Solitary fibrous tumors of the pleura (SFTP) are rare mesenchymal neoplasms that originate from mesenchymal growth in the pleura, tend to be single tumors, usually have an indolent course and show nonspecific symptoms. SFTP can be often diagnosed from an incidental finding of a single mass in the thorax and should be confirmed by biopsy and immunohistochemistry. A minority of cases may present Doege–Potter syndrome (DPS, episodes of refractory hypoglycemia) associated with production of insulin-like growth factor 2 (IGF-2). Both SFTP and DPS are rare occurrences with less than 2000 cases reported worldwide. The curative treatment is tumor resection. Two cases of patients with DPS caused by SFTP are presented below.

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Background Tuberculosis is the first infection-related cause of death worldwide. Early diagnosis of paucibacillary tuberculosis represents a challenge, even with direct tissue examination. Digital pathology allows the digital analysis of tissues to identify microorganisms. We aim to develop a program to detect and quantify typical and atypical mycobacteria in paraffin-embedded Ziehl–Neelsen-stained tissues. Methods Program development: The building of the program, named Pat-Scan, included pathology, systems engineering, and scientific applications. The iScan Coreo Au scanner® was used, and 9 variables were adjusted: Temp Directory Path, Output Directory Path, Server Path, Focus Approach, Focus Mode, AOI Detection Approach, Scan at, No. of Z Layers, and Z Delta. Software parameter settings : Brightness, contrast, sharpness, and red/green/blue. Control module scan and analysis : Ten Ziehl–Neelsen-stained samples were fragmented into 2,000 images and analyzed by a multidisciplinary team to validate the reproducibility of the bacilli images in the tissue, as detected by the software. Results Pat-Scan included software and a scanner that were used to detect and quantify bacilli in paraffin-embedded Ziehl–Neelsen-stained tissues. HD quality image segmentation was performed, and nine planes of the Z-axis were scanned with a 1-micron distance between planes. Image magnification: 40x–80x. Scan time: 10–12 minutes. All samples containing mycobacteria were successfully analyzed by the scanner, and the bacilli could be detected; these results were validated by expert pathologists by microscopy examination, and the presence of bacilli was confirmed in all cases. Conclusions Pat-Scan allowed the identification and quantification of mycobacteria in paraffin-embedded Ziehl–Neelsen-stained tissues, offering a reproducible diagnostic method that reduces the time for diagnosis and does not affect precision. Further validation is needed for application in the clinical setting.

BackgroundTuberculosis is the first infection-related cause of death worldwide. Early diagnosis of paucibacillary tuberculosis represents a challenge, even with direct tissue examination. Digital pathology allows the digital analysis of tissues to identify microorganisms. We aim to develop a program to detect and quantify typical and atypical mycobacteria in paraffin-embedded Ziehl–Neelsen-stained tissues.MethodsProgram development: The building of the program, named Pat-Scan, included pathology, systems engineering, and scientific applications. The iScan Coreo Au scanner® was used, and 9 variables were adjusted: Temp Directory Path, Output Directory Path, Server Path, Focus Approach, Focus Mode, AOI Detection Approach, Scan at, No. of Z Layers, and Z Delta. Software parameter settings: Brightness, contrast, sharpness, and red/green/blue. Control module scan and analysis: Ten Ziehl–Neelsen-stained samples were fragmented into 2,000 images and analyzed by a multidisciplinary team to validate the reproducibility of the bacilli images in the tissue, as detected by the software.ResultsPat-Scan included software and a scanner that were used to detect and quantify bacilli in paraffin-embedded Ziehl–Neelsen-stained tissues. HD quality image segmentation was performed, and nine planes of the Z-axis were scanned with a 1-micron distance between planes. Image magnification: 40x–80x. Scan time: 10–12 minutes. All samples containing mycobacteria were successfully analyzed by the scanner, and the bacilli could be detected; these results were validated by expert pathologists by microscopy examination, and the presence of bacilli was confirmed in all cases.ConclusionsPat-Scan allowed the identification and quantification of mycobacteria in paraffin-embedded Ziehl–Neelsen-stained tissues, offering a reproducible diagnostic method that reduces the time for diagnosis and does not affect precision. Further validation is needed for application in the clinical setting.