BIOPSY AND POST MORTEM EXAMINATION Flashcards
Pathology is divided into two major areas:
Clinical Pathology
Anatomical Pathology
Histopathology
CFITS
Cytology
Frozen Biopsy
Immunohistochemistry/ Immune staining
Tissue Processing
Special Staining
The study of tissues affected by disease
Useful in making a diagnosis and in determining the severity and progress of a condition
HISTOPATHOLOGY
Includes all activities done in the laboratory in order to produce a suitable specimen slide for viewing by the pathologist
HISTOPATHOLOGIC TECHNIQUES
PROFESSIONALS UNDER HISTOPATHOLOGY
Pathologist
Associate Pathologist
Histotechnologist/Histotechnician
(Head of the Laboratory)
Pathologist
Sections large and hollow organs to allow fixation down to mounting
Examines the tissue sections, cytologic slides under the microscope
Pathologist
o Monitor staff performance
o Pinpoint problematic situations and find solutions
Associate Pathologist
Assists the pathologists by providing spx slides that are properly labeled, processed, stained, and mounted
Histotechnologist/Histotechnician
o Ensures high quality conditions of equipment, formalin, and other chemicals and reagents
o Analyze problems and corrects them
Histotechnologist/Histotechnician
Work systematically to minimize error
Histotech
QUALITY IN HISTOPATHOLOGY LABORATORY
Quality Assurance
Quality Management Systems
• Ensuring that everything is right (test time, specimen, patient, diagnosis and price)
Quality Assurance
• Set of coordinated activities to regulate a lab in order to continually improve its performance
Quality Management Systems
Considers pre-analytic, analytic, and post-analytic phase
Quality Management Systems
•
From receiving to specimen accessioning down to mounting
•
Actual reading of the slides
•
Releasing of results
Pre-analytic
Analytic
Post-analytic
Documents
RRAP
Request forms
Reports
Accession Logbooks
Preventive Maintenance
Types of results
• Surgical Pathology
• Cytopathology
• Autopsy Report
TAT Surgical Pathology and Cytology =
2 days
TAT
Frozen Sections =
5-15 minutes
TAT
Autopsy Report =
7 days
Reports
Patient report
Telephone report
Preliminary report
Final report
Incident report
Post mortem examination
Autopsy
Ante mortem examination
Biopsy
Autopsia Cadaverum
Autopsy
Biopsy
“____” - life;
“___” - to see
Bio
Opsia
AUTOPSY
• AKA “
Necropsy
Post-Mortem
Thanatopsy
Purposes of autopsy
• Determine the cause of death and extent of injury
• Uncovering existence of an undetected disease
Types of Autopsy according to:
Purpose
Completeness
Manner of incision
Types of Autopsy according to:
(n)
• Purpose
Medical/ Hospital
Medico-legal
Types of autopsy acc to
COMPLETENESS
Partial
Complete
Types of autopsy acc to incision
Y-shaped
Straight cut
DISSECTION/EVISCERATION TECHNIQUES
GHON
ROKITANSKY
LETULLE
VIRCHOW
One by one removal of organs
Most widely used
VIRCHOW
“In situ” (in place) dissection, followed by en bloc removal
Rokitansky
“En bloc” removal
Organs of same group/activity/region are removed at the same time
Ghon
“En masse” removal of organs
All organs are removed at the same, then dissected by blocks
Letulle
Prerequisites:
•Written or informed consent from the legal next-of-kin
• Medical abstract or clinical data
• Autopsy Request (suspicious evidence of foul play)
Personnel
CPD
Coroner
Prosector
Diener
A public official who is empowered to order an inquest into the manner or cause of death
Coroner
• Pathologist who performs the dissection
Prosector
Comes from the German word
“leichendiener” meaning “servant of the dead”
Diener
Diener
Comes from the German word
“_____” meaning “servant of the dead”
leichendiener
Assists during an autopsy, and assumes many and varied responsibilities in the autopsy laboratory
Diener
(____= before;____ = death)
ante
mortem
TYPES OF BIOPSY
Fine needle aspiration
Core needle
Incisional
Excisional
Punch
Shave
Curettage
• Simplest, least invasive
Minor type of getting tissue sections
• Uses very thin needle attached to a syringe to take out a small amount of fluid and tissue from area
Fine needle aspiration
• Uses slightly larger needle
Core needle
Remove small column of tissue
(1/16 inch in diameter, (½ inch long)
Core needle
• Surgical
• Small part of a large lesion or tumor is taken
Incisional
• Surgical
• Entire affected area is taken
Excisional
• For skin
Uses circular blade to obtain deeper skin sample that removes a short cylindrical core of tissue (“apple core”)
Punch
• For skin
• Small fragments of outer layers of skin are “shaved” or scraped
Shave
• Tissues are removed from body cavity (or canals) using a currette
Curettage
Methods of Examination
Fresh
Fixed
What are the processes which are performed in histopathologic techniques
Tissue processing
Cytology
Frozen biopsy
Immunohistochemistry
Special staining
What phase is the tissue processing
Pre analytic
Autopsy comes from the GREEK word
Autopsia Cadaverum
Ms. Rose kay nag somatic death na. Unsa man ang type of examination of tissue?
AUTOPSY
Malamang…
Who submits the autopsy request?
Coroner
Bone marrow aspiration utilizes
Core needle biopsy
Asa gina obtain and bone marrow aspirate?
Iliac crest of hip bone
Fresh tissue examination
Teasing
Crushing/ Squashing
Frozen section
Smear preparation
Smear preparation
Streaking
Spreading
Pull-apart
Touch preparation
Fixed tissue examination
Fixation
Decalcification
Dehydration
Clearing
Infiltration
Embedding
Blocking
Trimming
Sectioning
Staining
Mounting
Labelling
Microscopic examination
Bone marrow aspirate examination is done through
Pull-apart
Is the tissue in frozen sections fresh??
Yuh
Requested during intra-operative procedures to help the surgeon in choosing his next plan of action
Frozen sections
Fresh tissues are frozen using a cryostat or freezing microtome
● Can use two types of microtome
● When using these types, the temperature inside
should be maintained…
(-10 to -30 degree Celsius)
Which has better quality slides?
Fresh or Fixed?
Fixed
Which histopathologic examination is faster? Fixed or Fresh?
Fresh
