Unveiling Anatomic Pathology: A Comprehensive Guide to Diagnosis - Essay Sample

Introduction

Anatomic pathology is a specialty in the medical field that deals with the diagnosis of illnesses based on the immunologic, microscopic, macroscopic, and biochemical examination of tissues and organs (Park et al. 2012). It is one of the two branches of pathology, the other being clinical pathology, which relies on laboratory evaluation and assessment of bodily tissues and fluids to diagnose a disease. Pathologists can conduct both clinical and anatomical pathology through a process referred to as the general pathology. Anatomic pathology is associated with the diagnosis, examination, and processing of surgical apparatus by trained physicians. The difference between anatomical and clinical pathology is defined by the processes entailed in each. For instance, the clinical approach processes are more familiar to the general public as they include coagulation studies, glucose level determination, and blood cell counts (Park et al. 2012). On the other hand, anatomic pathology has a unique approach that is not common to many. It is divided into subspecialties, including cytopathology, hematopathology, surgical pathology, and neuropathology.

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Cytopathology

Cytopathology is the application of diagnostic approaches that assess the cells obtained from the organs to determine the state, nature, and cause of a disease. Undertaking this process requires the physician to gather cell samples through routine diagnostic tests. These tests include cystoscopy, and bronchoscopy, and other individual tests such as Papanicolaou (Park et al. 2012). After the tests, there is an analysis of the cell samples. This process is often rapid and must be performed by a specialist with experience. Such necessity must be observed to ensure that the cells that are a potential danger to the body are identified correctly. The infectious cells include cancerous and pre-cancerous cells.

Hematopathology

Hematopathology is a specialty in anatomic pathology that is concerned with the disorder found in blood cells. It analyses the production of the cells and the organs and tissues involved. Hematopathology is used to treat and diagnose various diseases, including lymphoma and leukemia (Park et al. 2012).

Surgical Pathology

Surgical pathology is the study of body organs and tissues extracted from the patients during surgical processes to help with the diagnosis process and treatment. A pathologist must provide consultative explanations with regards to the variety of organs involved in this medical subspecialty. For instance, when performing cancer surgery, the surgical pathologist is obliged to provide diagnostic aspects of the tissues removed (Serrano et al. 2010). If its breast cancer, the Surgeon can give a reason for removing lymph nodes under the arms of the patients.

Neuropathology

According to Serrano et al. (2010), neuropathology is the specialty that is concerned with the nervous system, including the spinal cord, brain, and the extensive nerve network of the body. The diseases that affect the nervous system portrays various symptoms that the pathologist must observe in neuropathology. These signs include pain, weakness, vision loss, seizures, and challenges with behavior and thinking. A neuropathologist is tasked to examine the organs and tissues to determine abnormal tissues and tumors. The neurologists also analyze the nerve tissue samples that are taken from different parts of the body.

The ideologies of the subspecialties of the anatomic pathology are applied in various stages, some with similar names as the subspecialties. These stages include autopsy care center, anatomic records, cytopathology, and histopathology.

Autopsy Care Center

This phase is also referred to as Decedent Care Center (DCC). It provides professional and compassionate support to the hospital staff and families after the death of a patient (Serrano et al. 2010). Doing this facilitates tissue, organ donation, family visits, and the release of the deceased to funeral homes. The autopsy services are to provide patient-centered medical assistance for the benefit of the hospital staff and families.

Anatomic Records

This phase assists with report transcription, distribution, and overall preparation. It also aids in the filing of final autopsy reports, and surgical pathology. The importance of anatomic records is to create a comprehensive oversight for all the organ and tissue requests for the information and materials required by the physician (Serrano et al. 2010).

Histopathology

In this stage, a routine surgical tissue processing is conducted as shown in the image below.

(Mrak et al. 2018)

In the image, the house staff is performing tissue processing. Additionally, there is the application of microtomy, the embedding of the tissues, and cytochemical staining in the laboratory (Mrak et al. 2018). Microtomy is the process of supporting nerve, brain, and muscle specimens through the diagnosis of various disorders.

An anatomic pathologist has the role of determining the precise type and stage of cancer that an individual has. In the modern world, cancer care has become more personalized. Therefore, it is critical to obtain a biopsy sample that will be enough for both diagnosis and genetic material analysis (Lohr et al. 2014). A biopsy refers to a small section of a tissue removed primarily for review to make a definitive diagnosis. The anatomical pathologist will then analyze the morphology of the cells under a microscope. The study is followed by determining whether the tissue was malignant(cancerous) or benign (non-cancerous). In a case where the tissue analyzed by the pathologist is cancerous, other tests are run to show additional characteristics of cancer and whether there is a likelihood that it will spread to the different parts of the body. A report is then made, which describes in detail the pathologist's diagnosis based on the results of the tissue analysis (Lohr et al. 2014). If the pathologist diagnoses cancer, the report is made to include specific information on the characteristics of the cancerous cells. This particular information will aid the doctor in recommending the best course of treatment to be undertaken.

With the emergence of newer technologies, anatomic pathologists have been able to apply the concept of genomic sequencing, which has dramatically improved the diagnosis of disease. Cancer is a genetic disease caused by mistakes in how the body's genes are used, which in the long-term lead to changes in growth and division of cells. The modern genomic sequencing has enabled further classification of cancers and the identification of specific proteins, genes, and genetic mutations that speed up the growth of tumors (Lohr et al. 2014).

Also, genomic sequencing has lowered the cost and the period for analyzing genetic material in tissues. The genome sequencing test is called MSK-IMPACT (Memorial Sloan Kettering- Integrated Mutation Profiling of Actionable Cancer Targets) and was developed by experts at MSK (Lohr et al. 2014). Similarly, another new technique, flow cytometry, identifies specific antigens or molecules expressed by cancerous cells on their surfaces. Different cancers express different surface antigens. In this case, flow cytometry uses lasers to detect fluorescent tags that attach to antibodies that bind them. With the results obtained through genomic sequencing and flow cytometry, it is easy to treat individual patients with the available therapies or clinical trials.

In the field of research, anatomic pathologists have contributed immensely to disease diagnosis. Sometimes, all tests carried out by other pathologists may fail to yield a diagnosis. Therefore, it is paramount to seek out alternatives. Samples of tissue biopsy are collected and taken to research laboratories. In these research facilities, a thorough analysis of the samples is done using very advanced technologies available only in research settings until a result is gotten (RodriguezCanales et al. 2011). The results are then reported to the hospital where the test was requested. The research laboratory goes on further to indicate to other hospitals in a case similar tests were done before, and patients were misdiagnosed. (RodriguezCanales et al. 2011) Similarly, the report may be shared in committee meetings, seminars, or conferences, which prompts patient cases to be reviewed.

Furthermore, anatomic pathology has played a significant role in the evaluation of surgical samples. As the most significant area of study for most anatomical pathologists, surgical pathology involves both microscopic and gross examination of specimens from surgeries as well as biopsy materials submitted by surgeons and non-surgeons (Rosai, 2011). The interpretation of biopsy material by an anatomical pathologist is critical in determining a malignant or benign tumor's diagnosis. Results from a biopsy analysis can also differentiate the types and grades of cancer in addition to assessing the behavior of specific molecular pathways in the tumor. The biopsies collected can also be used to diagnose other diseases, including infectious, inflammatory, and idiopathic diseases affecting the gastrointestinal tract and the skin (Rosai, 2011). On the other hand, the surgical resection specimen is obtained when the diagnosis of a disease is already known or when strongly suspected. The procedure involves surgical removal of organs or an entire diseased area.

Anatomic Pathology and Patient Safety

Various studies have investigated the level of errors in anatomic pathology that might jeopardize patient safety. It has been shown that optimizing the work process can limit the frequency of dangers and mistakes associated with pathological processes. Additionally, there are measures placed by the Institute of Medicine (IOM) that physicians must observe during the operations. These regulations include efficiency, timeliness, patient-centeredness, equity, and effectiveness (Condel et al. 2004).

However, for anatomic pathology to be performed effectively, various steps must be incorporated. There are individual operations undertaken during the pre-analytic-phase. Through these processes, the anatomic pathology laboratory is the center factor as it provides the room to conduct all the activities. Such a state creates a place for various errors to occur during surgical processes. A diagnostic error can occur if there is a failure in single or multiple steps in the tests performed. For instance, an error may be made when a wrong procurement approach is applied, leading to an inadequate sample. Besides, a specimen can be lost during transit. To prevent such mistakes from occurring, it is crucial to develop a team approach through the collaboration of the laboratory personnel and clinical practitioners (Condel et al. 2004). The staff's collective involvement will improve the activities as there are a latent of factors that could lead to an error.

Conclusion

In conclusion, anatomic pathology plays a vital role in the diagnosis of human diseases. An excellent example of such a condition is cancer. Pathologists have adopted the new techniques such as modern genomic sequencing to accurately diagnose the type of cancer affecting an individual as well as the stage of the disease. With the results obtained from anatomical pathology labs, doctors have been able to recommend the proper treatment for the affected sick patients. In the new management strategy, which applies individualized and targeted therapy, anatomic pathology plays a central role in the initial diagnostics process. This new management strategy has been successful in saving many lives since not all people respond well to specific therapies. However, the role of anato...