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Encyclopedia > Surgical pathology

Anatomic pathology is a medical specialty (a branch of pathology) that is concerned with the diagnosis of disease based on the gross, microscopic, and molecular examination of cells and tissues. Pathology (from Greek pathos, feeling, pain, suffering; and logos, study of; see also -ology) is the study of the processes underlying disease and other forms of illness, harmful abnormality, or dysfunction. ... Drawing of the structure of cork as it appeared under the microscope to Robert Hooke from Micrographia which is the origin of the word cell. Cells in culture, stained for keratin (red) and DNA (green). ...

Contents

Role of the anatomic pathologist

Surgical Pathology

Malignant melanoma of the skin. This is as it would appear on the patient.
Malignant melanoma of the skin. This is as it would appear on the patient.
Malignant melanoma of the skin. This is a section of tissue, stained with hematoxylin & eosin, and viewed on a microscope slide

The primary duty of anatomical pathologists in most healthcare systems is to give the final diagnosis of disease (or lack thereof) in any case where tissue is surgically removed from a patient. This is usually performed by a combination of gross (ie. macroscopic) and histologic (ie. microscopic) examination of the tissue, and may involve evaluations of molecular properties of the tissue by immunohistochemisty or other laboratory tests. Generally there are two situations where tissue removal takes place: biopsy or resection. Image File history File links No higher resolution available. ... Image File history File links No higher resolution available. ... Melanoma is a malignant tumor of melanocytes. ... Image File history File linksMetadata Malignant_melanoma_(3)_at_thigh_Case_01. ... Image File history File linksMetadata Malignant_melanoma_(3)_at_thigh_Case_01. ... Haematoxylin is extracted from the wood of the logwood tree. ... Eosin is an orange-pink dye derived from coal tar. ... A thin section of lung tissue stained with hematoxylin and eosin. ... Brain biopsy A biopsy (in Greek: bios = life and opsy = look/appearance) is a medical test involving the removal of cells or tissues for examination. ... Resection is a method of orientation (direction or position finding) using a compass and topographic map. ...


In a biopsy, a small piece of a suspected lesion is removed. In this case, the pathologist renders a diagnosis based on the piece of tissue removed in order to guide future treatment. For example, when a surgeon or oncologist is uncertain of the nature of a tumor, they may perform a biopsy, sending a fragment of tumor to an anatomical pathologist. Based on histologic examination of the tumor biopsy, the pathologist can usually determine if the tumor is benign or malignant, and can differentiate between different types and grades of cancer. This information is important for estimating the patient's prognosis and choosing the best treatment to administer. Biopsies are also used to diagnose diseases other than cancer, including inflammatory, infectious, or idiopathic diseases of the skin and gastrointestinal tract, to name only a few. Surgeon may refer to: a practitioner of surgery the moniker of British electronic music producer and DJ, Anthony Child; see Surgeon (musician) This is a disambiguation page—a list of articles associated with the same title. ... Please refer to cancer for the biology of malignant disease, as well as a list of malignant diseases. ... Tumor or tumour literally means swelling, and is sometimes still used with that meaning. ... Benign can refer to any medical condition which, untreated or with symptomatic therapy, will not become life-threatening. ... In medicine, malignant is a clinical term that is used to describe a clinical course that progresses rapidly to death. ... Cancer is a class of diseases or disorders characterized by uncontrolled division of cells and the ability of these cells to spread, either by direct growth into adjacent tissue through invasion, or by implantation into distant sites by metastasis (where cancer cells are transported through the bloodstream or lymphatic system). ... Prognosis (older Greek πρόγνωσις, modern Greek πρόγνωση - literally fore-knowing, foreseeing) is a medical term denoting the doctors prediction of how a patients disease will progress, and whether there is chance of recovery. ... Inflammation is the first response of the immune system to infection or irritation and may be referred to as the innate cascade. ... Infection is also the title of an episode of the television series Babylon 5; see Infection (Babylon 5). ... Idiopathic means arising spontaneously or from an obscure or unknown cause. ... It has been suggested that this article or section be merged with Epidermis (skin). ... The gastrointestinal tract (GI tract), also called the digestive tract, alimentary canal, or gut, is the system of organs within multicellular animals that takes in food, digests it to extract energy and nutrients, and expels the remaining waste. ...


Resection, in contrast to biopsy, is when an entire diseased area or organ is removed (ocassionally multiple organs), often during the definitive surgical treatment of a disease where the diagnosis is already known or strongly suspected. In this case, the pathologist examines the removed tissue to (1) decide whether the previously-suspected diagnosis is correct, (2) investigate whether there were any unsuspected concurrent diseases, and (3) determine whether the entire diseased area was removed. Especially in the case of cancer, if there is any small area of disease remaining in the patient, another operation or further treatment is often necessary. One example of a resection is a mastectomy, where the specimen consists of the entire breast, plus the overlying skin and adjacent lymph nodes. In medicine, mastectomy is the medical term for the surgical removal of one or both breasts, partially or completely. ... A pregnant womans breasts. ...


In any case where a pathologist examines tissue, whether from a biopsy or resection, the pathologist's opinion is written as a pathology report, addressed to the doctor who performed the procedure.


Autopsy

Many people may have been exposed to pathology primarily through popular novels (such as Michael Crichton's A Case of Need) and television shows (such as CSI and X-Files), where the starring pathologists spend their time almost exculsively performing autopsies (or sometimes, indeed, replacing an entire police and forensic team). A Case of Need is a mystery novel written by Michael Crichton under the pseudonym Jeffery Hudson. ... CSI: Crime Scene Investigation is a popular Alliance Atlantis/CBS police procedural television series, running since October 2000, about a team of forensic scientists. ... X-Files intro from first 8 seasons The X-Files was a popular 1990s American science fiction television series created by Chris Carter. ... Post-mortem, postmortem and post mortem redirect here. ...

Cadaver dissection table. Similar to those used in medical or forensic autopsies.
Cadaver dissection table. Similar to those used in medical or forensic autopsies.

Consequently, there may some mistaken impressions regarding the promimence of autopsy within the field of pathology. In fact, there is a subspecialty of anatomical pathology, called forensic pathology, which concerns itself almost exclusively with the medico-legal investigation of deaths through autopsy; this is generally the profession being portrayed in popular works. For most anatomical pathologists, autopsy plays a relatively minor and waning --- although still important --- role in their practice, generally secondary to that of surgical pathology as described above. Image File history File linksMetadata Size of this preview: 800 × 555 pixel Image in higher resolution (1938 × 1345 pixel, file size: 194 KB, MIME type: image/jpeg) cadaver dissection table File links The following pages on the English Wikipedia link to this file (pages on other projects are not listed... Image File history File linksMetadata Size of this preview: 800 × 555 pixel Image in higher resolution (1938 × 1345 pixel, file size: 194 KB, MIME type: image/jpeg) cadaver dissection table File links The following pages on the English Wikipedia link to this file (pages on other projects are not listed... A cadaver is a dead body. ... Forensic pathology, first recognized by the American Board of Pathology in 1959, is a branch of medicine concerned with determining cause of death usually for civil or criminal law cases. ...


Autopsies performed outside of the bounds of forensic pathology are referred to as medical autopsies. These are performed, often in the hospital where the patient died, at the request of the patient's attending physician. The purpose is to definitively establish a cause of death or details of the manner of death, in a situation where these may be in doubt. Classically, medical autopsies were much more common, and often resulted in the discovery of new diseases when pathological changes in the body were matched to signs and symptoms exhibited by the patient prior to death.


Anatomic Pathologist Training

USA

Anatomic Pathology (AP) is one of the two primary certifications offered by the American Board of Pathology. The other is Clinical Pathology (CP). To be certified in anatomic pathology, the trainee must complete four years of medical school followed by three years of residency training. Many US pathologists are certified in both AP and CP, which requires a total of four years of residency. After completing residency, many pathologists enroll in further years of fellowship training to gain expertise in a subspecialty of AP. Clinical Pathology is one of the two major divisions of Pathology. ...


Canada

Anatomic Pathology (AP) is one of the specialist certificates granted by the Royal College of Physicians and Surgeons of Canada. Other certificates related to pathology include general pathology (GP), forensic pathology, hematopathology, and neuropathology. Candidates for any of these must have completed four years of medical school and five years of residency training. After becoming certified in either AP or GP, it is common for pathologists to seek further fellowship training in a subspecialty of AP.


Procedures

Image of a gross lung specimen (the entire lung) demonstrating the honeycomb pattern of end-stage pulmonary fibrosis.

The procedures used in anatomic pathology include: Image File history File links No higher resolution available. ... Image File history File links No higher resolution available. ... Diffuse parenchymal lung disease (DPLD), also known as interstitial lung disease, refers to a group of lung diseases, affecting the alveolar epithelium, pulmonary capillary endothelium, basement membrane, perivascular and perilymphatic tissues. ...

  • Gross pathology - the examination of diseased tissues with the naked eye. This is important especially for large tissue fragments, because the disease can often be visually identified. It is also at this step that the pathologist selects areas that will be processed for histopathology.
  • Histopathology - the microscopic examination of stained tissue sections using histological techniques. The standard stains are haematoxylin and eosin, but many others exist. The science of staining tissues sections is called histochemistry. Antibodies can also be used to stain specific proteins, a technique called immunohistochemistry. Specific DNA and RNA molecules can be identified on sections using the technique of in situ hybridization. When the probe is labeled with fluorescent dye, the technique is called FISH.
  • Cytopathology - the examination of loose cells spread and stained on glass slides using cytology techniques.
  • Electron microscopy - the examination of tissue with an electron microscope, which allows much greater magnification, enabling the visualization of organelles within the cells. Its use has been largely supplanted by immunhistochemistry, but it is still in common use for certain tasks, including the diagnosis of kidney disease and the identification of immotile cilia syndrome among many others.
  • Tissue cytogenetics - the visualization of chromosomes to identify genetics defects such as chromosomal translocation.
  • Flow immunophenotyping - the determination of the immunophenotype of cells using flow cytometry techniques. It is very useful to diagnose the different types of leukemia and lymphoma.

Look up gross, groß in Wiktionary, the free dictionary. ... Histopathology is a field of pathology which specialises in the histologic study of diseased tissue. ... Robert Hookes microscope (1665) - an engineered device used to study living systems. ... A thin section of lung tissue stained with hematoxylin and eosin. ... Haematoxylin Haematein Haematoxylin, hematoxylin, Natural Black 1, or C.I. 75290 is extracted from the wood of the logwood tree. ... Eosin is an orange-pink dye derived from coal tar. ... ... Immunohistochemistry or IHC refers to the process of localizing proteins in cells of a tissue section exploiting the principle of antibodies binding specifically to antigens in biological tissues. ... The structure of part of a DNA double helix Deoxyribonucleic acid (DNA) is a nucleic acid that contains the genetic instructions for the development and function of living organisms. ... This article or section does not adequately cite its references or sources. ... In situ hybridization (ISH) is a type of hybridization that uses a labeled complementary DNA or RNA strand (i. ... Fluorescence induced by exposure to ultraviolet light in vials containing various sized cadmium selenide (CdSe) quantum dots. ... A metaphase cell positive for the bcr/abl rearrangement using FISH. The chromosomes can be seen in blue. ... Cytopathology is a branch of pathology that studies and diagnoses diseases on the cellular level. ... Cytology (also known as Cell biology) is the scientific study of cells. ... The electron microscope is a microscope that can magnify very small details with high resolving power due to the use of electrons rather than light to scatter off material, magnifying at levels up to 500,000 times. ... In cell biology, an organelle is one of several structures with specialized functions, suspended in the cytoplasm of a eukaryotic cell. ... It has been suggested that Immunohistochemical staining be merged into this article or section. ... It has been suggested that Renal anomalies and Renal plasma threshold be merged into this article or section. ... Primary ciliary dyskinesia (PCD), also known as immotile ciliary syndrome, is a rare autosomal recessive genetic disorder caused by a defect in the action of the tiny hairs (cilia) lining the respiratory tract. ... A metaphase cell positive for the bcr/abl rearrangement using FISH Cytogenetics is the study of the structure of chromosome material. ... Chromosomal translocation of the 4th and 20th chromosome. ... Flow cytometry is a technique for counting, examining and sorting microscopic particles suspended in a stream of fluid. ... Immunophenotyping is a technique notably used in the diagnosis of leukemia. ... Flow cytometry is a technique for counting, examining and sorting microscopic particles suspended in a stream of fluid. ... Leukemia or leukaemia (see spelling differences) is a cancer of the blood or bone marrow and is characterized by an abnormal proliferation (production by multiplication) of blood cells, usually white blood cells (leukocytes). ... This article is about lymphoma in humans. ...

Subspecialties

Doctors turn to pathologists for help when the diagnosis is not evident. Therefore, pathologists are expected to know many more diseases than clinicians - they are the "doctor's doctor". The amount of knowledge needed is enormous. Since one person cannot possibly know everything, pathologists tend to sub-specialize. The American Board of Pathology certifies anatomic pathologists, and recognizes the following secondary specialties of Anatomic Pathology: Neuropathology, Cytopathology, Dermatopathology, Forensic pathology, Hematology. Here is a (probably incomplete) list of the commonly recognized subspecialties, including those which do not have subspecialty boards: Neuropathology is the study of diseases of the nervous system, and is a medical subspecialty within the specialty of anatomical pathology, itself a division within pathology in many English speaking countries. ... Cytopathology is a branch of pathology that studies and diagnoses diseases on the cellular level. ... Dermatopathology is a subspecialty of anatomical pathology interested in skin diseases. ... Forensic pathology, first recognized by the American Board of Pathology in 1959, is a branch of medicine concerned with determining cause of death usually for civil or criminal law cases. ... Hematology is the branch of medicine that is concerned with blood and its disorders. ...

  • Surgical pathology: diagnosis of diseases in organs removed by general surgeons, especially breast, lung, bowel. This is the core of anatomic pathology. Most of these organs are covered by sub-subspecialties:
Histologic slide demonstrating viral myocarditis, an infection of the heart muscle

Oral & Maxillofacial pathology is different; the American Board of Oral and maxillofacial pathology certifies dentistry doctors, not medical doctors, to practice this sub-specialty of Pathology. A pregnant womans breasts. ... Respiratory system The lungs flank the heart and great vessels in the chest cavity. ... The intestine is the portion of the alimentary canal extending from the stomach to the anus and, in humans and other mammals, consists of two segments, the small intestine and the large intestine. ... Image File history File linksMetadata No higher resolution available. ... Image File history File linksMetadata No higher resolution available. ... For the Physics term GUT, please refer to Grand unification theory The gastrointestinal or digestive tract, also referred to as the GI tract or the alimentary canal or the gut, is the system of organs within multicellular animals which takes in food, digests it to extract energy and nutrients, and... Brain biopsy A biopsy (in Greek: bios = life and opsy = look/appearance) is a medical test involving the removal of cells or tissues for examination. ... Gastroenterology or Gastrology might be better described as the field of digestive diseases, which are traditionally separated by anatomic or functional category. ... The liver is an organ in some animals, including vertebrates (and therefore humans). ... The urinary system is a system of organs, tubes, muscles, and nerves that work together to create, store, and carry, urine. ... Anatomic pathology is a medical specialty (a branch of pathology) that is concerned with the diagnosis of disease based on the gross, microscopic, and molecular examination of cells and tissues. ... The endocrine system is a control system of ductless endocrine glands that secrete chemical messengers called hormones that circulate within the body via the bloodstream to affect distant organs. ... Gynecologic pathology is the medical pathology subspecialty dealing with the study and diagnosis of disease involving the female genital tract. ... The placenta is an ephemeral (temporary) organ present only in female placental vertebrates during gestation (pregnancy). ... Otolaryngology is the branch of medicine that specializes in the diagnosis and treatment of ear, nose, throat, and head & neck disorders. ... Neuropathology is the study of diseases of the nervous system, and is a medical subspecialty within the specialty of anatomical pathology, itself a division within pathology in many English speaking countries. ... Neurosurgery is the surgical discipline focused on treating the central and peripheral nervous system. ... In animals, the brain, or encephalon (Greek for in the head), is the control center of the central nervous system. ... The Spinal cord nested in the vertebral column. ... Post-mortem, postmortem and post mortem redirect here. ... The removal of the entire orbital contents, including the eye, extraocular muscles, fat, and connective tissues; usually for malignant orbital tumors. ... Dermatopathology is a subspecialty of anatomical pathology interested in skin diseases. ... Dermatology (from Greek derma, skin) is a branch of medicine dealing with the skin and its appendages (hair, nails, sweat glands etc). ... A thin section of lung tissue stained with hematoxylin and eosin. ... Dermatology is a branch of medicine dealing with the skin, its structure, functions, and diseases (from Greek derma, skin), as well as its appendages (nails, hair, sweat glands). ... Ophthalmology is the branch of medicine which deals with the diseases of the eye and their treatment. ... Hematopathology is the branch of pathology which studies diseases of hematopoietic cells (see below). ... ISBN 1-58829-149-9 A branch of immunology concerned with pathology caused by the immune system, such as an autoimmune disease or immune mediated tissue damage in response to an infection. ... Cytopathology is a branch of pathology that studies and diagnoses diseases on the cellular level. ... Forensic pathology, first recognized by the American Board of Pathology in 1959, is a branch of medicine concerned with determining cause of death usually for civil or criminal law cases. ... Oral pathology, also known in the United States of America as oral and maxillofacial pathology is the specialty of dentistry and pathology which deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. ... A Dentist and Dental Assistant perform surgery on a patient. ...


See also

Pathology (from Greek pathos, feeling, pain, suffering; and logos, study of; see also -ology) is the study of the processes underlying disease and other forms of illness, harmful abnormality, or dysfunction. ... Clinical Pathology is one of the two major divisions of Pathology. ... Forensic pathology, first recognized by the American Board of Pathology in 1959, is a branch of medicine concerned with determining cause of death usually for civil or criminal law cases. ... Molecular pathology is an emerging discipline within anatomic pathology which is focused on the use of nucleic acid-based techniques such as DNA sequencing, fluorescent in-situ hybridization, reverse-transcriptase polymerase chain reaction, and nucleic acid microarrays for specialised studies of disease in tissues and cells. ... Veterinary medicine is the application of medical, diagnostic, and therapeutic principles to companion, domestic, exotic, wildlife, and production animals. ... Phytopathology is the study of how disease processes develop in plants. ... A thin section of lung tissue stained with hematoxylin and eosin. ...

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