What is histopathology?
The branch of pathology which deals with tissues and cells, that helps in diagnosis and study of diseases. In this sub speciality biopsies, surgical resections and cytology samples are used. A pathologist specialized in this field is called a Histopathologist.
What are the main areas in Histopathology , the samples taken and how they are taken?
In Cytology a single cell is examined usually found in fluid specimens like aspiration of tissues and tissue fluids, and are mainly used in diagnosing cancer. Cytology is also helpful in screening for fetal abnormalities, pap smears, diagnosing infectious organisms, and other screening and diagnostic areas.
The specimens for cytology are taken as;
Scraping or brushing the tissue surface
Other types of tissue incisional or excisional biopsy
In histology surgical resection biopsies and direct biopsies are examined, after preparing under frozen section and different staining techniques like hematoxylin and eosin, safranin, Oil Red O, congo red, silver salts and artificial dyes.
History of the Histopathology department of NHSL
The history of pathology is as old and as rich as any other field in medicine. From the ancient Middle East and the era of Dr Rudolf Virchow, the â€œfather of cellular pathologyâ€ to the present times it encompasses basic principles which are still true today and the most innovative medical advances that are used to diagnose and guide management of patients.
The history of pathology in Sri Lanka dates back to 1870, when the Colombo Medical School which is the second oldest medical school in South Asia was established, and recognizing its importance in the practice of medicine diagnosing and managing patients, Pathology was one of the first subjects taught in the medical curriculum in Sri Lanka, by Dr James Loose, the first principal.
The first Sri Lankan Professor of Pathology, Prof W A E Karunaratne (1936 to1953) was the pioneer in coordinating pathological services between the laboratory and the hospital and also served as the head of Pathology of the Colombo General Hospital, as it was then known. He was succeeded by Dr G S W De Saram in 1940, followed by Dr W D Ranawale in 1954 and Dr Doris Peiris in 1964. In the late 1970s, with the development of the fields of chemical pathology and bacteriology, Dr A B V Perera and Dr Meena Mahendran were appointed in charge of the two fields, respectively. This was followed by vast improvements in laboratory services and currently the Department of Pathology of NHSL consists of four laboratories, namely, Histopatholgy, Haematology, Chemical Pathology and Microbiology.
Following the retirement of Dr Doris Peiris in 1983, Dr H R Wickremasinghe and Dr Chitrika de Silva were appointed to the General Hospital Colombo as Consultant Histopathologists in 1983 and 1984, respectively. They were followed by Dr A Ileperuma and Dr Ruchira Fernando. The National Hospital of Sri Lanka currently obtains the services of three histopathologists, Dr Janakie Fernando (Head of Department), Dr Ananthie Samarasekera and Dr Karuna Dissanayake.
The histopathology laboratory of the Colombo General Hospital had humble beginnings when all procedures were done manually and with the basic stains. Gradually special histochemical staining was initiated to facilitate diagnosis and reporting. The laboratory continued to grow under the leadership of its dedicated heads and consultants over the years, and today the Histopathology laboratory of the National Hospital houses automated tissue processors, an autostainer and provides facilities for frozen sections. Immunohistochemical staining was started in 1998 and was gradually developed over the years. Currently the NHSL immunohistochemistry laboratory provides islandwide services. The very recent acquisition of an automated immunostainer will expedite these services and aims to give a better and faster service.
The histopathology laboratory of NHSL currently provides clinical training facilities to the medical students of the Faculty of Medicine, University of Colombo and the General Sir John Kotelawala Defense University. It has been one of the main training centers of postgraduate trainees in histopathology since the establishment of the postgraduate Institute of Medicine in 1974. The services of the laboratory are carried out by a dedicated staff consisting of the postgraduate trainees of the Colombo cluster, five medical officers, eleven medical laboratory technologists and other support staff. The laboratory handles around 12000 histological samples and over 8000 cytological samples per annum.
One of the main future goals for the NHSL Histopathology laboratory is the introduction of new tests that will bring our diagnostics parallel to the rest of the world and the available evidence to give better therapeutic options for our patients. These include establishment of immunoflourescence and in situ hybridization (ISH) techniques FISH, CISH, SISH and dual colour ISH for detection of amplification, gene rearrangements and mutations which will aid in providing targeted therapy in conditions such as colorectal, lung and breast carcinomas, gastrointestinal stromal tumours and lymphomas. Electron microscopy is also unavailable and will provide us with valuable information in diagnosis.
Another goal is to establish the NHSL Histopathology laboratory as a referral centre for the country with all facilities for diagnosis, training and opportunities for sub specialization.
Upgrading the post mortem rooms to the standards of a modern theatre with observation facilities is a much needed aspect for both academic and training purposes and this will improve our knowledge and research opportunities vastly.
All these goals will be feasible only with the much needed development of the infrastructure of the laboratory. With the plans to introduce new testing methods the laboratory will need a much larger space than what is currently available. The field of histopathology deals with a number of chemicals, including hazardous ones and proper storage of these as well as the safety of the staff must always be ensured. With the ever increasing number of surgical procedures being performed our storage space for specimens and slides need to increase as well. Improved grossing stations with facilities for taking photographs and radiographs is much needed. Establishment of an IT unit will aid to store macroscopic and microscopic images for future reference and these can also be provided to the clinicians and even patients together with the reports when necessary. Linking the histopathology laboratory to the theatres and wards will improve data correlation, communication and reporting vastly.
With all these improvements, validation of our procedures and obtaining accreditation is of great importance. Although the process of accreditations is time consuming and tedious, it has become an absolute necessity to move with the rest of the world in the ever evolving field of histopathology.
83519 tests were done in 2013
How to get the srvice of Histopathology department of NHSL
Through Referrals and By Appointments