The Augmented Cytopathologist: A Conceptual Exploratory Narrative Review on Immersive and Vision-Language Models Tools in Digital Pathology
Abstract
Emerging digital technologies, including immersive environments (VR/AR/XR) and Vision-Language Models (VLMs), have the potential to reshape digital pathology and medical imaging. While immersive tools can enhance spatial visualization and procedural training, VLM-based copilots offer cognitive and workflow support. Their combined impact on cytopathology remains largely conceptual and preclinical. This Conceptual Exploratory Narrative Review (CENR) examines how immersive technologies and VLM-based copilots may jointly influence cytopathologists' professional workflow, training, and diagnostic processes, introducing the notion of the "augmented cytopathologist." A structured exploratory approach integrated peer-reviewed literature, position papers, preprints, gray literature (technical reports, white papers, conference abstracts, blogs), and cross-disciplinary perspectives. Database searches (PubMed, Web of Science, Scopus) confirmed a limited number of studies addressing immersive or AI-assisted cytopathology imaging. Thematic analysis focused on four conceptual dimensions: (1) technological capabilities and maturity; (2) workflow and educational applications; (3) professional implications and cytopathologist role; and (4) responsible use of LLMs and VLMs as supportive tools. This approach emphasizes interpretation of emerging trends over aggregation of empirical data, enabling conceptual synthesis of early-stage implementations and perspectives in the field. Immersive…
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