Basic Diagnostic Services: Business hours of the UIMC Surgical Pathology service laboratory are 8am to 5:00 pm Monday through Friday. During these hours specimens are routinely accepted for processing and diagnosis by specimen receiving located in Room 3110. Tissue is examined and selected for processing into hematoxylin and eosin stained microscopic slides, a series of procedures that takes from 18 to 24 hours to complete. Once slides are prepared, surgical pathologists and pathology residents review the slides and construct diagnostic reports. Slide review to a final diagnosis posted in the UIMC HIS may take another 24 hours to complete. All cases are reviewed by surgical pathology faculty.
Biopsies: Small or limited tissue specimens taken for diagnosis are given priority by the service with expedited processing by surgical pathology. Biopsies are reviewed immediately as slides become available from the histology laboratory
Routine Specimens: Large or complex specimens requiring
Surgical Pathology is divided into the following:
Specimen Receiving: Tissue specimens are accessioned in the Laboratory Information System (PathNet/Cerner) and assigned identifiers. The specimens are triaged for examination and selection of tissue by specimen type.
Personnel:
Laboratory Technician
Preparatory Technicians (shared with Cytopathology)
Gross Room: The tissue specimens are examined by pathology residents, pathologists' assistants and pathology faculty. Tissue is selected for to be processed to make microscopic slides.
Personnel:
Pathologists' assistants (PA): Pathologists' assistants are physician extenders and are trained to examine tissue including special dissections. At UIMC, they oversee operations in the gross room and specimen receiving and they also instruct pathology residents in gross pathology and dissection techniques.
Surgical Pathology Fellows: Instruct Residents in gross anatomy and dissection (in collaboration with Pathologists' assistants)
Pathology Residents: Pathology residents receive instruction in gross pathology, anatomy and dissection from faculty, fellows and pathologists' assistants and under their guidance submit tissue for microscopic sections.
Histology Laboratory:
Routine Histology: Tissue for microscopic slides is chemically dehydrated and infused with paraffin by automated tissue processors. Histotechnologists manually embed the tissue to make tissue blocks. These tissue blocks are then manually sectioned using microtomes and mounted on glass slides. The glass slides are stained using an automated stainer and coverslipped using an automated coverslipper. The slides are organized and delivered to residents and faculty.
Special Stains: A variety of histochemical stains are performed using automated stainers to provide pathologists with information concerning tissue structure, cell products and non-human tissue elements (foreign bodies and organisms)
Immunohistochemistry: Immunohistochemical stains are performed on automated instruments to provide pathologists with information on tissue structure, cellular antigens, proteins indicating lines of differentiation, intracellular infections, and therapeutic targets.
Personnel:
Supervisor
Histotechnicians/Histotechnologists
Frozen Section: The surgical pathology service provides intraoperative consultation, both gross examination and if needed selection of tissue for immediate microscopic sectioning (by freezing). A member of the Surgical Pathology service will come to the operating room to obtain the tissue specimen and clinical information. Additional members of the service provide technical assistance in order to expedite the consultation process.
Surgeons in the UIMC operating room suite may call 996-3886 during regular laboratory hours to obtain an intraoperative consult.
Other procedurists must call prior to beginning a procedure to set up consultation or can walk the specimen to Surgical Pathology for immediate consultation.
Outside of regular laboratory hours, consultation may be obtained by paging the surgical pathology resident on call.
Microscope Rooms: Residents and faculty members review microscopic slides at multiheaded microscopes. These microscopes also allow students and physicians from other services to also view the microscopic slides as they are being review by pathology faculty and residents.
Pathology central office: The pathology central office houses the transcription service of surgical pathology, billing, customer service, and surgical pathology managers. This office receives all enquiries concerning the service, transcribes reports, performs intake on consultation cases, locates and distributes requested slides and reports and monitors quality assurance indicators.
Personnel:
Surgical Pathology Service Manager
Office Manager
Transcriptionist
Billing Co-ordinator
Customer Service Representative
Surgical Pathology Archives: Surgical Pathology slides and tissue blocks are kept on file. These are available for consultation. Patients may have slides sent to other institutions when patients obtain care outside of UIMC.
Faculty: Please see the faculty list. The Faculty has specialists in gastrointestinal, liver, kidney, prostate, urinary bladder, breast, skin, lung, gynecologic, oral, neural and opthomologic pathology.
Residents and Fellows:
Surgical Pathology Fellows: The surgical pathology service has two post residency fellowship positions in surgical pathology. The pathology fellows are post residency (BE/BC) pathologists who are obtaining an additional year of training in general surgical pathology. The fellows review all outside consultation cases with faculty members, provide instruction to residents in gross anatomy and dissection, participate in quality assurance and specialty sign out, and staff multiple hospital conferences.
Pathology residents PGY1-4 participate on the service in the gross room, intraoperative consultation (frozen section and interventional radiology) and case sign out.
Conference Room: There are daily conferences for the residents in pathology. These include didactic sessions on selected topics and working conferences (consensus conference). The conference room has video links to other hospitals with UI pathology residents.
