
The Armed Forces Institute of Pathology (AFIP) (1862 – September 15, 2011) was a
U.S. government institution concerned with diagnostic consultation, education, and research in the medical specialty of
pathology
Pathology is the study of disease. The word ''pathology'' also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when used in the context of modern medical treatme ...
.
Overview
It was founded in 1862 as the Army Medical Museum in
Washington, D.C.
Washington, D.C., formally the District of Columbia and commonly known as Washington or D.C., is the capital city and federal district of the United States. The city is on the Potomac River, across from Virginia, and shares land borders with ...
, on the grounds of the
Walter Reed Army Medical Center
The Walter Reed Army Medical Center (WRAMC), officially known as Walter Reed General Hospital (WRGH) until 1951, was the United States Army, U.S. Army's flagship medical center from 1909 to 2011. Located on in Washington, D.C., it served more ...
(WRAMC). 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. In 2009, the
Environmental Protection Agency shut down many of the labs, especially those dealing with
anthrax
Anthrax is an infection caused by the bacterium '' Bacillus anthracis'' or ''Bacillus cereus'' biovar ''anthracis''. Infection typically occurs by contact with the skin, inhalation, or intestinal absorption. Symptom onset occurs between one ...
, due to improper storage practices.
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 staffed by some of the finest radiologists and attended by most of the US trained radiologists during their residency. 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.
Building 54, the building occupied by AFIP on the Walter Reed Campus, is unique in that it was designed to be atomic
bombproof in 1951. It has no windows and walls are said to be 8-ft thick.
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
The World Health Organization (WHO) is a list of specialized agencies of the United Nations, specialized agency of the United Nations which coordinates responses to international public health issues and emergencies. It is headquartered in Gen ...
(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'', published by the ''American Registry of Pathology'' were, and still are, monumental contributions to standards in diagnosis throughout the world.
Disestablishment
The
Base Realignment and Closure proposal for 2005 included a realignment of the Walter Reed Army Medical Center campus that had as one element the disestablishment of AFIP with relocation of its "military relevant functions" to the
National Naval Medical Center (NNMC), Bethesda, Maryland;
Dover AFB, Delaware; and
Fort Sam Houston
Fort Sam Houston is a United States Army, U.S. Army post in San Antonio, Texas.
"Fort Sam Houston, TX • About Fort Sam Houston" (overview), US Army, 2007, webpageSH-Army. Known colloquially as "Fort Sam", it is named for the first president o ...
, 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)
ection 722establishing 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. AFIP shut its doors on September 15, 2011.
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 in January 2011.
Building status and future
Following the WRAMC's closure in 2011, the AFIP building and other space totaling 12 acres was given to
Children's National Hospital to establish its Research & Innovation Campus. When completed, the campus will host a wide variety of medical research, as well as biomedical
incubator space and a
primary care
Primary care is a model of health care that supports first-contact, accessible, continuous, comprehensive, and coordinated person-focused care. It aims to optimise population health and reduce disparities across the groups by ensuring equitable ...
clinic.
Renovation work started in 2018 and the first phase of the project opened in 2021.
References
External links
Joint Pathology CenterAsk Rad PathRadiologic-Pathologic Correlation
Radiology Residents AFIP Group* Armed Forces Institute of Patholog
* Final issue of ''The AFIP Letter'
{{DEFAULTSORT:Armed Forces Institute Of Pathology
United States Army medical installations
1862 establishments in Washington, D.C.
Medical museums in the United States
2011 disestablishments in the United States