Η ιστολογική εξέταση ασχολείται με την εξέταση ιστικών δειγμάτων κάτω από το μικροσκόπιο. Τα δείγματα υπόκεινται σε επεξεργασία και απαιτούν μια σειρά από προπαρασκευαστικές ενέργειες για να εξεταστούν και αναλυθούν, ανάλογα με το είδος του ιστού και το είδος της εξέτασης που ζητείται.
Για την εξαγωγή διαγνωστικών συμπερασμάτων άμεσα κατά τη διάρκεια μιας χειρουργικής επέμβασης, διενεργείται «ταχεία βιοψία».
Δείγματα που ορίζονται ως μεγάλα περιλαμβάνουν ολόκληρα όργανα ή τμήματα αυτών, τα οποία αφαιρούνται με την εγχείρηση. Παραδείγματα μπορεί να αποτελούν μια μήτρα που αφαιρείται με υστεροτομία, το παχύ έντερο ύστερα από μια κολεκτομή, ή οι αμυγδαλές ύστερα από μια αμυγδαλεκτομή.
Οι ιστολογικές εξετάσεις αφορούν στους ακόλουθους τομείς:
When talking about histological examination one refers to the process of examining histological samples under the microscope. The samples are subjected to treatment and need a series of preparatory steps in order to be examined and analyzed depending on the type of tissue and the type of examination required.
Whenever there is a need for an immediate diagnosis during the performance of a surgery, a rapid biopsy is performed.
Specimens that are classified as large include entire organs or pieces thereof which have been removed during surgery. Examples can include a uterus removed with the performance of a hysterectomy, the large intestine removed with a colectomy or the tonsils removed after a tonsillectomy.
In general histological examinations can be classified under the following categories:
BREAST HISTOPATHOLOGY
A pathologist’s contribution concerning ailments that appear on the breast is found in the following actions:
- Diagnosing the ailment
- Determining whether the prognosis and subsequent treatment are commensurate
- Fine Needle Aspiration Biopsy (FNA or FNAB) for the collection and testing of individual cells from the area under examination
- Core Biopsy (the collection of a small piece of the suspect tissue). In case a tumor in the breast is found, the examination by the pathologist is going to provide the medical team with the following information which are crucial for the subsequent prognosis and treatment:
- Histological grading
- Stage of the tumor
- Existence of lymphatic infiltrates
- Appraisal of surgical margins
- Existence of metastatic spots on lymph nodes
- Appraisal of hormonal receptors existence as well as cerbB-2 receptors for anti-HER-2 treatment
- Tumors
- Cervical prolapse
- Amenorrhea (lack of menstruation)
- Dysmenorrhea (painful menstruation)
- Infertility
- Menorrhagia (large amount of blood during menstruation)
- Molar pregnancy
- Ectopic pregnancy
- Infections (fungal, bacterial or viral)
- The performance and appraisal of cervical smears (PAP tests) to detect the existence of precancerous distortions
- Cervical biopsies to detect the existence of precancerous distortions or the existence of cancer
- Performance and appraisal of endocervical or endometrium scrape tests, to check the contents of the uterine cavity in case of menstrual disruptions or in case of hyperplasias and neoplasias.
- Hysterectomies (surgical removal of the uterus)
- Ovariectomy (surgical removal of the ovaries)
- Salpingectomy (surgical removal of the fallopian tubes)
- Hyperplasia of the prostate gland (adenomatous hyperplasia)
- Chronic prostatitis
- Carcinoma of the prostate gland
- Orchitis
- Testicular and scrotum tumors
- Inflammations and tumors of the penis
- Needle prostate biopsies to determine the presence of a tumor. To assure an accurate diagnosis the biopsy material is exhausted after procuring unstained samples from it for our archive in order to be in a position to perform immunohistochemistry examinations at a later point in time if the need arises. Double or triple stains are performed to reduce costs without compromising the validity of the immunohistochemistry tests.
- Transurethral resection of the prostate (TURP). If the need arises we exhaust the collected material to achieve the most accurate and conclusive diagnosis possible.
- Testicular biopsies – azoospermia and ypospermatogenesis appraisals
- Orchiectomies
- Radical prostatectomies
- Kidney biopsies (to eliminate the existence of malignancies)
- Ureter biopsies
- Bladder biopsies
- Urethra biopsies
- Samples collected after surgery from the aforementioned organs, which, after being submitted to the necessary preparatory treatment are examined in order to determine the nature of the existing tumor and put together the definitive diagnosis upon which the urologist surgeon and the rest of the medical team responsible for the patient will base the subsequent surgical/therapeutical treatment.
- acne, vitiligo, hair loss, various scars
- rosacea, fungal infections
- systemic diseases (eg systemic lupus erythematosus)
- keratoses, warts
- warts (HPV infection)
- carcinomas of the skin
- benign skin tumors
- Melanocytic nevi (Skin moles)
- Melanoma
- Reflux – gastroesophageal reflux (GERD)
- Barrett’s esophagus
- Gastritis – infection with helicobacter pylori (helicobacter pylori)
- Idiopathic inflammatory bowel disease (crohn’s disease, ulcerative colitis)
- Microscopic colitis
- Infectious colitis / pseudomembranous colitis
- Celiac disease – malabsorption syndrome
- Diverticula – diverticulitis
- Chronic pancreatitis
- Cholecystitis – lithiasis cholecystitis
- Esophageal papillomas
- Esophageal carcinoma
- Polyps stomach, small intestine and colon
- Gastric carcinoma
- Carcinoma small & large intestine
- Anal warts
- Genital wart
- Anal carcinomas
- Benign and malignant tumors pancreas
- Benign and malignant tumors of the liver
- Infectious diseases such as tuberculosis, infectious mononucleosis
- Systemic diseases such as sarcoidosis
- Neoplastic diseases such as Hodgkin and Non-Hodgkin’s lymphomas, leukemias
- Metastasis of malignant tumor in the lymph nodes
- Acute Myelogenous Leukemia (AML)
- Myelodysplastic Syndromes (MDS)
- Myeloproliferative neoplasms (MPN)
- Chronic Myelogenous Leukemia (CML)
- Polycythemia vera (PV)
- Essential thrombocythaemia (ET)
- Chronic neutrophilic leukemia (CNL)
- Chronic Eosinophilic Leukemia (CEL) / Idiopathic Hypereosinophilic Syndrome (iHES)
- Chronic Idiopathic myelofibrosis (CIMF)
- Myeloid neoplasms associated with eosinophilia and PDGFRA rearrangements of genes, PDGFRB and FGFR1
- Acute Lymphoblastic Leukemia (ALL)
- Chronic Lymphocytic Leukemia (B-CLL)
- Multiple Myeloma (MM)
- Mantle cell lymphoma (Mantle Cell Lymphoma)
- Marginal Zone Lymphoma (Marginal zone b-cell lymphoma of malt type)
- Follicular lymphoma (Follicular Lymphoma)
- Diffuse large B-cells (Diffuse Large B-Cell Lymphoma)
- Burkitt’s lymphoma
- Anaplastic Lymphoma (Anaplastic Large Cell Lymphoma)
- Information about internal problems that lead to death which don’t make themselves apparent nor can they be recognized by an external examination of the fetus’s body.
- Important information concerning any future conception as well as any future healthcare needs that might arise in the family, are linked to the cause of death of the fetus and need to be addressed.
- Acquisition of medical knowledge that might prove useful in other similar cases.
- Examination of the surface of the ear, the throat and of the skin.
- Examination of the placenta and the umbilical cord.
- External photographs may be taken.
- A skin sample may be collected in order to test the chromosomes.