PhD defence J.L. (Janina) Wolf

Dissertation in short:

The thesis „Augmenting the power of small biopsies in thoracic oncology by the use of state-of-the-art ancillary techniques” highlights the value of thoracic biopsy specimens. There is a focus on lung adenocarcinomas, but other thoracic lesions, such as congenital pulmonary adenomatoid malformations and thymic neoplasms are also be discussed. Since biopsies contain just small amounts of tissue, routine diagnostic workup can in some cases be challenging. In this thesis different “ancillary techniques” are used to support the diagnosis made on a biopsy specimen. The most obvious “tool” underpinning the diagnosis is the morphologic classification which is made on the standard Hematoxylin and Eosin stain. In case of a pulmonary malignancy, especially when dealing with adenocarcinoma, a genetic work up can also be of importance.  This is primarily done to select patients for certain therapies or to support malignancy in case of uncertainty. But next to the classical approach, also new techniques such as µ-CT scans of formalin fixed and paraffin embedded tissue blocks or artificial intelligence tools for morphology classification and recurrence prediction can offer additional information and support the diagnosis. Moreover, the use of digital microscopy and diagnosis by an expert panel are also discussed. The information gained from a biopsy is not only important to offer an adequate diagnosis, it also has the potential to guide therapeutic decisions and plan follow up strategies. Therefore, it is important and necessary to get as much reliable information as possible out of a small piece of tissue.