What is pathology?

Pathology is a medical specialty dedicated to the study of health and disease through the direct examination of human tissue.

Pathology is an important area of medicine because for many diseases, a specific diagnosis can only be made after examining the tissue under a microscope. In particular, all cancers are diagnosed by a pathologist and in most hospitals, treatment for cancer cannot start until a pathologist has examined the tissue and issued a pathology report.

There are many subspecialties of pathology and each is focused on studying different types of tissues. The largest subspecialty of pathology is anatomical pathology and the doctors who practice this area of pathology are called anatomical pathologists. Anatomical pathologists examine cells or tissues taken from anywhere in the body other than the blood. If you have ever had any tissue removed from your body, it was probably sent to an anatomical pathologist for examination and diagnosis.

How is my tissue sample examined?

Anatomical pathologists use two basic techniques for examining tissue. The first is called gross examination which means to look at the tissue with the naked eye and to feel the tissue to identify any abnormal areas. This method of examination is very effective for common diseases that involve a large area of an organ. For example, the gross examination of a lung can identify an area of pneumonia because the tissue has a characteristic look and feel. The gross examination of a segment of colon can also quickly identify a cancer and distinguish it from the surrounding normal tissue. However gross examination cannot determine what kind of cancer is present.

The second technique is called microscopic examination and it involves looking at the tissue under the microscope. The microscope allows pathologists to see the individual cells inside a tissue and to identify groups of abnormal cells. Microscopic examination of tissue is critical for several reasons. First, some diseases occur on such a small scale that they are not visible by gross examination alone.  Second, many diseases have a similar gross appearance and it is only after examining the cells that the diagnosis can be narrowed down to a specific disease. Finally, there are many features of a disease that can only be seen under a microscope. Often these features provide critical information to your other doctors that will guide your medical care. This is especially important if you have been diagnosed with cancer.

Are there different types of anatomical pathologists?

Yes. Anatomical pathology is further divided into surgical pathology which focuses on the examination of whole tissues and cytopathology which focuses on the study is individual cells and bodily fluids. Aside from anatomical pathology, other subspecialties of pathology include hematopathology which focuses on the examination of blood and forensic pathology which focuses on the examination of an entire body (also known as a forensic autopsy) to determine the cause of death.

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