Pathology

Pathology Lab consists of well trained pathologists to conduct high end tests required for diagnosis and pin point detection of cancer.

Services and Facilities :

Frozen Section Services:

The frozen section service is one of the most active services provided with purpose of assessment of margins while the surgeons are operating. The sections are reported by senior histopathologists in 10-20 minutes (Depending on diagnosis or/and status of margins) Strict adherence to optimum turn around times, periodic quality checks with final histopathology and external validation are done periodically.

Fine needle aspiration cytology:

FNA fulfills the need for rapid turn around time of diagnosis in cancer and non neoplastic lesions. FNAC’s are performed by cytopathologists and adequacy is ascertained immediately limiting the need for repeat visits by the patient for adequacy related issues. Exfoliative cytology (gynaec & nongynaec )samples are received in large numbers and reported by trained cytopathologists.

Biopsies:

Small biopsies of various cancers received at the department comprise of punch biopsies, trucut biopsies under guidance (Ultra sound/CT) endoscopic and bronchoscopic biopsies, stereotactic biopsies and bone biopsies. Approximately 20-25 major surgical specimens are received for histopathologic examination which warrants extensive lymph node dissection, inking of margins, ascertaining the depth of infiltrates to give an appropriate and complete histopathology report with all progrostic indicators.

Tissue is requested for research in 10% cases and there are collected under sterile conditions at the time of dissection. All research requests need to be made in the format provided by the department of lab medicine and submitted to the institutional ethics committee subsequent to clearance from respective authorities in the hospital.

Immunohistochemistry:

The institute takes pride in being one of the major centers handling largest load of immunohistochemistry in the state with approximately 5000-6000 slides annually in cancer. These consist of various diagnostic and progrostic markers of cancer.

The different panels provided to name a few are:

o Breast prognosis profile (ER,PR,HER2/neu-by IHC &/or FISH,,Ki 67)

o Spindle cell panel (Vimentin ,S100,SMA Caldesmon CD34 CD31 Desmin CD99

o Calponin- markers decided by pathologist based on morphology Neuroendocrine Panel NSE,Chromogranin ,synaptophysin CD56 Pancytokeratin,Ki67

o Myoepithelial panel Pancytokeratin.p63 calponin SMA

o Lymphoma panel LCA, CD3, CD20 CD30, CD15, BCl2, BCl6,MUM1,ALK1,Ki67 Kappa, lambda CD138 markers decided by pathologist based on morphology

o Metastatic panel CK7,CK 20,TTF1,Villin,GCDFP-15 markers decided by pathologist based on morphology

Requests for IHC are received from within the hospital and as referrals.

Routine hematology Trained pathologists and technologists handle nearly 200 CBPs a day most of which are abnormal with the help of automated cell counters.

Bone Marrow Lab:

Bone marrow lab handles bone marrow aspiration and trephine biopsy services. These procedures are performed by trained pathologists as an outpatient procedure under local anesthesia. There is integration of morphology, flow cytometric data, cytogenetic molecular data before release of report to ensure streamlined approach to diagnosis and patient care. The various cytochemical stains in hematology include Myeloperoxidase , PAS, LAP score , ANAE, CAE and Perls stain.

Flow Cytometry Facility:

The flow cytometry facility was established in 2005 for the first time in the AP state with the goal of immunophenotyping of leukemia and lymphomas and stem cell enumeration and then expand its applications to research .The facility has been successfully running ever since enabling oncologists to give appropriate therapy and monitoring of stem cell transplants .The department is equipped with state of art four color FACS caliber flow cytometer and has standardized all the procedures and has been successfully doing immunophenotyping acute leukemias chronic lymphoproliferative disorders and CD34 enumeration .Periodic calibration ,focus on quality and Stem cell enumeration with viability count (7AAD) makes our services exclusive .

Requests for flow cytometry are received from within the hospital and as referrals.

The markers include CD34 CD45 Anti HLA DR, CD13, CD33, CD117, CD 2, CD3, CD5, CD7, CD4, CD8, CD19, CD 22, CD 103 kappa lambda.

Samples for analysis by flow cytometry (Referral cases).

o For *Peripheral Blood, collect 10-20 ml venous blood in EDTA (purple-top) vacutainer tubes.

o For *Bone Marrow, collect 1-3 ml. in a non-heparinized syringe is used for the initial bone marrow collection; then transferring the specimen to the sterile EDTA vacutainer tube without using a needle to dispense the sample.