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Laboratory Medicine

Histopathology

Histopathology is the study of disease in human tissue using microscopes for close examination.


What do Histopathologists do?

Histopathologists look at tissues and cells removed from patients in the clinic or during an operation either as biopsies or as 'excision' or 'resection' specimens.

They use a range of scientific methods to discover if a disease is present and what action needs to be taken. When a Histopathologists receives a tissue sample, they: 

  • firstly examine tissue with the naked eye to look for any visible abnormalities and to select pieces to examine in more detail
  • these small pieces are treated with chemicals so that very thin slices can be cut
  • the slices are stained to show different parts of the cells and examined under a microscope
  • the Histopathologist tells the patient’s doctor what is wrong and often provides information about the correct treatment to give.

Histopathologists sometimes look at tissue while the patient is having an operation. The surgeon removes a small amount of tissue and waits for the Histopathologist to make a diagnosis using the frozen section method before deciding how to proceed. The patient is asleep while this is going on and knows nothing about it.

Histopathologists are the people who diagnose cancer and other serious illnesses, but they also often have good news, for example discovering that a lump or mole is completely benign and nothing to worry about.  

It’s all about team work

Histopathologists don’t work alone. They are supported by highly qualified scientific and technical staff who prepare the specimens and undertake specialised tests to help the Histopathologist understand the changes they see under the microscope.

We use highly sophisticated state-of-the-art equipment to help in the analysis of specimens. Together, Histopathologists, scientists, technicians and clerical staff work as a team to ensure that the patient’s doctor gets the information they need.to diagnose and treat the patient.

Focussed on quality

The Cellular Pathology team is focussed on quality – from accuracy of the microscopic diagnosis, to making sure that the report is provided on time. Every step on the specimen journey - from the patient to the delivery of the report back to the doctor - is scrutinised and monitored to ensure that the service is of the highest possible quality.

A partner in research

Our close association with Newcastle University allows many exciting and ground-breaking opportunities for joint research.

Our fully-accredited laboratory with excellent equipment and high calibre staff is a natural partner for the world-renowned university and its pioneering research. The excellence of our tissue-based research work has attracted interest from some of the leading companies who develop treatments for a range of conditions, from cancer to eczema.

Key members of 'multi-disciplinary clinical teams'

Histopathologists are key members of various multi-disciplinary teams (or MDTs which include staff with a range of skills) that manage the investigation and care of patients with cancer and other life-threatening conditions. They examine biopsies from patients who have had organ transplants - such as kidney, liver, lung, heart or bone marrow transplants - to see whether the transplant is being rejected, or to look for an explanation if the transplant is not working properly.

Some Histopathologists also carry out autopsies (post-mortems) to find out why someone has died, especially if the person has died in hospital after surgery or other treatment, or has died unexpectedly in other locations. The Histopathologist will then report to and advise the Coroner and will often give evidence at the Coroner’s Inquest.

What skills are needed to be a Histopathologist?

Histopathologists need good attention to detail for examining tissue and diagnosing disease. Many diseases look very similar, so being able to spot small differences is important.

They need to be able to work under pressure and make critical decisions every day - their interpretation of what they see under the microscope will determine what treatment patients are given.

As well as having high levels of self-motivation, Histopathologists need to be able to work alone and as part of a team. Good communications skills are essential for discussing the relevance of microscopic findings with colleagues.

Because of the type of work Histopathologists are involved in, they are often at the very forefront of ground-breaking research into many diseases such as cancer.

Pathology myths

“Pathology is all about dead bodies”

Most television pathologists are forensic pathologists, however this is not the case in the real world. Many histopathologists do not perform autopsies and those who do generally spend only a few hours per week doing them, as most of their time is spent looking at samples from living patients. Forensic pathologists make up less than 1% of pathologists - fewer than 100 people in the country.

“Pathologists don’t take care of patients”

In a recent survey, only 6% thought that pathologists looked after patients in hospital. Although not all pathologists have direct patient contact, they are all key members of the MDTs that managed the investigation and care of patients with cancer and other life threatening conditions. The vast majority of pathologists’ work is done for the benefit of living patients.

“Pathologists don’t diagnose cancer”

In a recent survey, only 29% of the public knew that pathologists diagnose cancer. In Histopathology particularly, a large part of the work involves diagnosing cancer and studying tissue to work out what sort of cancer it is and how far it has spread, so the correct treatment can be chosen.  

In fact, almost all cancers are diagnosed by Pathologists. Diagnoses may be made by testing blood, urine or other fluids or from a biopsy. Pathologists tell other doctors what type of cancer patient have got, and how far it has spread so they know what treatment to offer.

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