What a Medical Student What a Medical Student

Should Know About Surgical Should Know About Surgical

Pathology Pathology
Jose Ma. C. Avila, M.D. Jose Ma. C. Avila, M.D.
Medical Center Manila Medical Center Manila
What is Surgical Pathology? What is Surgical Pathology?
Surgical Pathology is the.. Surgical Pathology is the..
Pathology specialties: Pathology specialties:
Anatomic Pathology Anatomic Pathology
Clinical Pathology Clinical Pathology
Scope of Surgical Pathology Scope of Surgical Pathology
Routine tissue biopsies, excisions, Routine tissue biopsies, excisions,
operative procedures operative procedures
Frozen section diagnosis (rapid) Frozen section diagnosis (rapid)
Cytology Cytology
Effusions, exudations, other body fluids Effusions, exudations, other body fluids
FNAB (palpable, CTguided, UTSguided) FNAB (palpable, CTguided, UTSguided)
Special Procedures Special Procedures
mmunohistochemistry: ERA, PRN, Her2Neu, mmunohistochemistry: ERA, PRN, Her2Neu,
other other
Histochemistry: Giemsa Histochemistry: Giemsa
Surgical Pathology in MCM Surgical Pathology in MCM
Tissue processing (routine) Tissue processing (routine)
Special immunohistochemistry (ERA, Special immunohistochemistry (ERA,
PRN, C PRN, C- -ERB ERB- -2, CYTOKERATN, EMA) 2, CYTOKERATN, EMA)
Frozen section diagnosis Frozen section diagnosis
Routine cytology (smears, cell block) Routine cytology (smears, cell block)
Giemsa for H. pylori demonstration Giemsa for H. pylori demonstration
Bone marrow core biopsy decalcification Bone marrow core biopsy decalcification
What is my role as a medical What is my role as a medical
intern? intern?
Labelling Labelling
Fixation Fixation
Clinicopathologic correlation Clinicopathologic correlation
Communication Communication
Fixation of Specimens Fixation of Specimens
Crucial step Crucial step
10% formalin 10% formalin
95% ethyl alcohol 95% ethyl alcohol
No fixation if for frozen section No fixation if for frozen section
Fillling up the Request Form Fillling up the Request Form
Full name and age/sex of patient Full name and age/sex of patient
Organ submitted and side if appropriate Organ submitted and side if appropriate
Type of procedure done Type of procedure done
Pertinent Clinical Data and Diagnosis Pertinent Clinical Data and Diagnosis
Other things expected to be resolved by Other things expected to be resolved by
the pathologist the pathologist
For requests outside MCM For requests outside MCM
Paraffin blocks needed with slides Paraffin blocks needed with slides
Best block with tumor chosen Best block with tumor chosen
No completion procedures please! Tumor No completion procedures please! Tumor
may not be there. may not be there.
Decalcification Decalcification
Acid used (nitric) Acid used (nitric)
Core marrow biopsy or bony hard Core marrow biopsy or bony hard
specimens specimens
May take days or even weeks depending May take days or even weeks depending
on the hardness of the specimen on the hardness of the specimen
H. Pylori demonstration H. Pylori demonstration
in gastric biopsies in gastric biopsies
Cytology preparation Cytology preparation
Equal volume of 95% ethyl alcohol for Equal volume of 95% ethyl alcohol for
body fluids body fluids
mmediate fixation for Pap smear (wet mmediate fixation for Pap smear (wet
fixation) and FNAB slides fixation) and FNAB slides
Difficult cases Difficult cases
Specialty consultation Specialty consultation
Deeper cuts or Thinner Cuts or even Deeper cuts or Thinner Cuts or even
Recuts Recuts
Pathologists are not machines reading Pathologists are not machines reading
your slides and referrals your slides and referrals
Poor preparation or scanty material may Poor preparation or scanty material may
be responsible for difficulties in diagnosis be responsible for difficulties in diagnosis
Clinicopathologic correlation Clinicopathologic correlation