Abstract

In the second half of the 19th century, up to the first years of the 20th century, the undisputed
stars of the international medical scene were the psychoanalysts, such as Sigmund Freud
(1856-1939), and the pathologists, the most famous among them Rudolf Virchow (1821-
1902). From his microscopic studies on tumour cells, a clinical-therapeutic branch of
anatomical pathology was born and developed in the 20th century, precisely oncology, while
the discovery of X-rays by Wilhelm Conrad Röntgen (1845-1923) paved the way for the radiomacroscopic
branch of the discipline. In Italy, Armando Businco (1886-1967) immediately felt
the great importance of radiology and was profoundly convinced that, being a morphological
science, it should belong to anatomical pathology. Moreover, he aspired to the control of
nascent radiotherapy by pathologists, given their commitment to oncological diagnostics.
Today, in the modern era of personalized medicine, anatomical pathology is recovering its
leadership role, where the pathologist is the mind and the bridge between the radiologist, a
sort of pathologist's hand for harvesting, by means of high-resolution imaging techniques,
tissue or cells on which to make a diagnosis and predictive tests of therapeutic response, and
the oncologist, a sort of pathologist’s contralateral hand, who administers drugs to the patient
on the basis of certain predictions provided by the pathologist in terms of immunotherapy,
target therapy and precision oncology. Predictive immunohistochemistry, next-generation
sequencing (massive parallel sequencing) and bioinformatics are therefore those
technologies that are revolutionizing cancer treatment, and which make the pathologist the
renewed star of future oncological medicine.