Surgical pathology is a medical specialty that involves the examination of tissues removed from living patients during surgery to aid in the diagnosis and progression of disease. For most anatomical pathologists, it is the most important and time-consuming area of practice.
Surgical pathology examines surgical specimens on a gross and microscopic level, as well as biopsies submitted by surgeons and non-surgeons such as general internists, medical subspecialists, dermatologists, and interventional radiologists. The pathologist, a medical doctor who has received specialized training in pathology, examines these tissues under a microscope and reports back to the surgeon or other physicians involved in the patient’s care.
In any case where tissue is surgically removed from a patient, surgical pathology allows for the definitive diagnosis of disease (or lack thereof). This is typically accomplished through a combination of gross (i.e., macroscopic) and histologic (i.e., microscopic) examination of the tissue, and may include evaluations of the tissue’s molecular properties via immunohistochemistry or other laboratory tests.
Here are key aspects of surgical pathology:
- Tissue Examination: The pathologist receives tissue samples, also known as specimens, from a variety of surgical procedures. Organs, tumors, and other abnormal tissues are examples of these specimens.
- Microscopic Analysis: The pathologist examines the tissues at a microscopic level for abnormalities such as cancer cells, inflammation, infections, or structural changes. This procedure aids in the accurate diagnosis.
- Diagnosis and Reporting: The pathologist writes a pathology report that includes a detailed description of the tissue’s characteristics based on the microscopic findings. The diagnosis, information about the tumor or disease, and sometimes recommendations for further testing or treatment are all included in the report.
- Cancer Staging: In cases of cancer, surgical pathology plays a crucial role in determining the stage of the disease. Cancer staging helps guide treatment decisions and provides prognostic information about the likely course of the disease.
- Frozen Section Examination: During surgery, a rapid evaluation known as a frozen section examination is performed in some cases. This technique allows for a preliminary diagnosis in minutes, which is especially useful when decisions about the extent of surgery must be made quickly.
Surgical pathology is an essential component of the multidisciplinary approach to patient care, and its findings influence treatment planning and patient outcomes significantly. It works in tandem with other diagnostic modalities, such as radiology and clinical laboratory testing, to provide a complete picture of a patient’s condition.
