these lesions, once grouped with hyperplastic polyps. Like the other topics presented in this issue, I think you will find their perspective and expertise valuable every day in your practice.

Kevin O. Leslie, MDDr Leslie received his medical degree from the Albert Einstein College of Medicine in 1978, trained in anatomic and clinical pathology at the University of Colorado, and completed a fellowship in surgical pathology at Stanford University Medical Center in 1983. He is board certified in anatomic and clinical pathology.  In 1986 Dr Leslie joined the faculty of the University of Vermont and served as director of surgical pathology (1988–1990) and director of anatomic and surgical pathology (1990–1995) during his tenure. In addition to service activities, he directed the Morphology Core of the Vermont Specialized Center for Organized Research (SCOR) in occupational and environmental lung disease, with a research focus on the role of myofibroblasts and contractile proteins in experimental lung fibrosis.  In 1996 he joined the faculty of the Mayo Clinic in Scottsdale, Ariz, where he is currently a consultant in the Department of Laboratory Medicine and Pathology and holds the academic rank of professor from the Mayo Clinic College of Medicine. He has authored more than 100 peer-reviewed publications and serves on the editorial boards for several pathology journals, including as an associate editor with the Archives. Most recently he coauthored and coedited (with Dr Mark Wick) the textbook Practical Pulmonary Pathology. A Diagnostic Approach. This work was awarded “Medical Textbook of the Year” in 2005 by the Royal Society of Medicine. Dr Leslie lectures nationally and internationally on a wide range of pulmonary pathology topics and is a fellow of the College of American Pathologists.

Kevin O. Leslie, MDDr Leslie received his medical degree from the Albert Einstein College of Medicine in 1978, trained in anatomic and clinical pathology at the University of Colorado, and completed a fellowship in surgical pathology at Stanford University Medical Center in 1983. He is board certified in anatomic and clinical pathology.  In 1986 Dr Leslie joined the faculty of the University of Vermont and served as director of surgical pathology (1988–1990) and director of anatomic and surgical pathology (1990–1995) during his tenure. In addition to service activities, he directed the Morphology Core of the Vermont Specialized Center for Organized Research (SCOR) in occupational and environmental lung disease, with a research focus on the role of myofibroblasts and contractile proteins in experimental lung fibrosis.  In 1996 he joined the faculty of the Mayo Clinic in Scottsdale, Ariz, where he is currently a consultant in the Department of Laboratory Medicine and Pathology and holds the academic rank of professor from the Mayo Clinic College of Medicine. He has authored more than 100 peer-reviewed publications and serves on the editorial boards for several pathology journals, including as an associate editor with the Archives. Most recently he coauthored and coedited (with Dr Mark Wick) the textbook Practical Pulmonary Pathology. A Diagnostic Approach. This work was awarded “Medical Textbook of the Year” in 2005 by the Royal Society of Medicine. Dr Leslie lectures nationally and internationally on a wide range of pulmonary pathology topics and is a fellow of the College of American Pathologists.

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The author has no relevant financial interest in the products or companies described in this article.

Author notes

Reprints: Kevin O. Leslie, MD, Mayo Clinic Arizona, Department of Laboratory Medicine and Pathology, 13400 E Shea Blvd, Scottsdale, AZ 85259 ([email protected])