Artificial Intelligence Improves the Accuracy in Histologic Classification of Breast Lesions.

OBJECTIVES: This study evaluated the usefulness of artificial intelligence (AI) algorithms as tools in improving the accuracy of histologic classification of breast tissue. METHODS: Overall, 100 microscopic photographs (test A) and 152 regions of interest in whole-slide images (test B) of breast tissue were classified into 4 classes: normal, benign, carcinoma in situ (CIS), and invasive carcinoma. The accuracy of 4 pathologists and 3 pathology residents were evaluated without and with the assistance of algorithms. RESULTS: In test A, algorithm A had accuracy of 0.87, with the lowest accuracy in the benign class (0.72). The observers had average accuracy of 0.80, and most clinically relevant discordances occurred in distinguishing benign from CIS (7.1% of classifications). With the assistance of algorithm A, the observers significantly increased their average accuracy to 0.88. In test B, algorithm B had accuracy of 0.49, with the lowest accuracy in the CIS class (0.06). The observers had average accuracy of 0.86, and most clinically relevant discordances occurred in distinguishing benign from CIS (6.3% of classifications). With the assistance of algorithm B, the observers maintained their average accuracy. CONCLUSIONS: AI tools can increase the classification accuracy of pathologists in the setting of breast lesions.

Inverted Papilloma of the Bladder Coexisting with Urothelial Carcinoma. A Case Report.

BACKGROUND: Inverted papilloma (IP) is an unusual benign neoplasm, most commonly found in the bladder. Cases of malignant transformation have been reported in the past, although most of them are now considered to be urothelial carcinomas with an inverted growth pattern. CASE: A 54-year-old man was diagnosed with urothelial carcinoma in situ (UCIS), high-grade papillary urothelial carcinoma (HGPUC), and IP by transurethral resection specimen of the bladder. The urothelial carcinoma cells were seen colonizing the inverted papilloma. CONCLUSION: The coexistence of IP with UCIS and HGPUC is rare. Immunohistochemistry helps distinguish between IP and UC in difficult cases such as this one. A brief review of other reported cases of inverted papilloma coexisting with urothelial carcinoma in the English literature over the past 25 years is presented.