What Patients Need to Know
What every patient needs to know about pathology
Very little is known about pathology and various misconceptions have arisen about this service.
We have analysed the situation and arrived at the perfect diagnosis - to inform you about the complex and comprehensive workings of the pathology laboratory.
The Pathology laboratory
After listening to a patient's complaints and performing a thorough physical examination, a doctor will diagnose the disease, institute the most appropriate therapy and thereafter monitor the results.
He might need the back up of additional tests such as laboratory investigations, which enable him to diagnose, detect, or exclude disease more reliably.
Prudent use of the pathology laboratory by the clinical team is essential to improve diagnostic ability, thus reducing the period of illness by the efficient institution of the most appropriate therapy.
In order to achieve this goal, specimens must be transported rapidly to the laboratory for accurate analysis by the pathologist and a team of highly trained medical technologists.
Large numbers of specimens are processed daily. Correct specimen identification and handling is critical. Elaborate procedures designed to minimize the possibility of human error have been set up. Sophisticated, analytical equipment, linked to advanced computer systems, is used in the analysis of specimens.
Quality assurance is considered a priority and so both local and international quality control programs are adhered to. The modern pathology laboratory is equipped with state-of-the-art technology and is run by highly trained people.
The comprehensive pathology laboratory encompasses four disciplines.
More than 120 different tests, profiles and screening panels can be performed. A variety of chemical components, proteins and hormones present in blood and other body fluids, found normally or in diseased states, are measured.
Chemical profiles and screening panels are specifically designed to detect susceptibility to kidney disease, liver disease, diabetes, and iron deficiency and thyroid dysfunctions amongst others.
Abnormal results lead to more definitive testing after consultation between the referring doctor and the pathologist. Many chemistry tests are particularly useful in monitoring the course of a disease and the effect of the chosen therapy.
The toxicology section detects and monitors the level of drugs or poisons in specimens. Blood levels are monitored in industrial employees exposed to toxic compounds, such as lead. Similarly, blood levels of therapeutic agents, such as anticonvulsants taken by epileptics, require monitoring.
Haematology: the study of blood disease
The most commonly performed test in the laboratory is the counting and categorizing of blood cells (known as the full blood count).
Complex machines are used for this and the blood slides are examined microscopically. This is often the first-line screening test for disease or to detect specific conditions such as anaemia or leukaemia.
Te pathologist often consults with the referring doctor, suggesting further tests, if indicated. The clotting ability of the blood is also evaluated in patients with abnormal bleeding or bruising to detect the possible causes.
Microbiology and Serology: the study of infectious diseases.
Microbiology is primarily engaged in the testing of patient specimens (e.g. urine, pus and sputum) for the presence of micro-organisms (germs).
Micro-organisms are cultured in patient specimens, so that the germ causing the infection may be identified and its sensitivity to antibiotics determined. This allows for the early administration of the most appropriate antibiotic, thus reducing the periods of illness.
Serology implies the screening of patient serum for antibodies produced by the body in defence of germs, such as the viruses causing AIDS, German measles and hepatitis, which are not easily cultured.
Anatomical Pathology
Histology is the study of diseased tissue.
This department is mainly employed in the analysis of tissue and organs from the operating theatre. Extremely thin sections of tissue are stained and consequently examined microscopically by the pathologist.
Specific reaction patterns are described for certain causative agents such as tuberculosis. Malignancies (cancerous growths) are assessed for completeness of removal and to assist in determining the prognosis (long-term outlook).
The frozen section biopsy technique is used intra-operatively to instruct the surgeon on the most appropriate therapy for a particular tumour, in many cases doing away with subsequent surgery and extra expense.
Cytology: the study of exfoliated cells
Superficial cells derived from various sites (e.g. cervix in a PAP smear) are examined for microscopic abnormalities. Early detection of potential malignancies favours the possibility of cure by timely therapy.
