The anatomic pathologist meets molecular pathology.

With the publication in this issue of " Stuck Between a Scalpel and a Rock, or Molecular Pathology and Legal-Ethical Issues in Use of Tissues for Clinical Care and Research: What Must a Pathologist Know? " by Dry et al, 1 we launch a new series for the American Journal of Clinical Pathology in a forward-looking celebration of the Journal's commitment to readers' education. It will include invited articles that are intended to provide helpful, timely, and informative reviews to assist pathologists and laboratorians alike in anatomic pathology to provide appropriate care when molecular testing is needed. This first article of the series provides an important and insightful overview of the ethical, regulatory, legal, and technical background needed by pathologists for appropriate specimen management. The articles to follow will include detailed information in specific organ systems and disease processes about current testing for which there is evidence to support its use in clinical care, together with an exploration of questions and challenges that remain unanswered regarding test utilization, validation, and interpretation. In addition to this invited series, the Journal encourages submissions of reports of original research that address the extensive knowledge gaps that exist between descriptions of new diagnostic markers and evidence-based guidance on how to implement them in an ethical and economically responsible manner, adding value to patient care and advancing the quality of treatment options. Rare diseases and conditions will require collaborative investigation to gain sufficient experience for informed decisions. Practicing pathologists must adapt continuously. Some of us trained in an era of classical histomorphology and electron microscopy and only then learned to apply emerging techniques in immunohistochemistry, confronting over time an ever-increasing number of diagnostic and predictive immunohistochemical markers. Today, pathologists may be much better versed in immunohistochemistry and related techniques, but now we must select among an expanding choice of other evolving tissue-based diagnostic modalities, including in situ hybridization, cytogenetics, image cytom-etry, and flow cytometry, as appropriate, in a given clinical setting. With more clinical emphasis on therapies that are targeted to specific genetic mutations in neoplasia, we must now rapidly integrate gene-based diagnostic tests into surgical pathology, cytopathology, and autopsy practice. Most of us cannot take time off from our busy practices for specialized fellowship training in molecular pathology, yet we are called on to be primary decision makers in many situations and central consultants to clinicians and patients receiving direct marketing information about commercially …