Diagnostic Work

Histopathology:
The microscopic examination of tissue in order to establish the nature of diseases (tumor or non-tumor, benign or malignant, etc.), the adequacy of the surgical treatment (surgical margin), and follow up the efficacy of medical treatment (post-radiotherapy prostate biopsy,etc.). The same method could be used for biopsy or large organ resection, with routine hematoxylin and eosin stain. If necessary histochemical and immunohistochemical stainings can also be performed.

Immunohistochemistry:
Immunohistochemistry is one of the most powerful and widely-used ancillary methods in surgical pathology. The technique makes it possible to simultaneously visualize cell type and differentiation markers in standard tissue sections by light microscopy, and has revolutionized diagnostic surgical pathology.
Antigens in tissue sections were first detected using antibodies via immunofluorescence performed on formalin-fixed paraffin-embedded tissue sections. By using the enzymatic labeling technique (multi-step peroxidase-antiperoxidase avidin-biotin conjugate methods) along with amplification techniques such as tyramide and polymer-based labeling, allow much greater sensitivity in antigen detection.

Frozen Section:
Frozen sections, are performed to establish a tissue diagnosis intraoperatively, in order to determine the nature of a lesion, followed by appropriate surgical treatment.


Cytopathology:
“the study of cellular disease and the use of cellular changes for the diagnosis of disease”
Source can be:
1. Body fluids (including urine, cerebrospinal fluid, and sputum) from various sources, including peritoneum and pleural and pericardial cavities.
2. Scrapings, washings, or brushings from various sites, including peritoneal washings, bronchial washings, bronchial brushings, bile duct brushings, and esophageal brushings.

Advantages:
1. Relatively painless.
2. Quick diagnosis (results could be ready within 1 hour).
3. Relatively inexpensive.
4. May provides useful information for the preoperative or pretreatment investigation
5. Complications from the procedure are relatively rare.


Molecular Pathology:
Polymerase Chain Reaction (PCR):
Most molecular pathological tests performed focus on somatic or acquired DNA variations in the cells of the disease process that provide information that aids in diagnosis, identifies prognostic indicators, stratifies patients into effective treatment options, helps monitor treatment response, and identifies patients at increased risk of disease. Because polymerase chain reaction (PCR)-based approaches are quick, reliable, and sensitive, PCR (e.g. K-ras and BRAF mutation) has become a central technology for much of clinical molecular genetic testing.


Florescence in situ hybridization:
Florescence in situ hybridization (FISH) uses tagged probes that bind to chromosome-specific DNA sequences of interest, thereby allowing for the identification of both structural and numeric aberrations that specify certain (non-)hematopoietic malignancies. It has several major advantages over conventional cytogenetics in that it can be applied in many clinical settings, can be performed on non-dividing cells, can be performed on air-dried or formalin-fixed specimens, can facilitate detection of molecular abnormalities in neoplasms with low proliferation rates (e.g. myeloma), and can facilitate detection of numeric abnormalities. In surgical pathology, this technique is used primarily to detect somatic cancer-associated alterations for diagnostic, prognostic, or therapeutic purposes.

Our institute performs Her2/Neu FISH routinely and K-ras and EGFR selectively.

Autopsy:
An autopsy — also known as a post-mortem examination — is a medical procedure that consists of a thorough examination of a corpse to determine the cause and manner of death, when it is unknown clinically, and to evaluate any disease or injury that may be present.
 

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