Do Pathologists read films?

[Sir James Bond]

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As part of diagnosing diseases, can a pathologist read a patient's CT scan or MRI to help nail down a diagnosis? I imagine the most dedicated pathologist will not only examine the gross and microscopic evidence, but also review any other labs or imaging results to be complete and thorough. Or is this not customary?

 

[2121115]

Definitely yes. Most physicians (not just pathologists) can interpret CTs, plain films and MRIs, to some degree at least. Although, we can't bill for it. Definitely labs and other clinical data too. You can't even think about signing out a sarcoma without seeing the imaging.

 

[liliequist]

Where is this question coming from?
Neuropathologists definitely read their own films.

 

[TinyFish]

Yes! It's another piece of essential clinical information! Why would we ignore imaging studies?

 

[Sir James Bond]

Splendid. As a 3rd year medical student who loves diagnosing disease with his eyes, I am happy to hear this. The question comes from a medical student who is on the precipice of choosing pathology as a career, so all of your feedback is greatly appreciated. I've taken a long hard look at all of the specialties, and this by far is an excellent and oft-overlooked field.

This is a very exciting step, so my occasional random questions may appear on this board. Apologies in advance.

It's nice to meet you all.

And remember, serve the martini shaken, not stirred.

 

[pathstudent]

Yes! It's another piece of essential clinical information! Why would we ignore imaging studies?

Personally I never read films. I find it much better to just look at what the radiologist thinks rather than me logging into PACS and trying to interpret the images myself. Moreover, I never even look at them except when they are shown at a conference and then I just nod my head when they say "and this lymph shows slight hypermetabolic activity" and try to refrain from asking "now which is the left side again".

 

[gschl1234]

As part of diagnosing diseases, can a pathologist read a patient's CT scan or MRI to help nail down a diagnosis? I imagine the most dedicated pathologist will not only examine the gross and microscopic evidence, but also review any other labs or imaging results to be complete and thorough. Or is this not customary?

At our program, the residents' computers are not hooked up to be able to look at the films themselves but we'll read the radiologists report, especially prior to grossing. Radiologic correlation is essential for bone pathology. In fact, our bone pathologist will always look at the radiograph before making a final diagnosis. In consult cases where radiographs aren't provided, he will give a descriptive top line and put the differential in a note saying that radiologic correlation is needed to make a diagnosis. Our neuropathologist always looks at whatever imaging is provided (the radiographs, not just reports). Outside of these two subspecialties, I haven't seen any other attendings looking at radiographs.

 

[KCShaw]

Depends, and I pretty much agree with everyone else. Certain path subspecialties are more geared towards doing this with regularity -- they see them essentially daily, and may look at them with a different eye than a run-of-the-mill radiologist (as others have said, primarily neuropath and bone/soft tissue path). That said, anyone who has interest in doing so could, certainly if you're working in a hospital setting and are wired to see digital images. But you'll also find that some imaging interpretations are limited or simply wrong, and with certain studies on certain organs you may prefer to -avoid- imaging results.