Introduction to the Anatomical Pathology Laboratory, continued - LabCE.com, Laboratory Continuing Education
 

Introduction to the Anatomical Pathology Laboratory, continued

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Introduction to the Anatomical Pathology Laboratory, continued

The gross pathology laboratory is where patient tissues taken from surgery or other procedures are received, described, and sectioned in preparation for microscopic examination. Pathologists, pathologists' assistants, or technicians perform the initial evaluation and processing while using appropriate physical safeguards and personal protective equipment (PPE). Most tissues received in the gross laboratory are sectioned into small pieces and placed in a formalin solution for fixation.
The frozen section laboratory is where fresh tissue taken during surgery is submitted by the surgeon for immediate diagnosis by the pathologist. This is only done when the surgeon needs an immediate diagnosis, typically regarding cancer. The fresh tissue is rapidly frozen and then sectioned into very thin slices using an instrument called a microtome. The tissue slices are then placed on glass slides, stained, and examined by a pathologist using a microscope. The pathologist must provide the diagnosis to the surgeon within 15 minutes. Often, this means the pathologist must make an instant decision on whether or not cancer is present in the specimen. The pathologist then reports the diagnosis to the surgeon in the operating room. The surgeon will decide how to proceed based on the immediate frozen section diagnosis.
The histology laboratory is where routine slides are made from the fixed tissue received from the gross pathology laboratory. Automated equipment processes the fixed tissues in various fluids before a histotechnologist embeds the processed tissue into blocks of paraffin or similar synthetic substances. The histotechnologist sections the paraffin-embedded tissue blocks into very thin, almost transparent sections using a microtome (see last image). The super thin slices of tissue are placed on glass slides and stained. Finally, the slides are presented to the pathologist for microscopic examination, diagnosis, and reporting.
The cytology laboratory is where cytologists prepare and examine tissues and body fluids for the presence of abnormal cells, such as cancer cells. The pathologist then evaluates the specimen and provides a final diagnosis.
The autopsy suite is where autopsies are performed by the pathologist and pathologists' assistant and/or morgue diener upon request of the deceased patient's family or physician. The suite is usually adjacent to the hospital morgue. The autopsy procedure includes a review of the patient's medical record, a gross examination of the organs, a microscopic examination of selected tissue samples, and a review of special studies, such as toxicology. Finally, the pathologist generates a comprehensive report with conclusions as to the cause of death and contributing factors.
2. Bushen, Bethany. “Nothing 'Gross' About It: The Work of a Pathologists' Assistant.” Pathology & Laboratory Medicine: Blog, University of Rochester Medical Center, 13 Apr. 2016, www.urmc.rochester.edu/pathology-labs/blog/april-2016/nothing-gross-about-it-a-day-in-the-life-of-a-path.aspx. MediaLab was given permission to use these images by Lori Barrette on 06 August 2020.

Top: A pathologists' assistant grosses a breast specimen.
Middle: A pathologists' assistant checks dictation reports in the gross room.
Bottom: A frozen tissue sample that will be cut, stained, and examined under a microscope by a pathologist. (2).