Histo and Cytopathology

The primary role of Anatomical Pathology is to identify morphological and molecular abnormalities that can help to diagnose disease and manage treatment.

Histopathology

Histopathology focuses on the structural changes that occur in cells, tissues and organs when exposed to injurious stimuli. It is also intimately involved in the diagnosis of tumours and in determining their biological behaviour i.e. distinguishing benign from malignant (cancer).

Histopathology is based on a thorough macroscopical evaluation of the submitted specimen followed by routine microscopical examination of selected tissue sections. Routine haematoxylin and eosin (H&e) stains are performed on all tissue sections and special stains are performed if indicated.

In certain cases the histopathologist has to resort to more advanced ancillary diagnostic methods. These may include immunohistochemistry, immunofluorescence, electronmicroscopy or molecular testing. In cases where an urgent diagnosis is required, for example when the surgeon excises a suspicious breast lump, a frozen section may be performed in theatre.

Histotechnicians and -technologists are the laboratory professionals responsible for the processing of the specimens and preparing the stained sections onto microscope slides to be examined by the histopathologists.

PathCare places a premium on rendering an all-inclusive comprehensive histopathology service throughout South Africa.  The practice employs more than 40 permanent histopathologists in total, many with a special field of interest, for example dermatopathology, nephropathology, gastro-intestinal pathology, breast pathology, uropathology, lymphomatous neoplasms, etc.

In addition, sessional academic medical professionals (including oral pathologists, neuropathologists and dermatopathologists) assist with difficult cases on a part time basis.

The availability of multi-headed microscopes in the major centers make inter-collegial referrals and consequently optimal diagnostic pathology a major cornerstone of this department.  We can therefore compete with most international centers.

In addition PathCare uses a digital imaging facility to enable remote analysis of inter alia immunohistochemistry stains and also off-site consultations in difficult cases. We also offer

Cytopathology

Cytopathology is the study of individual cells, aspirated or obtained from body fluids or tissues, including exfoliative cytology, to detect abnormalities.  A well-known application of cytopathology is the Pap smear, used as a screening tool, to detect precancerous cervical lesions and prevent cervical cancer.

Histopathologists are also trained cytopathologists and report on gynaecological and non-gynaecological cytology cases. The histopathologists are assisted by trained cytotechnologists and -technicians who perform the primary screening of the cytology cases.

We offer a comprehensive range of cytology tests, including both non–gynaecological cytology and gynaecological cytology (liquid based and conventional cytology)

1.  Non–gynaecological cytology specimens

• Cytology of material obtained by fine needle aspiration (FNA), scrapings, etc.
• The examination of fine needle aspirates in theatre, as well as aspirations performed under radiological guidance.
• Cytology of fluids such as bronchial smears / brushings and washings, gastrointestinal brushings, sputum, urine, CSF etc.

2. Gynaecological Cytology

Gynaecological cytology (LBC and conventional cytology), together with HPV testing to identify high-risk HPV types, form the basis of PathCare cervical screening product.

PathCare uses the Bethesda 2014 system for the reporting of gynaecological cytology.