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Thursday, August 21, 2014

Pathology : The Answer To Life And Death

Originally Published: August 21, 2014
By: Sarina Lalla

Pathology. While many of us may have heard such a term on shows such as CSI, for when a body at a crime scene needs to be examined through autopsy, how many of us really know what exactly it means?

Pathology is the study of any manifestations of illness or foul play that can touch an organ or any anatomical element. Simply put, let’s just say that there is a patient that either 1) has an illness or 2) is dead and we would like to know why. Pathology is a science that has the answers. How, you may ask? There are many steps that must be followed before the mysteries can be solved.

First of all, anything that passes through a pathology lab is referred to as a specimen. Specimens vary in size, as they can come from any part of the body. Heck, they can even be the whole body. These specimens come from clinics and hospitals, usually the ones closest to the pathology lab itself. Pathology labs are even usually part of some hospitals, which is more efficient : any specimen, which is unique and irreplaceable (ex. if the specimen’s a gallbladder, we only have one), can be analyzed without leaving the hospital.

So, the specimens are brought to the autopsy/biopsy room, where they are soaked in formalin. This disinfects them all while helping them maintain their form. Depending on the size of the specimen, it will soak in formalin from a couple of hours to a few days.
After that process, the specimens are examined by technicians and pathologists. The latter must make a gross description of the specimen (shape, consistency, presence of anomalys, cysts, tumors, etc) by making specific cuts through them and extracting pieces of tissue.
After the description is made, the pieces of tissue (which very much look like meat) are placed in small cassettes. Once all of the cassettes have been numbered, registered, and closed, they are placed in a machine that coats them in paraffin, or wax. Once they have become blocks of wax, they go through a histology lab, where a knife slices the blocks in strips of a micrometric thickness. These strips are then placed on microscope slides and, with the help of many chemicals, are colored and stuck to the slides.

Once these slides are finished, they are sent back to the pathologists, who must look at them through a microscope to see any microscopic abnormalities or pathogens. They then write anything that they notice and these notes, along with the gross desciption made initially, are sent to the doctors for a final diagnosis and to deliver the information to the patients.
In the case of an autopsy, a full body investigation, this series of steps is done on each organ that is deemed important to examine, like the heart, the brain, the kidneys, and the lungs. The patient is cut open very carefully so not to be too damaged (as many families like to have an open casket).

As an administrative agent working in a pathology lab this summer, I have seen some pretty amazing cases. Every day, there is something different to see : from ovarian cysts the size of beach balls with hair and teeth on them (!) to horseshoe kidneys (kidneys fused together) there is never a dull moment. And I have learned so much along the way, anatomically and in terms of diseases as well. So next time you get your tonsils removed, your wisdom teeth, that suspicious mole, at least you know where it goes now and why the results take some time before coming back!

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