Armed Forces Institute of Pathology
Encyclopedia
The Armed Forces Institute of Pathology (AFIP) was a US government institution concerned with diagnostic consultation, education, and research in the medical specialty of pathology
. It was founded in 1862 as the Army Medical Museum and was located in Washington, DC on the grounds of the Walter Reed Army Medical Center
. It primarily provided second opinion
diagnostic consultations on pathologic specimens such as biopsies from military, veteran, and civilian medical, dental, and veterinary sources. The unique character of the AFIP rested in the expertise of its civilian and military staff of diagnostic pathologists whose daily work consisted of the study of cases that are difficult to diagnose owing to their rarity or their variation from the ordinary. The accumulation of such cases has resulted in a rich repository of lesions, numbering over three million, that have been the basis of major pathological studies.,
Examples are the published reports on the clinical, pathological and molecular characteristics of the relatively newly recognized gastrointestinal stromal tumors .
Another special feature of the AFIP was the interaction between its departments in analyzing complex cases. The AFIP's diagnostic departments were based on organ sites, e.g. dermatological, hepatic, gastrointestinal, genitourinary, pulmonary, soft tissue, bone, hematological, neurological, endocrine and gynecological pathology. In addition, there were specialty departments dealing with infectious and parasitic diseases, molecular studies and environmental pathology. As all of these specialties were located in one institution, rapid collaborative examination of a case was facilitated and interdepartmental collaborative research was the rule rather than the exception.
Unique to the AFIP was the Department of Radiologic Pathology, which pursued the interface between diagnostic radiology and anatomic pathology. This department was responsible for a course attended by virtually all North American radiologists in their training. A by-product was an unmatched repository of medical cases having extensive radiological images and pathological slides, a great source for studies in this field .
The educational mission of the Institute consisted of formal courses providing continuing medical education (CME) credits for postgraduate medical personnel. A number of these courses had microscope slide
study sets for individual examination by the participants as well as authoritative lectures by the AFIP and visiting staff. Fellowships were available as were one month visits to individual departments.
campus including the disestablishment of AFIP with relocation of its "military relevant functions" to the NNMC
, Bethesda, Maryland; Dover AFB, Delaware; and Fort Sam Houston
, Texas.
The implications of the BRAC and reaction to it by the pathology world resulted in congressional legislation in the National Defense Authorization Act of 2008 (NDAA 2008)[section 722] establishing a Joint Pathology Center (JPC). This recognized the significant contributions of the AFIP and mandated the JPC to assume many of AFIP's responsibilities in consultation, education, and research, as well as the modernization of its unique tissue repository.
The stepwise disestablishment of the Institute saw the discontinuation of civilian case consultations on September 30, 2010. The education function ended October 15, 2010 with the final AFIP Radiologic Pathology Course. Research projects concluded in December 2010.. All pathology consultations ceased on April 1, 2011; government case consultations from that date were to be handled by the Joint Pathology Center.
Pathology
Pathology is the precise study and diagnosis of disease. The word pathology is from Ancient Greek , pathos, "feeling, suffering"; and , -logia, "the study of". Pathologization, to pathologize, refers to the process of defining a condition or behavior as pathological, e.g. pathological gambling....
. It was founded in 1862 as the Army Medical Museum and was located in Washington, DC on the grounds of the Walter Reed Army Medical Center
Walter Reed Army Medical Center
The Walter Reed Army Medical Center was the United States Army's flagship medical center until 2011. Located on 113 acres in Washington, D.C., it served more than 150,000 active and retired personnel from all branches of the military...
. It primarily provided second opinion
Second opinion (medicine)
A second opinion is a visit to a physician other than the one a patient has previously been seeing in order to get a differing point-of-view. Second opinions may be sought by a patient under the following circumstances:*Physician recommends surgery....
diagnostic consultations on pathologic specimens such as biopsies from military, veteran, and civilian medical, dental, and veterinary sources. The unique character of the AFIP rested in the expertise of its civilian and military staff of diagnostic pathologists whose daily work consisted of the study of cases that are difficult to diagnose owing to their rarity or their variation from the ordinary. The accumulation of such cases has resulted in a rich repository of lesions, numbering over three million, that have been the basis of major pathological studies.,
Examples are the published reports on the clinical, pathological and molecular characteristics of the relatively newly recognized gastrointestinal stromal tumors .
Another special feature of the AFIP was the interaction between its departments in analyzing complex cases. The AFIP's diagnostic departments were based on organ sites, e.g. dermatological, hepatic, gastrointestinal, genitourinary, pulmonary, soft tissue, bone, hematological, neurological, endocrine and gynecological pathology. In addition, there were specialty departments dealing with infectious and parasitic diseases, molecular studies and environmental pathology. As all of these specialties were located in one institution, rapid collaborative examination of a case was facilitated and interdepartmental collaborative research was the rule rather than the exception.
Unique to the AFIP was the Department of Radiologic Pathology, which pursued the interface between diagnostic radiology and anatomic pathology. This department was responsible for a course attended by virtually all North American radiologists in their training. A by-product was an unmatched repository of medical cases having extensive radiological images and pathological slides, a great source for studies in this field .
The educational mission of the Institute consisted of formal courses providing continuing medical education (CME) credits for postgraduate medical personnel. A number of these courses had microscope slide
Microscope slide
A microscope slide is a thin flat piece of glass, typically 75 by 25 mm and about 1 mm thick, used to hold objects for examination under a microscope. Typically the object is placed or secured on the slide, and then both are inserted together in the microscope for viewing...
study sets for individual examination by the participants as well as authoritative lectures by the AFIP and visiting staff. Fellowships were available as were one month visits to individual departments.
AFIP and International Standardization
The AFIP played a critical role in the standardization of pathologic diagnosis of tumors. This was mainly the result of the participation of AFIP staff as panel members and reference center heads in the International Histological Classification of Tumors (IHCT) series of the World Health Organization (WHO) . WHO reference and collaborating centers were established at the AFIP in a number of subjects aimed at international standardization of tumor nomenclature, classification, and diagnostic criteria. AFIP staff contributed the largest number of IHCT panel members than any other institution. AFIP staff played key roles in the Tumor Node Metastasis (TNM) project of the Union for International Cancer Control (UICC). The AFIP Atlases of Tumor Pathology were, and still are, monumental contributions to standards in diagnosis throughout the world.Disestablishment
The Base Realignment and Closure proposal for 2005 affects a realignment of the WRAMCWalter Reed Army Medical Center
The Walter Reed Army Medical Center was the United States Army's flagship medical center until 2011. Located on 113 acres in Washington, D.C., it served more than 150,000 active and retired personnel from all branches of the military...
campus including the disestablishment of AFIP with relocation of its "military relevant functions" to the NNMC
National Naval Medical Center
The National Naval Medical Center in Bethesda, Maryland, USA — commonly known as the Bethesda Naval Hospital — was for decades the flagship of the United States Navy's system of medical centers. A federal institution, it conducted medical and dental research as well as providing health care for...
, Bethesda, Maryland; Dover AFB, Delaware; and Fort Sam Houston
Fort Sam Houston
Fort Sam Houston is a U.S. Army post in San Antonio, Texas.Known colloquially as "Fort Sam," it is named for the first President of the Republic of Texas, Sam Houston....
, Texas.
The implications of the BRAC and reaction to it by the pathology world resulted in congressional legislation in the National Defense Authorization Act of 2008 (NDAA 2008)[section 722] establishing a Joint Pathology Center (JPC). This recognized the significant contributions of the AFIP and mandated the JPC to assume many of AFIP's responsibilities in consultation, education, and research, as well as the modernization of its unique tissue repository.
The stepwise disestablishment of the Institute saw the discontinuation of civilian case consultations on September 30, 2010. The education function ended October 15, 2010 with the final AFIP Radiologic Pathology Course. Research projects concluded in December 2010.. All pathology consultations ceased on April 1, 2011; government case consultations from that date were to be handled by the Joint Pathology Center.
Continuation as American Institute of Radiologic Pathology
Recognizing the educational value of the radiology-pathology correlation course and corresponding vast database of cases, the American College of Radiology has been instrumental in creating the American Institute of Radiologic Pathology (AIRP) to allow continuation of the radiology-pathology course. The first course of the AIRP began January of 2011 .External links
- Armed Forces Institute of Pathology
- Ask Rad Path Radiologic-Pathologic Correlation
- Radiology Residents AFIP Group