Surgical pathology
Surgical pathology is the most significant and time-consuming area of practice for most
The practice of surgical pathology allows for definitive 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 (i.e., macroscopic) and histologic (i.e., microscopic) examination of the tissue, and may involve evaluations of molecular properties of the tissue by immunohistochemistry or other laboratory tests.
Specimens
There are two major types of specimens submitted for surgical pathology analysis: biopsies and surgical resections.[1]
A biopsy is a small piece of tissue removed primarily for the purposes of surgical pathology analysis, most often in order to render a definitive
Surgical resection specimens are obtained by the therapeutic surgical removal of an entire diseased area or organ (and occasionally multiple organs). These procedures are often intended as definitive surgical treatment of a disease in which the diagnosis is already known or strongly suspected. However, pathological analysis of these specimens is critically important in confirming the previous diagnosis,
In the determination of surgical margin of a surgical resection, one can use the
Workflow
- Gross examination
- Frozen section
- Fixation & Embedding
- Histopathologic examination
- Ancillary testing
- The surgical pathology report
- Direct consultation
Subspecialties
Many pathologists seek fellowship-level training, or otherwise pursue expertise in a focused area of surgical pathology. Subspecialization is particularly prevalent in the academic setting, where pathologists may specialise in an area of diagnostic surgical pathology that is relevant to their research, but is becoming increasingly prevalent in private practice as well. Subspecialization has a number of benefits, such as allowing for increased experience and skill at interpreting challenging cases, as well as development of a closer working relationship between the pathologist and clinicians within a subspecialty area. Commonly recognized subspecialties of surgical pathology include the following:
- Bone pathology
- Cardiac pathology
- Cytopathology (A board-certifiable subspecialty in the U.S.)
- Dermatopathology (A board-certifiable subspecialty in the U.S.)
- Endocrine pathology
- Gastrointestinal pathology
- Genitourinary pathology
- Gynecologic pathology
- Head and Neck pathology
- Hematopathology (A board-certifiable subspecialty in the U.S.)
- Neuropathology (A board-certifiable subspecialty in the U.S. and a recognised specialty in the U.K.)
- Ophthalmic pathology
- Pediatric pathology (A board-certifiable subspecialty in the U.S. and a recognised specialty in the U.K.)
- Pulmonary pathology
- Renal pathology
- Soft tissue pathology
- Breast pathology
See also
- Anatomical pathology
- Digital pathology and Telepathology
- List of pathologists
- History of pathology
- United States and Canadian Academy of Pathology
Notes and references
- PMID 18568681.
Bibliography
- Richard Cote, Saul Suster, Lawrence Weiss, Noel Weidner (Editor) (2003). Modern Surgical Pathology (2 Volume Set). London: W B Saunders. ISBN 0-7216-7253-1.)
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