Morphomolecular pathology: setting the framework for a new generation of pathologists

Molecular diagnostics and precision medicine are now a reality. With the roll-out of the 100 000 Genomes Project, one of the most ambitious initiatives of its kind worldwide ( Siva, 2015 ), pathways are being established for the adoption of genomic medicine across the National Health Service of the UK, the largest existing operation providing universal healthcare for its citizens. This requires a transformation in the way in which the NHS handles patient samples and integrates complimentary analyses on tissues to direct patient management. New approaches in molecular pathology are essential to address the challenges of this new era of genomic medicine. Indeed, how pathologists are able to transit from an approach to tissue diagnostics driven by morphology alone towards a true morphomolecular ethos ( Salto-Tellez, 2007 ) is arguably the most important test for tissue and cellular pathologists (histopathologists or surgical pathologists and cytopathologists) in the last 60 years.