Pathology, Leopoldina Hospital, Gustav-Adolf-Str 8, D-97422 Schweinfurt.
Institute of Pathology, University of Wuerzburg, Josef-Schneider-Str. 2, D-97080 Wuerzburg.
Afr Health Sci. 2020 Sep;20(3):1313-1321. doi: 10.4314/ahs.v20i3.37.
BACKGROUND/OBJECTIVE: In a project of telepathology (TP) between German pathologists and a hospital in Tanzania, trained technical assistants have uploaded digital histological images onto the internet-based platform ipath. The diagnoses from 486 paediatric specimens were analysed.
The investigation included diagnoses, either primarily done via TP or secondarily after a further workup of the paraffin-embedded tissue, which was sent to Germany for cases which could not be solved via TP. In the latter, the initial TP-diagnoses were compared with the results after re-evaluation.
The median age was 11 years. The cohort comprised 390 benign diseases (80.2%) and 96 malignant diseases (19.8%). For benign diseases, the most frequent anatomic sites were lymph nodes, skin, and soft tissue, breast, and head&-neck. Frequent diagnoses were non-specific inflammations and benign tumors. In malignant diseases, the most sites were lymph nodes, skin, soft tissue, head&neck, and ovary and the most frequent diseases sarcomas and lymphomas. The paraffin embedded tissue of 179 cases (36.3%) was shipped to Germany. With the concordance analysis, we could discover the mandatory necessity for the possibility of second opinion in difficult cases.
An exclusively TP-support cannot meet all requirements of modern medical diagnostics. The education of local pathologists is imperative.
背景/目的：在德国病理学家与坦桑尼亚一家医院之间的远程病理学（TP）项目中，经过培训的技术助理将数字化组织学图像上传到基于互联网的 ipath 平台上。对 486 例儿科标本的诊断结果进行了分析。
该研究包括通过 TP 进行的诊断，或者在对石蜡包埋组织进行进一步检查后进行的诊断，对于无法通过 TP 解决的病例，将这些组织送到德国进行诊断。在后一种情况下，将初始的 TP 诊断结果与重新评估后的结果进行了比较。
中位年龄为 11 岁。该队列包括 390 例良性疾病（80.2%）和 96 例恶性疾病（19.8%）。对于良性疾病，最常见的解剖部位是淋巴结、皮肤和软组织、乳腺以及头颈部。常见的诊断是非特异性炎症和良性肿瘤。对于恶性疾病，最常见的部位是淋巴结、皮肤、软组织、头颈部和卵巢，最常见的疾病是肉瘤和淋巴瘤。有 179 例（36.3%）石蜡包埋组织被送到德国。通过一致性分析，我们发现对于疑难病例，有必要进行二次诊断。
仅通过 TP 支持无法满足现代医学诊断的所有要求。对当地病理学家进行教育是必要的。
