Generating dermatopathology reports from gigapixel whole slide images with HistoGPT

Nat Commun. 2025 May 27;16(1):4886. doi: 10.1038/s41467-025-60014-x.

Abstract

Histopathology is the reference standard for diagnosing the presence and nature of many diseases, including cancer. However, analyzing tissue samples under a microscope and summarizing the findings in a comprehensive pathology report is time-consuming, labor-intensive, and non-standardized. To address this problem, we present HistoGPT, a vision language model that generates pathology reports from a patient's multiple full-resolution histology images. It is trained on 15,129 whole slide images from 6705 dermatology patients with corresponding pathology reports. The generated reports match the quality of human-written reports for common and homogeneous malignancies, as confirmed by natural language processing metrics and domain expert analysis. We evaluate HistoGPT in an international, multi-center clinical study and show that it can accurately predict tumor subtypes, tumor thickness, and tumor margins in a zero-shot fashion. Our model demonstrates the potential of artificial intelligence to assist pathologists in evaluating, reporting, and understanding routine dermatopathology cases.

Publication types

  • Multicenter Study

MeSH terms

  • Artificial Intelligence
  • Dermatology* / methods
  • Humans
  • Image Processing, Computer-Assisted* / methods
  • Natural Language Processing
  • Skin Neoplasms* / diagnosis
  • Skin Neoplasms* / pathology