Anatomic pathology is a branch of medicine concerned with the diagnosis of disease based on gross, microscopic, chemical, immunologic and molecular examination of organs, tissues and cells. Anatomical pathology is itself divided in subspecialties, the main ones being autopsy, cytopathology and surgical pathology.
Autopsies have long held a fundamental role in understanding disease mechanisms. They represent a consultative service in which there is a synthesis of the medical record with anatomic and occasionally chemical findings in such a way that a final correlation can be made to understand the patient’s illness. There are numerous reasons for performing autopsies including determination of the cause and mechanisms of death, providing quality assurance for diagnostic procedures and therapy and providing information for families of the deceased. The autopsy also provides a unique learning opportunity for clinicians, clinical house staff, pathologists, pathology residents, medical students and other hospital personnel.
Cytopathology centers on morphologic diagnostic studies at the cellular rather than whole tissue level. Cells are obtained by scraping a tissue surface, aspiration of body cavity fluids or fine needle aspiration of solid tissues. Examination of these cell preparations is usually used to aid in the diagnosis of neoplasia (cancer), but also helps in the diagnosis of certain infectious diseases and other inflammatory conditions. Often used as a screening method to guide further diagnostic procedures such as biopsy or surgery, cytopathologic studies may offer a more rapid and convenient method for determining the type and stage of a patient’s cancer.
Surgical pathology involves the study of tissue biopsied or removed from patients during surgery to help diagnose a disease and determine a treatment plan. Surgical pathologists are often called to provide immediate consultation during surgery to help determine the best surgical procedure. Examination of tissue with the naked eye (gross examination) is complemented with examination of processed tissue under a microscope using routine and various special stains which allow accurate characterization of the patient’s disease. There are multiple branches of surgical pathology, including:
Breast/Gyn pathology deals with neoplastic and non-neoplastic diseases of the breast and reproductive organs of the female.
Cardiovascular pathology is the study of diseases of the heart and blood vessels, including inflammatory conditions, atherosclerosis and cardiac transplantation.
Endocrine pathology deals with neoplastic and non-neoplastic disease of the thyroid, parathyroid and adrenal glands.
- Gastrointestinal (GI)
Gastrointestinal pathology deals with neoplastic and non-neoplastic diseases of the digestive tract.
- Genitourinary (GU)
Genitourinary pathology deals with the urinary system (bladder, ureters, urethra) in males and females as well as the reproductive organs of the male.
Head/neck pathology deals with neoplastic and non-neoplastic diseases of the neck, scalp, face, ears, paranasal sinuses, nasal cavity, oral cavity, salivary glands, pharynx and larynx.
Hepatobiliary pathology deals with the neoplastic and non-neoplastic diseases of the liver, bile ducts and gallbladder, to include evaluation of liver transplantation.
Neuropathology involves neoplastic, inflammatory and degenerative diseases of the nervous system (including pituitary gland) and skeletal muscle. These studies are conducted using premortem tissue but are also a key facet of postmortem evaluations, especially for the various forms of dementia.
Pancreatic pathology deals with neoplastic and non-neoplastic diseases of the pancreas to include pancreatic transplantation.
Pulmonary pathology deals with neoplastic and non-neoplastic diseases of the lungs and structures of the thorax (pleura and mediastinum).
Renal pathology deals with medical (non-neoplastic) conditions of the kidneys, including renal transplantation.