The challenges of histology education.

Generations of students have struggled to learn histology. They have found the subject extremely dry and the nomenclature very challenging. Insidiously, histology is fading from the minds of stakeholders. Unless this is rectified, it is not inconceivable that the subject will be further diluted in the medical curriculum. What contributing factors could there be? Via a survey and focus group discussions, international faculty (n = 111) were asked what the challenges in teaching histology were. Both qualitative and quantitative data were collected and stratified by the number of teaching years. A collaborative teaching session with a pathologist was also delivered to the YLLSoMM1 students (n = 280), who gave opinions about it. Of the international faculty, 85 (±1)% responded. Among those, 60 (±1)% felt that the pedagogy should be reformed (e.g., by gamification). Interestingly, 30 (±1)% opined that organ system histology should be moved into the clinical years. Notably, 70 (±1)% of teachers preferred to teach face to face (FTF) using either microscopes or virtual microscopy. Among the students, 71 (±1)% reported self-teaching from online resources. Significantly, 88 (±1)% of M1 students agreed that having the pathologist co-teach histology was beneficial. Some teachers, and most students, struggle with histology. There is a generational divide in opinions concerning how histology should be taught. The traditionalists wish to maintain the status quo while the reformists want changes. Learners want to be engaged with hybrid approaches aided by the pathologist. They also welcome more clinical context during histology lessons.

Utilization of contrast-enhanced ultrasound in the evaluation of craniofacial osseous lesions: A case report.

A 14-year-old boy undergoing brain MRI had an incidental avidly enhancing lobulated lesion in the left superolateral orbital rim with associated cortical erosion. Apart from Contrast-enhanced Magnetic Resonance Imaging (MRI), and Computed Tomography (CT), Contrast-Enhanced Ultrasound (CEUS) was obtained prior to a biopsy. It provided additional information about the microvasculature and an orbital biopsy was subsequently performed through an upper eyelid crease incision with minimal blood loss and no postoperative complications. Histopathological examination revealed features which were compatible with the diagnosis of LCH. The authors propose that CEUS may be considered as an adjunct and possibly alternative imaging modality for the evaluation of craniofacial osseous lesions, especially in the orbital region (due to the known radio-sensitivity of the eyes) and in pediatric patients, to minimize the risk of ionizing-radiation exposure.

An Unusual Cause of Fever and Rash in a Child With Severe Aplastic Anemia.

A 4-year-old girl with severe aplastic anemia and 2 previous failed T-depleted haploidentical peripheral blood stem cell transplants developed persistent neutropenic fever and multiple erythematous maculopapular rashes 2 days after her third T-replete haploidentical bone marrow transplant. Skin biopsy confirmed the diagnosis of Trichosporon asahii infection. She was on caspofungin prophylaxis which is not effective against Trichosporon. A high index of suspicion, prompt investigation, and appropriate treatment with voriconazole for 4 months was instrumental in controlling the infection and she remains well presently 9 months posttransplant with full donor chimerism and free from infection.