Histological microdissection in diagnostic and investigative pathology

Molecular analysis is here to stay in diagnostic histopathology. Some commentators have predicted a diminishing role for histomorphological interpretation in future diagnostics including the classification and predictive testing of neoplasia. A more probable scenario is increasing synergy between morphological and molecular aspects of diagnosis. Analytical techniques applicable to DNA, RNA, and proteins, including important post-translational protein modifications, continue to develop with application to universally available formalin-fixed paraffin-embedded tissues a particularly active area of growth. Successful nanoscale analysis applicable to routinely available materials makes histological microdissection an increasingly attractive tool for diagnostic as well as research practice. Well-engineered laser-assisted microdissection systems allow tissue capture without demanding unrealistic levels of manipulative skill, but even without access to such equipment, non-laser methods can be effective and may not require heavy investment in equipment. Diagnostic histopathologists with molecular interests should consider the use of microdissection-based analysis strategies to increase the sensitivity and specificity of molecular analysis in their diagnostic research and clinical practice.