Specialist services | Pathology
Pathology
Pathology is the study of diseases and the area most concerned with the diagnosis and study of tumours, both benign (not a cancer) and cancerous, is histopathology.
Histopathology at Barts and The London
At Barts and the London NHS Trust, histopathology is a large department that provides a diagnostic service of both histology and cytology to our own hospitals and also to the Homerton and Newham hospital trusts. We look at over 40,000 different samples in histology and over 70,000 in cytology each year. The department has over a hundred staff including biomedical scientists and pathologists. We employ over twenty consultant pathologists, each fully qualified Fellows of the Royal College of Pathologists, and within these we have three who specialise in gynaecological pathology and tumours, Doctors Naveena Singh, Asma Faruqi and Purnima Makhija.
What do we look at and how do we do it?
The tissue samples we look at might be tiny biopsies removed for the purpose of obtaining a diagnosis or they might be larger samples, even whole organs removed during operations such as hysterectomies (the womb).
The pathologists first examine by eye and sample these tissues looking for visually abnormal areas. The tissues are then processed by qualified biomedical scientists. All fluid needs to be removed and replaced with wax so that extremely thin slices can be cut and mounted on glass slides. These slices are inherently colourless so our biomedical scientists colour them using a range of techniques to reveal the different cells within the samples. The slides are then viewed by our consultant pathologists using microscopes. The pathologists may then be able to make a first diagnosis in the case of biopsies. If a tumour is present they may be able to tell its nature and if it has spread. Many tumours turn out to be simple and benign, such as intrauterine fibroids, however diagnosis is not always easy and so histopathology uses a number of sophisticated techniques to obtain further information about your tissue samples. This is important in deciding the clinical course of treatment to be followed.
This all takes time, particularly if these more sophisticated techniques are needed. Histology takes at least two days for the smallest biopsies and longer for larger samples; most however are completed within a week.
What do we do with our results?
Our pathologists produce a histopathology report that is sent to the requesting clinician as soon as it is finished. However, the most up to date method of looking at pathology results is to do so in a holistic way in collaboration with everybody concerned with your care at a multi-disciplinary meeting. The information obtained from slides enables our Pathologists to meet weekly with the other members of the clinical team treating you and discuss all aspects of each case. These meetings play a vital role in the diagnosis, staging and management of gynaecological tumours and are essential in ensuring that your samples get the best consideration and that you get the best and most up to date treatment.
What do we do with your tissues?
Once your treatment has been decided our work is not finished. We hope to collect as many different cases as we can so that we can compare different tumours.
Cancer is not one condition, there are hundreds of different tumours and each may look different and behave differently. Later we can look at how successful treatments have been and we can compare how various tumours react to them. When you gave consent for your operation you may remember having been asked if you minded your sample being used for research and this is what is meant. Such comparative clinical research is what improves treatments and this has contributed greatly to improved survival rates and cures from cancer.
Should you not wish your samples to be used in these studies, this is respected. We still retain your samples however, stored safely and confidentially in our archives so that they might be looked at again if your disease recurs or if you are unfortunate enough to suffer other diseases or should you go to another hospital and they need to examine your tissue to ensure continuity of treatment.
For further details about our use of tissue samples, please click here to read our leaflets (available in English, Bengali, Turkish, Chinese and Somali) please visit the Human Tissue Resource Centre on Barts and The London's main website.
Contact details:
Pathology and Pharmacy Building
Barts and The London NHS Trust
80 Newark Street
London E1 2ES
