Molecular pathology — The future?

The diagnosis and management of complex disease requires multidisciplinary clinical collaboration. Histopathological assessment of tissues is an important part of this approach and relies on the morphological appraisal of stained tissues by light microscopy. Although considered the ‘gold standard’, morphology alone is becoming increasingly insufficient in disease where molecular characterisation has altered clinical practice. As the ability to define the molecular alterations associated with disease expands, the requirement to analyse such alterations for diagnostic and therapeutic purposes follows suit. Despite the widespread use of small scale molecular approaches such as immunohistochemistry and fluorescent in situ hybridisation, the demand for detailed molecular classification of disease states increases unabated. In this review, we summarise the clinical applications of various molecular techniques already used within the modern histopathology department. Thereafter, we consider novel high throughput, array based technologies and their possible impact on future histopathological practice.