Synopsis
Surgical pathology and cytopathology are two branches of pathology that are adapted to the specific needs of pathologists to decide on the further treatment of the patient. Surgical pathology involves an examination of tissues removed as a biopsy or in the process of a surgical procedure. It is used in cancer treatment to perform tissue examinations. Cytopathology is applied when it comes to examining individual cells and very small amounts of tissue. Very often, the aspiration through a fine needle is applied too. Both surgical pathology and cytopathology involve a wide array of services. Surgical pathology involves a biopsy that deals with a large volume of tissues. The methodology of cytopathology involves a thorough review of the cases, and very often uses hematoxylin and eosin staining, monolayers, and cell blocks. In case you need cellular samples, you can apply fluorescent hybridization. This article will explore these two branches and their characteristics to precisely describe their roles in the modern pathology laboratory.
The Basics of Surgical Pathology
Surgical pathology and cytopathology are part of anatomic pathology. Examining tissues that have been removed during surgery or as part of a biopsy is known as surgical pathology. Biopsy usually involves a small sampling of a lesion done by incision or by an invasive technique like a core needle biopsy or endoscopy. When the biopsy is done, you must determine what disease characteristics are present, and the extent of that disease.
Biopsy Diagnosis and Treatment
In all cases, you make your diagnosis by examining thin slices under the microscope. You also often use a variety of molecular techniques to further refine the diagnosis and to predict what treatment methods will be used. A surgical pathologist helps to guide the patient from the diagnosis through the whole treatment process the patient may need.
Understanding Cytopathology
Cytopathology involves an examination of very small amounts of tissue (cells) removed by scraping a surface, or by aspiration through a fine needle. Cytopathologists examine individual cells, and a small collection of cells to assess the presence or absence of malignancy. You can obtain a cytopathology specimen in a physician’s laboratory or a clinic as it is less invasive than obtaining a surgical pathology specimen.
| Surgical pathology | Cytopathology | |
|---|---|---|
|
What is? |
Examining tissues to help diagnose a disease and determine a treatment plan. |
Examining small amounts of tissues or cells to determine a diagnosis. |
|
Removal procedure |
Removed during surgery or as part of a biopsy. |
Removed by scraping a surface, or by aspiration through a fine needle. |
|
Observing component |
Tissues |
Individual cells |
|
Nature of technique |
Invasive techniques like a core needle biopsy or endoscopy followed. |
Less invasive |
What Does Surgical Pathology Involve?
Surgical pathologists provide general and subspecialty surgical pathology services. These can involve breast, lung, head, neck, gynecologic, genitourinary, liver, gastrointestinal, bone, and soft tissue pathology. Often, assistants to surgical pathologists are of great help in the laboratory. Assistants, administrative assistants, and laboratory assistants usually make up the staff team.
The Role of Histology Laboratories
Technical work is usually performed by a histology laboratory division that provides basic and advanced histology services for diverse sides. Surgical pathologists usually work with faculty and staff from the initial stage of frozen section progressing to gross dissection, and their involvement culminates in microscopic review and diagnosis. PreciPoint’s iO:M8 is a solution for rapid microscopic assessments. It enables intraoperative consultations, frozen sections, Mohs, FNA, and other examinations, of high resolution, real-time imaging, and easy, second opinion access. It delivers live images of superior quality.
Services provided in surgical pathology:
- Evaluation of resection and performance of intraoperative consultations: The procedure is performed on specimens from patients undergoing surgery.Â
- Clinical biopsy diagnosis involving a large volume of clinical biopsies: These biopsies primarily consist of gastrointestinal, endometrial, and cervical biopsies. With skin biopsies, dermatopathologists play a vital role.Â
- Consultations: Surgical pathologists often offer consultation services to pathologists with or without little experience, and to those who are still in the training process.Â
- Review of outside cases: Surgical pathologists not only examine patients who come for treatment to them but also those who had previous surgery somewhere else.Â
Additional services offered:
- Protocol support: There are numerous cancer patients; cancer is one of the leading causes of death worldwide. Surgical pathology laboratories can be a support system in specimen triage and handling.Â
- Tissue banking: Surgical pathology departments or laboratories in diverse institutions can often have specific departments where tissue specimens obtained from excision are conserved. These samples are preserved for diagnostic and research purposes.Â
- Education of students: Students can attend specific laboratory departments to acquire new knowledge and experience. Slide reviews, lectures, and conferences are some of the forms used for education.
What Does Cytopathology Involve?
In cytopathology, the laboratory or clinical department is usually managed by certified experts. They have the proper training and certification in cytopathology. Cytopathologists frequently collaborate with surgical pathologists. Many experts believe this dual practice enhances diagnostic ability by combining skills in cytomorphology for surgical specimens and immunohistochemistry knowledge for cytology cases. The cytology laboratory staff usually consists of specimen processing technicians and histotechnologists. Cytopathology labs often collaborate with other laboratories or clinical institutions to review cases more easily and accurately.
Support Provided by a Cytopathologist
- Services: Review of monolayer cervical and vaginal samples, traditional Pap smears, endoscopic guided gastrointestinal (GI), and lung/mediastinal aspiration biopsies. They can also perform fine needle aspiration biopsies, and adequacy checks in interventional acquired specimens in the CT or MRI studies.Â
- Technology: Cytopathologists can also use technology such as ultrasound to perform specific aspiration procedures.Â
Methods Applied in the Cytopathology
In cytopathology, cases are generally signed out by thorough review that often involves hematoxylin and eosin staining smears, monolayers, and cell blocks. In some cases, the cell blocks can be also prepared. Usually, cytopathologists utilize a broad array of immunohistochemical stains. If you need more cellular samples, you can always karyotype the same, culture them in specific ways or use fluorescent hybridization. If you work with cervicovaginal specimens, they are diagnostically triaged by automatic image analysis. Often, diverse reports from other experts can be of great help, because they can facilitate a more accurate diagnosis.
Conclusion
Surgical pathology and cytopathology are two interrelated branches within the field of pathology that significantly enhance the quality of pathology services, particularly in the realm of patient diagnosis and treatment. In general, surgical pathology deals with the larger specimens of tissues while cytopathology focuses mostly on the cells. In practice, surgical pathology involves dealing with diseases such as cancer, while cytopathology involves dealing with infectious diseases. Both disciplines involve specific procedure and methodology that is precise, accurate, and of high quality. The methodologies of both disciplines have a set of standards that precisely focus on the object of the research. For the best service, you’ll need the best devices including a microscope and a scanner. An ideal microscope needs to have the best features for your diagnostic or research work. PreciPoint’s iO:M8 is a perfect fit for this requirement as it lets you work effortlessly with high-quality digital images in real-time.
