The pathology report is the most important document that determines a patient’s treatment plan; therefore, pathological examination is essential for major diseases, especially cancer.
What is Pathology?
Pathology is the medical specialty that examines tissue, cell and body fluid samples taken from patients in a laboratory setting to investigate the causes of diseases, their development processes and the structural changes they produce in the body. The pathology department, which works to establish the definitive diagnosis of many infections and inflammatory diseases, especially cancer, enables the microscopic, macroscopic and molecular analysis of samples taken from patients. Pathology is essential, especially for the diagnosis of cancer. Through pathology, the structure of cells, the organization of tissues and abnormal changes are analyzed in detail.
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Which Diseases Do Pathology Deal With?
Pathology is not limited to a single group of diseases and is a fundamental discipline in the diagnosis of a wide range of conditions. Its most common use is in the diagnosis of cancer, where it determines whether tumors are benign or malignant. Also, infectious diseases can also be detected with pathology. Main disease groups that are diagnosed definitively with pathology result are listed below:
- Oncological diseases: Benign and malignant tumors are identified, along with the cancer type and stage.
- Inflammatory diseases: Inflammatory diseases in organs, such as gastritis and colitis, are detected.
- Infectious Diseases: The presence of fungi, parasites or certain types of bacteria and the extent of tissue damage, are determined.
- Autoimmune diseases: The effects of diseases in which the body attacks its own tissues are examined at the tissue level.
- Skin Diseases: It is necessary for the diagnosis of psoriasis, eczema and suspicious moles (nevus).
How Is A Pathology Test Performed?
The pathology laboratory is a medical unit where pathologists work using high-technology equipment. Pathology is essentially the process of examining tissues and cells. Samples obtained through smearing, scraping, surgical operations or biopsy are sent to the laboratory using a preservation method called “fixation,” where they undergo various processing steps.
In the initial stage, samples are properly preserved and prepared. They are then cut into thin sections and examined under a microscope. Staining techniques are used to make cellular structures more distinct. A pathologist evaluates whether the cells are normal or abnormal. In addition, factors such as the organization, size, and shape of the cells are analyzed.
The stages that a sample taken from a patient goes through in a pathology laboratory are as follows:
- Macroscopic examination: It includes the stages of examining the tissue with the naked eye, measuring it and identifying the areas from which samples will be taken.
- Tissue follow-up: It is the process of removing water from the tissue and replacing it with paraffin (a wax-like substance).
- Collecting slice: It is the process of slicing paraffin blocks into micron-thin sections (much thinner than paper) using a microtome device.
- Staining: Routine or special staining methods are applied to make the cells visible.
- Microscopic evaluation: It is the stage in which the prepared slides are examined and reported by a pathologist.
What Are Pathology Tests?
Pathology tests are classified into different categories depending on the type of sample being examined and the technology used for analysis. The most used pathology tests are as follows:
- Histopathological tests: Entire tissue specimens removed through surgical procedures or biopsy are examined.
- Cytopathological tests: These are tests in which individual cells or groups of cells are examined. Pap-smear can be given as an example.
- Immunohistochemical tests: It is the process of labeling specific proteins in cells using special antibodies to determine the subtype of cancer.
- Molecular pathology tests: It is the process of detecting genetic changes at the DNA and RNA level ( mutations etc.).
- Flow cytometry: It is the analysis of the physical and chemical properties of cells (usually in blood and bone marrow samples) using lasers.
How Long Does It Take For Pathology Result To Be Out?
It is not medically possible for a cancer patient to begin treatment without a pathology result. The pathology report reveals whether the surgical margins are clean, the tumor’s aggressiveness (grade) and its extent of spread (stage). A simple pathology can give result within 2-5 days, while complex cases requiring staining or molecular analysis may take 7-15 days to be finalized. However, some special tests can take longer. It may take weeks to learn the result of molecular analyses. Workload and laboratory capacity also affect how long it takes. In urgent cases, results can be obtained more quickly.
What Does Positive Pathology Result Mean?
A positive pathology result indicates that findings related to disease have been detected in the examined sample. In cancer tests in particular, a positive result indicates the presence of tumor cells; however, a positive result does not always mean something unfavorable. In infection tests, a positive result indicates the presence of an infectious agent and this is necessary for treatment planning. Positive results require detailed interpretation; the type and stage of the disease must be determined and evaluated together with clinical findings. A positive result may not enough on its own. It needs to be interpreted by a doctor.
What Does Negative Pathology Result Mean?
A negative pathology result indicates that no disease-related findings were detected in the examined sample. In cancer tests, a negative result indicates that no tumor was found in the examined area; however, it does not always provide absolute certainty. Rarely, sampling errors may occur or the disease may not be detected if it is in an early stage. Therefore, if clinical findings differ or there is suspicion, additional tests may be performed. Negative results should also be evaluated with care. Patient’s symptoms are important, follow-up is recommended if necessary. Results should definitely be interpreted by a doctor.
What Does “No Pathological Findings Observed” Mean?
The phrase “no pathological findings observed” indicates that no abnormal condition was found in the examined tissue; however, the result should be evaluated together with clinical findings, as some diseases may not show symptoms in the early stages. Because of this, follow-up may be needed.
Why Is A Pathology Report Requested?
Pathology report is requested for establishing final diagnosis. It is used especially in suspicious conditions. It is the most important tool in cancer diagnosis. The advantages of pathology report are as follows:
- It determines the type and stage of the disease.
- It helps plan the treatment.
- It is necessary for post-surgery evaluation.
- It is used for detection of infection.
- It plays a role in diagnosis of autoimmune diseases.
- It shows the spread of disease.
- It gives information about prognosis.
- It guides clinical decisions.
What Are Written In Pathology Report?
Pathology report contains detailed and technical information. First, patient-related information; the sample type and the method of sample collection are specified in the report. In a pathology report, the results of the macroscopic and microscopic examination, the diagnosis and additional test results are included; if there is a tumor, its type and grade are also stated. Reports have medical terminology so it should be explained by a doctor.
Frequently Asked Questions About Pathology
What Does “Atypia” in Pathology Result Mean?
Atypia refers to the fact that the cells do not have a normal appearance but there are not yet sufficient criteria to definitively diagnose cancer.
Is Pathology Tests Only Performed In State Hospitals?
No, pathological examinations can also be performed in university hospitals, private hospitals and private pathology laboratories.
Can Having A Pathology Examination With Biopsy Cause Cancer To Spread?
No, there is no scientific evidence that pathological examinations performed with modern techniques cause cancer to spread; on the contrary, they are essential for planning treatment.
