The rise of Artificial Intelligence (AI) has shown promising performance as a support tool in clinical pathology workflows. In addition to the well-known interobserver variability between dermatopathologists, melanomas present a significant challenge in their histological interpretation. This study aims to analyze all previously published studies on whole-slide images of melanocytic tumors that rely on deep learning techniques for automatic image analysis. Embase, Pubmed, Web of Science, and Virtual Health Library were used to search for relevant studies for the systematic review, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Articles from 2015 to July 2022 were included, with an emphasis placed on the used artificial intelligence methods. Twenty-eight studies that fulfilled the inclusion criteria were grouped into four groups based on their clinical objectives, including pathologists versus deep learning models (n = 10), diagnostic prediction (n = 7); prognosis (n = 5), and histological features (n = 6). These were then analyzed to draw conclusions on the general parameters and conditions of AI in pathology, as well as the necessary factors for better performance in real scenarios.

Spitzoid tumors (ST) are a group of melanocytic tumors of high diagnostic complexity. Since 1948, when Sophie Spitz first described them, the diagnostic uncertainty remains until now, especially in the intermediate category known as Spitz tumor of unknown malignant potential (STUMP) or atypical Spitz tumor. Studies developing deep learning (DL) models to diagnose melanocytic tumors using whole slide imaging (WSI) are scarce, and few used ST for analysis, excluding STUMP. To address this gap, we introduce SOPHIE: the first ST dataset with WSIs, including labels as benign, malignant, and atypical tumors, along with the clinical information of each patient. Additionally, we explain two DL models implemented as validation examples using this database.

Deep learning-based algorithms have led to tremendous progress over the last years, but they face a bottleneck as their optimal development highly relies on access to large datasets. To mitigate this limitation, cross-silo federated learning has emerged as a way to train collaborative models among multiple institutions without having to share the raw data used for model training. However, although artificial intelligence experts have the expertise to develop state-of-the-art models and actively share their code through notebook environments, implementing a federated learning system in real-world applications entails significant engineering and deployment efforts. To reduce the complexity of federation setups and bridge the gap between federated learning and notebook users, this paper introduces a solution that leverages the Jupyter environment as part of the federated learning pipeline and simplifies its automation, the Notebook Federator. The feasibility of this approach is then demonstrated with a collaborative model solving a digital pathology image analysis task in which the federated model reaches an accuracy of 0.8633 on the test set, as compared to the centralized configurations for each institution obtaining 0.7881, 0.6514, and 0.8096, respectively. As a fast and reproducible tool, the proposed solution enables the deployment of a cross-country federated environment in only a few minutes.

Whole-slide imaging (WSI) in cytopathology poses challenges related to segmentation accuracy, computational efficiency, and image acquisition artifacts. This study aims to evaluate the performance of deep-learning models for instance segmentation in cervical cytology, benchmarking them against state-of-the-art methods on both public and institutional datasets. We tested three architectures—U-Net, vision transformer (ViT), and Detectron2—and evaluated their performance on the ISBI 2014 and CNseg datasets using panoptic quality (PQ), dice similarity coefficient (DSC), and intersection over union (IoU). All models were trained on CNseg and tested on an independent institutional dataset. Data preprocessing involved manual annotation using QuPath, patch extraction guided by GeoJSON files, and exclusion of regions containing less than 60% cytologic material. Our models achieved superior segmentation performance on public datasets, reaching up to 98% PQ. Performance decreased on the institutional dataset, likely due to differences in image acquisition and the presence of blurred nuclei. Nevertheless, the models were able to detect blurred nuclei, highlighting their robustness in suboptimal imaging conditions. In conclusion, the proposed models offer an accurate and efficient solution for instance segmentation in cytology WSI. These results support the development of reliable AI-powered tools for digital cytology, with potential applications in automated screening and diagnostic workflows.

The histopathological classification of melanocytic tumours with spitzoid features remains a challenging task. We confront the complexities involved in the histological classification of these tumours by proposing machine learning (ML) algorithms that objectively categorise the most relevant features in order of importance. The data set comprises 122 tumours (39 benign, 44 atypical and 39 malignant) from four different countries. BRAF and NRAS mutation status was evaluated in 51. Analysis of variance score was performed to rank 22 clinicopathological variables. The Gaussian naive Bayes algorithm achieved in distinguishing Spitz naevus from malignant spitzoid tumours with an accuracy of 0.95 and kappa score of 0.87, utilising the 12 most important variables. For benign versus non‐benign Spitz tumours, the test reached a kappa score of 0.88 using the 13 highest‐scored features. Furthermore, for the atypical Spitz tumours (AST) versus Spitz melanoma comparison, the logistic regression algorithm achieved a kappa value of 0.66 and an accuracy rate of 0.85. When the three categories were compared most AST were classified as melanoma, because of the similarities on histological features between the two groups. Our results show promise in supporting the histological classification of these tumours in clinical practice, and provide valuable insight into the use of ML to improve the accuracy and objectivity of this process while minimising interobserver variability. These proposed algorithms represent a potential solution to the lack of a clear threshold for the Spitz/spitzoid tumour classification, and its high accuracy supports its usefulness as a helpful tool to improve diagnostic decision‐making.

Gastrointestinal bleeding in HIV patients secondary to coinfection by HHV8 and development of Kaposi’s sarcoma (KS) is a rare complication even if no skin lesions are detected on physical examination. This article indicates which patients might develop this type of clinical sign and also tries to recall that absence of skin lesions never rules out the presence of KS, especially if gastrointestinal involvement is documented. Gastrointestinal bleeding in terms of hematemesis has rarely been reported in the literature. We review some important clinical findings, diagnosis, and treatment approach. We present the case of an HIV patient who presented to the emergency department with hematemesis and gastrointestinal signs of KS on upper gastrointestinal endoscopy without any dermatological involvement.