Malays J Pathol 2021; 43(1): 113 – 192 CONFERENCE ABSTRACTS ICPaLM 2021: International Congress of Pathology and Laboratory Medicine 2021 and 18th Annual Scientific Meeting, College of Pathologists: Exploring the Advances and Potential of Disruptive Technologies in Pathology and Laboratory Medicine, organised by the College of Pathologists, Academy of Medicine of Malaysia and held virtually on 3rd-5th March 2021. Abstracts of K. Prathap memorial lecture, plenary, symposium and paper (poster) presented are as follows: K. Prathap Memorial Lecture: Exploring Advances and The Potential of Disruptive Technologies in Pathology and Laboratory Medicine Jo Martin Queen Mary University of London, Barts Health NHS Trust Rapid advances in technology are impacting all areas of pathology. Over the next few years we can expect to see even more amazing things come into our world and into our practice. Both the technology that we use and the ways in which we deploy it will change the way we work. We have glimpses of advances that will change the way we assess histological slides, and the data science tools are being developed that will allow us to provide personalised reports of therapeutic options for tumours. Integrative pathology, with the use of genetic and protein data alongside morphological interpretation, will come into every area of our practice, both benign and malignant. This presentation will highlight some of the new methods that are under development, some of the new tools becoming available and some of the changes that we can expect both in coming years and the longer term. Plenary 2: Role of Molecular Genetic and Immunohistochemistry in Renal Neoplasms Brett Delahunt Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand There have been major advances in the classification of renal cell neoplasia since the publication of the first classification by the World Health Organization (WHO) in 1981 and while the diagnostic emphasis has been on morphological features, the role of molecular genetics (MG) and immunohistochemistry (IH) is increasing. The Mainz Classification in 1986 established clear cell renal cell carcinoma (RCC), papillary RCC, chromophobe RCC and collecting duct carcinoma as distinctive tumor morphotypes, with renal medullary carcinoma later being added as a separate subtype of collecting duct carcinoma. It was also concluded that sarcomatoid RCC represented an extreme form of tumor dedifferentiation rather than a separate morphotype. Mucinous tubular and spindle RCC and translocation carcinomas were added to the classification in 2004 and here the role of IH and MG took on a new prominence. The Vancouver Classification of 2012 added tubulocystic RCC, acquired cystic disease-associated RCC, clear cell (tubulo) papillary RCC and hereditary leiomyomatosis RCC syndrome-associated RCC to the spectrum of RCC. Two further entities were also recognized. Hybrid oncocytic chromophobe tumor was classified as a variant of chromophobe RCC, while t(6;11) translocation carcinoma was added to the group of translocation carcinomas. In addition to these, three newly recognized morphotypes of RCC (thyroid-like follicular RCC, succinate dehydrogenase B deficiency-associated RCC and ALK-translocation RCC) were classified as emerging entities, emphasizing the increasing diagnostic role of IH. More recently eosinophilic solid and cystic RCC and biphasic papillary RCC have also been recognized as novel tumors with characteristic IH features. Plenary 3: Using Autopsy Data – More Can Be Done Philip Beh Department of Pathology, Li Ka Shing Faculty of Medicine, The University of Hong Kong Despite declining trends and numbers of autopsies throughout the world, large numbers of autopsies are still being performed annually. Findings from such autopsies are compiled in reports and frequently filed away with little attention given to the rich amount of information that can be obtained from such a large database of information. This presentation is a humble description of my personal journey and I hope an encouragement to the audience to think about the possibilities available to them and the opportunities to enrich knowledge and to prevent injuries and death. 113 Malays J Pathol April 2021 Plenary 4: The Uberisation of Laboratory Services: The Impact of Mobile Health Technology on Laboratory Services Tony Badrick Royal College of Pathologists of Australasia Quality Assurance Programs Uberisation is the act or process of changing the market for a service by introducing a different way of buying or using it, especially using mobile technology. Common examples are Uber, Waze and Airbnb. Could we see this same concept applied in laboratories? Uberization of Healthcare is a situation where the healthcare professional is able to reach out to the patient as and when required, using the power of technology and the internet. The concept of Uberization of Healthcare is very straightforward; with the use of smartphones, the internet, mobile apps and GPS, patients will be able to contact medical professionals as per their convenience. The medical professionals can provide remote treatment or emergency services, if the need arises, without the patients having to step out of their homes. The promise of platform systems is that they will improve aspects of healthcare such as waiting time, logistics support, referrals and times for treatment decisions. In general health care these promises are happening in the form of Retail Clinics in the USA where immediate demand is matched to slack supply. But there are practical problems. Traditional health care organizations fear patients’ Tweets and Yelp reviews because they are often a consequence of poor care or a bad experience. Funding is an obstacle to this form of disruption and healthcare generally lags decades behind consumer technology. There have been examples of the Uber concept in pathology. Delivery of specimens in cities by ‘Uber’ cyclists and the recent pandemic with its popup collection centres has shown what could be achieved. There is scope for more mobile PoCT testing for chronic disease markers. Perhaps looking at the Uber concept of developing universal platforms that improve efficiency, optimize access, and reduce cost of use is a likely development in Pathology. Digital image analysis supported by AI could be an example. Plenary 5: Lessons from COVID-19 Pandemic: Laboratory Perspective Ravindran Thayan Institute for Medical Research, Kuala Lumpur China had reported an outbreak of a respiratory infections in Wuhan province in late 2019. The outbreak was later defined as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), caused by a type of coronavirus similar to SARS-CoV-1 which also occurred in China in 2002-2003. COVID-19 is another name given to SARS-CoV-2 and the virus is zoonotic in nature and full genome sequencing revealed its close homology to pangolin and bat coronaviruses. Over the past 25 years there have been a number of outbreaks, mostly being zoonotic in nature. Past infections include Nipah, SARS-CoV-2, Pandemic Influenza 09, MERS-CoV, Ebola, Zika and Rabies. Because of the novelty of the infecting pathogen as well as the risk the pathogen, it is very important for laboratories to have the capacity to diagnose these infections, as this is the first step to isolate, contain and manage the infections. COVID-19 has served to remind us of several important things. First, outbreaks of infectious and transmissible pathogens occur more frequently due to increase in human and animal interface. Second, international travel and globalization are components for the global dissemination of emerging pathogens. Third, limitations of supply chain when a sharp increase in demand for products or substituents of products needs to be addressed. Fourth, clinical microbiology laboratories need to be fully operational and well equipped with the infrastructure and manpower to provide critical care testing for optimal patient care. A robust and well-funded public health system, including microbiology laboratory support, is critical to be able to respond to emerging infectious diseases challenges. Fifth, encourage national and international collaboration for urgent development of necessary interventions (i.e., diagnostic tests, drugs or vaccines). 114 CONFERENCE ABSTRACTS SYMPOSIUM Anatomic Pathology & Cytopathology Symposium 1A Digital Pathology in Anatomical Pathology: An Enabler of Artificial Intelligence Looi Lai Meng Consultant Histopathologist and National Distinguished Professor, University of Malaya, Malaysia Central to anatomical pathology practice is the visualization of alterations to tissue structure and cellular details, and the interpretation of what these alterations mean. Thus, the capture of high quality images is crucial. In principle, there are 3 essential components of image handling: (1) processing of tissues and cells to allow microscopic viewing, (2) tools to capture microscopic images for study, and (3) a trained histopathologist who can interpret the images and make a clinically relevant diagnosis. Automation for processing and staining of tissues has been the major advancement for the first component. However, it was the development of the virtual microscope, conversion of light microscopy images into electronic images (digital pathology), addressing the second essential component, that has been the major enabler of artificial intelligence (AI) in anatomical pathology. Computing power today can support scanning of complete tissue
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