Josep Antoni Bombí: “There are internationally prestigious research groups on pathological anatomy in all the university hospitals in Catalonia”
The book Història breu de lʼAnatomia Patològica a Catalunya has been recently published. The book, whose authors are the emeritus professors of the Faculty of Medicine and Health Sciences, Josep Antoni Bombí, Miquel Bruguera and Jacint Cobella, was requested by the Catalan Society on Pathological Anatomy to narrate the history of this discipline, which is about to reach its fifty years of history. During this time, the amount of experts on this field has gone from around ten to four-hundred. In the UB, Santiago Ramón y Cajal was the first professor to teach this discipline. Regarding this new publication, we interview Josep Antoni Bombí, emeritus professor of Pathological Anatomy at the UB and numerary member at the Royal Academy of Medicine of Catalonia.
The book Història breu de lʼAnatomia Patològica a Catalunya has been recently published. The book, whose authors are the emeritus professors of the Faculty of Medicine and Health Sciences, Josep Antoni Bombí, Miquel Bruguera and Jacint Cobella, was requested by the Catalan Society on Pathological Anatomy to narrate the history of this discipline, which is about to reach its fifty years of history. During this time, the amount of experts on this field has gone from around ten to four-hundred. In the UB, Santiago Ramón y Cajal was the first professor to teach this discipline. Regarding this new publication, we interview Josep Antoni Bombí, emeritus professor of Pathological Anatomy at the UB and numerary member at the Royal Academy of Medicine of Catalonia.
According to the definition of the Spanish National Commission of Specialties, human pathological anatomy is the branch of medicine that deals with the causes, development and consequences of diseases. To understand this discipline a little better, could you explain what the current job of an anatomopathologist is and the main challenges of his work?
The main purpose is the right diagnosis in autopsies, biopsies, surgical pieces and cytology. In medicine, the essential field of pathological anatomy is the one on human diseases. However, we cannot forget about other areas such as experimental pathology and comparative pathology, in which etiology works too, as well as pathogenesis, and disease sequelae, and the mechanism and results of applied therapeutics. Pathological anatomy uses a set of techniques, methods and theoretical and practical knowledge to explain the origin, development and consequences of the disease from a morphological perspective, understanding morphology as a continuous spectrum that includes from macroscopic anatomy, organography, histology and cytology, to the molecular confines of the structure in which vital activity lies.
In the evolution of medicine, we can think a specialty to be consolidated when it has created a structure in some institution, mainly in the teaching sector (university chair, official degree), or in the care serice (clinical service), in some accredited hospital. However, a previous period, sometimes a long period, with relevant episodes can have occurred.
In daily practice, anatomopathologists, also called pathologists, make diagnosis with tissue and liquid, observing these in the microscopy with histological techniques and sometimes working with other molecular techniques. This material comes from the biopsies, surgical pieces, cytologies and clinical autopsies. Recently, the microscopy has been replaced by a computer screen, since histological and cytological images can be digitalized. This diagnosis will be the base to implement a proper treatment and prognostic.
At the moment, the main challenges are, on the one hand, to get a good digitalization of the whole process, and this involves a proper funding. On the other, having anatomapathologist doctors who are good professionals, and together with other professionals such as biologists, biochemists, bio-computer scientists, and technicians, that collaborate in all processes to make an integral anatomapathological diagnosis. .
How did pathological anatomy begin to develop in Catalonia? What have been your main milestones?
In Catalonia, it started developing within the university field, when the chair on Histology and Pathological Anatomy was created in the University of Barcelona. The first professor who was in charge of it was Santiago Ramón y Cajal, who came in 1887 and left in 1892. In 1923, Ángel Ferrer Cagigal came here and among other things, he built an important museum on pathological anatomy, with more than 6,000 interesting pieces and a certain national and international echo which disappeared over time. The museum closed in 1984. His name is precisely the one in the square in front of the Faculty of Medicine and Health Sciences, on Casanova street.
We can say pathological anatomy has specially developed thanks to public healthcare, with the appearance of services on pathological anatomy, first in big hospitals and then in most areas of public and private healthcare centers.
What has been the historical role of our university when it comes to the training and research on this discipline?
Our university has played a central role in its development, largely linked to the fact that it was the only one in Catalonia that had a chair in the field at the beginning, and that is why at first all pathologists had a lot or little training in the chair of Histology and Pathological Anatomy, which after the Civil War was directed by professors Julio G. Sánchez-Lucas and Diego Ribas Mujal. That was the way to get the title of expertise. Later, with the creation of the MIR program for medical specialties, these experts began to be trained in big hospitals.
Today, we can say that the training and scientific quality of our pathologists is excellent in all Catalan hospitals and healthcare centers. Pathological anatomy has always been, and especially today, closely linked to research, and today there are research groups of great international prestige in all the university hospitals in Catalonia.
What other aspects are highlighted in the book?
In our book, I would highlight that, in addition to attending to the history of the great figures of the expertise, great care has been taken to reflect the important task carried out with the creation of pathological anatomy services in most health centers of our country. From the largest one to the smallest, they have been fundamental for the good healthcare in Catalonia. Also, it highlights the creation of the Catalan Society of Pathological Anatomy and its boards, as well as the Catalan Society of Cytopathology, closely linked to our specialty. This work includes a small list of colleagues who have worked on an important and recognized work abroad.