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Pathology consists of the words ‘pathos’ and ‘logos’. ‘Pathos’ in ancient Greek means disease, ‘logos’ knowledge. Pathology, which means ‘the study of disease’, is a specialty in medicine. Organs, tissues and cells in our body have their own unique outlook. Their macroscopic and microscopic images are identified. Many changes occur in the cells, tissues and organs during a disease. Pathology specialists diagnose diseases by examining the changes with specific techniques and tools.
Following the basic medical education of 6 years, physicians who want to become pathologists pursue a further 4 years of specialization. The pathologist diagnoses diseases by examining samples taken from tissues and organs that are considered to be sick. He/she conducts this examination either with a naked eye or under microscope and uses special techniques when necessary. He/she prepares the pathology report as a result of the investigations.
The main area of study of the pathology is to undertake the necessary investigations for definitive diagnosis of all kinds of diseases. However, there are also other areas of work:
An extraction of sample cells or tissues for a pathological examination is called a biopsy. A biopsy can be taken from each organ in the body, including the brain. Biopsies can be performed by local anesthesia or during surgery and biopsy samples can be taken on the organs directly through the use of a needle, through endoscopy with the stomach and esophagus, through colonoscopy with the intestines or through bronchoscopy with the lungs. There are 2 types of biopsies:
In some types of cancer, the organ and all the surrounding lymph nodes can be removed and sent to the pathology laboratory.
In cancer, the organ or surrounding tissues taken during surgery is sent to the pathology laboratory for a rapid examination. Frozen is the preliminary examination done quickly. If a diseased tissue is found after this procedure, surgery is done more extensively. If the examination result is normal, the operation is terminated. Therefore, frozen examination is very important.
In order to determine the actual cause of death, tissues or organs taken from the deceased are sent to the pathology laboratory.
Cytology is made up of the words ‘cyto’ and ‘logos’, which means study of cells. Cytology, due to the fact that disorders at the cellular level are the essential cause of diseases, examines deviations apart from the normal appearance of the cell. Samples are taken from body cavities, secretions and organs, and spread onto a thin glass called lam. Preparations are stained with cytological dyes. Cells are examined under microscope according to their structure, shape and staining properties. Diagnosis is made after evaluating cell conditions that stray from normal appearance and functioning.
Especially in the early diagnosis of cancer, in identifying the response to hormone therapy in some cancers, it serves as an easy and important diagnostical tool. Examined materials are obtained by exfoliative cytology and fine needle aspiration methods.
Pathologic examination is necessary for definitive diagnosis, follow-ups, and treatment responses of many diseases, of which cancer is the prominent beneficiary. Definitive diagnosis in all the organ cancers is made by pathology. As with cervix cancer, pathological examination is necessary to diagnose the stages which the cancer development has reached in order to take the necessary steps.
Pathological examination may also be necessary for the diagnosis of non-cancerous diseases. These include:
Tissues/organs/cell mass/fluids sent to the laboratory for examination by the pathologist are called specimens. A pathology report is issued to report the results of these samples.
When all conditions are appropriate, a definitive diagnosis of the disease is possible. These conditions are:
Sometimes findings of the examination may suggest more than one disease or condition. Or, the material may not provide sufficient information due to the method of extraction of the sample. In such cases, before any definitive diagnosis is made, pathologist may ask to repeat the procedure to obtain additional information or to take a sample with a different method, and after the investigation is completed, a definitive diagnosis is made.
In the samples sent to the pathology department, the statement which no pathological finding was found is made in the absence of any diseased tissue or disorder. Unable to observe any pathological finding does not always indicate that the person is healthy. This expression is used for the sample taken. Specimens may be taken from intact tissue and cells. In such cases, sampling is repeated if the presence of the disease is still suspected.
After the material to be examined reaches the pathology laboratory, the time it will take to write the report is not fixed. This period may be prolonged if the material is taken from a hard-to-examine tissue (such as a bone), if there is a need for a special procedure for the diagnosis of the material being investigated, or there is inadequacy of staff in the laboratory due to the intensity of the workload. Therefore, if there is a delay in the publishing of the report, it should not be considered a result of negligence. Cytological examination reports are prepared in a shorter time than other examinations. In some cases, the pathology results may take a full month to be reached.
Samples are sent to the laboratory with a uniquely barcoded form, including information about the patient and the sample taken. Once the sample is delivered to the laboratory, the number is given, registered and labeled. Names on the container and in the form are verified by the pathologist before examination. Precautions are taken to avoid mistakes such as tissue, preparation, and/or report meddling. If you think you are in such a case, you should talk to your doctor. The doctor may contact the laboratory if necessary.