Aids of telepathology in intra-operative histomorphological tumor diagnosis and classification

Visual telecommunication (telepathology) was applied for expert consultation in intra-operative frozen sections and tumor classification of paraffin-embedded, poorly differentiated bronchial carcinoma. The Institute of Pathology, Hospital Baumgartnerhöhe, Vienna and the Department of Pathology, Thoraxklinik, Heidelberg transmitted histological images by use of commercially available computerized modems (VP 2000) and conventional telephone lines. The expert consultation of the frozen sections included the clinical history, macroscopic findings and problems of final judgement of the images. Additional useful information could be obtained in about 35% of cases, and comprised expansion of differential diagnosis, certainty of final diagnosis, and side findings, such as concurrent inflammation, sarcoid-like lesions, etc. The time required for intra-operative diagnosis was 6-10 min. Cases of the Austrian-German quality control study on lung cancer with divergent tumor classification were discussed by use of telepathology. A final congruent tumor diagnosis could be obtained in all divergent cases. The data indicate that telepathology can be successfully used for expert consultation of intra-operative frozen sections and panel discussions of difficult bronchial carcinoma cases.