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Chapter-06 Principles of Pathology

BOOK TITLE: Surgical Oncology: Fundamentals, Evidence-based Approaches and New Technology

Author
1. Neimeier Leo A
2. Davison Jon M
ISBN
9789350250518
DOI
10.5005/jp/books/11193_5
Edition
1/e
Publishing Year
2011
Pages
10
Author Affiliations
1. University of Pittsburgh Medical Center, USA
2. University of Pittsburgh, USA
Chapter keywords

Abstract

Surgical pathology is the art and science of establishing a diagnosis through the evaluation of human tissue samples. This chapter will introduce the general approach surgical pathologists use in order to arrive at a diagnosis. It will also attempt to introduce some of the ancillary testing methods which are increasingly germane to this process. It is hoped that carefully chosen examples will illustrate these general principles. The final pathology report for a surgical specimen incorporates many elements, including a final diagnosis, a gross description, a microscopic description and results of ancillary testing as well as other data. Typical immunohistochemical markers used to identify common (mostly epithelial) neoplasms in the head/neck, thoracic cavity, gastrointestinal tract and genitourinary tract. Immunohistochemical markers are always interpreted in the context of a specific clinical and pathologic differential diagnosis. Few markers are truly specific to a given neoplasm. In this table, + means most frequently positive; +/- means approximately 50% are positive; – means most frequently negative. The clinical role of the surgical pathologist is that of a consultant. From the initial evaluation of a cytology specimen or biopsy to evaluation of intraoperative frozen sections and final characterization and pathologic staging of a resected neoplasm, the pathologist aids the surgical oncologist, medical oncologist and radiation oncologist among others in making optimal management decisions. Pathologists have always made use of available technology to gain insight into the nature of a pathologic process and provide the most useful information to guide patient care decisions. The light microscope, formalin, paraffin, hematoxylin and eosin are the tried and true technological mainstays of the practice of surgical pathology. This will likely remain so for the foreseeable future given the depth of insight, speed and relative low cost associated with these traditional methods. Increasingly, however, pathologists are asked to bring a wider and wider array of technology to bear on the classification of human neoplasia as targeted therapies become more commonplace and insights into the biology of human neoplasia are translated into novel therapies.

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