In order to provide detailed answers to the diagnostic questions, about 139,000 histopathology studies are performed at Pathology-DNA every year.
Histopathology, or the study of the microscopic anatomy of cells and/or tissues and their abnormalities, examines the structure and the special functions (specialties) of cells and, in particular tissues, formed by groups of cells that perform the same function or form an organ together. Specimens are received from various clinics and inpatient departments, as well as doctor’s offices (general practitioners) outside the institutions. These specimens can vary from small tissue parts (biopsies) to complete organs.
Specimens sent in for diagnosis are first examined with the naked eye (macroscopy) and described (size and number of tissue fragments, visual abnormalities such as abnormal structures or color differences, etc.). Smaller specimens are put into a tissue cassette in their entirety for further processing. Larger specimens are sectioned and relevant parts are subsequently removed and put into tissue cassettes. These samples are processed and packaged in paraffin wax. From these paraffin embedded tissues histopathology technicians cut very thin slices, only 4 µm thick (which is one four-thousandth of a millimeter). Afterwards, these slices are sticked on glass slides, stained and covered with a very thin second glass (cover slip). Then, the slides can be delivered to the pathologist for examination under the microscope (microscopy). During this process, cells and tissues are examined for abnormalities compared to their normal counterparts. These findings are reported and lead to a conclusion or diagnosis. Sometimes treatment advice is given in addition to the diagnosis. Results are sent electronically or by post to the referring clinician or general practitioner. Based on this diagnosis the doctor can determine the correct treatment. This whole process is completed within a few days. Beside the standard staining, there are special stains that are used to make different cell- or tissue structures visible. In addition, numerous immunohistochemical stains can be used to show specific cell parts.
Besides routine diagnostics, quick diagnostics (frozen section procedure) are performed as well. A frozen section procedure is a rapid way to fix and mount tissue sections using a refrigeration device. It is often used during a surgical procedure to remove a suspected process, allowing for rapid determination whether or not the process is malignant, or whether a tumor has been removed completely. During this frozen section procedure the patient remains under narcosis. Based on these intra-operative results the surgeon can decide whether to continue the operation or not.
Same-day diagnostics of breast pathology
In case of a suspected breast pathology, a preliminary result can be offered the same day. Biopsies taken before 11:00 are processed in an accelerated scheme in the department of pathology. Approximately 5 1/2 hours later, a preliminary diagnosis can be offered to assist the physician in the diagnostic and therapeutic process.
For biopsies offered before 16:00 ,results can be ready within 24 hours: by 11:00 the next morning a preliminary diagnosis is given, and by 16:00 a definitive diagnosis is available in case additional immunohistochemistry is needed.
Liver Pathology is a well-covered subspecialty, studied by four dedicated pathologist within Pathology-DNA. Pathology-DNA can therefore guarantee continuous qualitative diagnostics. In the near future, consultation services on liver pathology will start for St.Radboud UMC. Consultations between the three locations of Pathology-DNA are facilitated by sharing digitized images of these liver biopsies.