After passing my fellowship exam in early 2019, I was working in a lab where I used to see cases for histopathological diagnosis from across my province in Pakistan. These specimens often travel long distances to reach a lab with adequate facilities for histopathology diagnosis. If specimens were not placed in proper air-tight containers, formalin would spill out and the specimen became autolyzed – something that happened often. This certainly caused frustration when it necessitated repeat biopsies, but things became grave in cases of excisional biopsies. Once, we received an axillary mass of a 13-year-old boy – four days after surgery. It was without formalin and on histopathology it turned out to be autolyzed Hodgkin’s lymphoma. I felt sorry for the little boy – more perhaps because I am a mother. If only we had digital pathology and telepathology facilities, then small specimens and biopsies could be sent to labs with the help of scanners. We could also get second and third opinions so difficult cases could be taken easily across the globe.
I live in the developing world. More than two thirds of the world’s population live here. The bulk of the world’s diseases are here. But our less-equipped laboratories and diagnostic facilities result in delayed diagnoses and grave consequences. Yet digital and computational pathology appear as rays of hope. Despite all constraints and limited resources, my colleagues and I advocate for technological adoption, and together we conducted the first country-wide survey among pathologists regarding the future of remote digital pathology in light of COVID-19. Using open source repositories and software, I have been involved in many different digital pathology projects, and was even the first recipient of a travel award for developing countries for the annual Digital Pathology Association conference in 2021. Of course, the fight is far from over. I am thankful to all those vendors, pathologists, AI scientists – and especially Dr. Anil Parwani – who helped me in my digital and computational pathology journey despite all constraints.