Department of Laboratory Medicine and Pathobiology, University of Toronto, University Health Network, Ontario, Canada.
Arch Pathol Lab Med. 2011 Feb;135(2):183-6. doi: 10.5858/2008-0432-CCR.1.
Histopathology, like other branches of medicine in West Africa, has suffered largely from economic, political, social, and infrastructural problems, becoming a shadow of the top quality that had been obtained in the past. To address the prevailing problems, one needs to attempt defining them.
The existing structure of training and practice are discussed, highlighting the author's perception of the problems and suggesting practical ways to address these while identifying potential roles for North American pathology organizations.
The author's past and ongoing association with pathology practice in Nigeria forms the basis for this review.
Pathology practice is largely restricted to academic medical centers. The largest of academic centers each accession around 4000 or fewer surgical specimens per year to train 9 to 12 residents. Histopathology largely uses hematoxylin-eosin routine stains, sometimes with histochemistry but rarely immunohistochemistry. Pathologists depend largely on their skills in morphology (with its limitations) to classify and subclassify tumors on routine stains, including soft tissue and hematolymphoid malignancies. Immunofluorescence, intraoperative frozen section diagnosis, electronic laboratory system, and gross and microscopic imaging facilities are generally not available for clinical use.
The existing facilities and infrastructure can be augmented with provision of material and professional assistance from other pathology associations in more developed countries and should, among other things, focus on supplementing residency education. Virtual residency programs, short-visit observerships, development of simple but practical laboratory information systems, and closer ties with pathologists in these countries are some of the suggested steps in achieving this goal.
与西非的其他医学分支一样，组织病理学在很大程度上受到经济、政治、社会和基础设施问题的影响，已经沦为昔日顶尖水平的影子。为了解决当前存在的问题，我们需要尝试对其进行定义。
讨论现有的培训和实践结构，突出作者对问题的看法，并提出解决这些问题的实际方法，同时确定北美病理学会可能发挥的作用。
作者在尼日利亚从事病理实践的过去和现在的经历为本文的综述提供了基础。
病理实践主要局限于学术医疗中心。最大的学术中心每年接收的外科标本约为 4000 份或更少，以培训 9 到 12 名住院医师。组织病理学主要使用苏木精-伊红常规染色，有时进行组织化学染色，但很少进行免疫组织化学染色。病理学家主要依靠其在形态学方面的技能（具有其局限性）来对常规染色的肿瘤进行分类和亚分类，包括软组织和血液淋巴恶性肿瘤。免疫荧光、术中冷冻切片诊断、电子实验室系统以及大体和显微镜成像设备通常无法用于临床。
现有的设施和基础设施可以通过来自更发达国家的其他病理学会提供物质和专业援助来扩充，除其他事项外，应侧重于补充住院医师教育。虚拟住院医师培训计划、短期访问观察、开发简单但实用的实验室信息系统以及与这些国家的病理学家建立更紧密的联系，都是实现这一目标的一些建议步骤。
