There is a variety of professional areas of pathology.
Chemical pathologists analyse body fluids, such as blood, urine, and cerebrospinal fluid, to assess biochemical markers. They help diagnose conditions related to metabolism, hormones, and organ function, monitor treatment effectiveness, and assess overall health.
Haematologists study blood disorders, including anaemia, leukemia, lymphoma, and clotting disorders as well as diseases affecting the bone marrow and spleen. They analyse blood smears, coagulation factors, bone marrow aspirates and other haematological specimens.
Microbiologists identify and study microorganisms (bacteria, viruses, fungi, parasites) responsible for infections using various techniques such as microscopy, culture, biochemical tests, and molecular methods like polymerase chain reaction (PCR) and sequencing. They guide antibiotic treatment and infection control measures.
Anatomical pathologists examine tissue samples (biopsies, surgical specimens, etc.) under a microscope to diagnose diseases. They play a vital role in cancer diagnosis and staging.
Genetic pathologists focus on genetic and molecular aspects of diseases. They analyze DNA, RNA, and proteins to diagnose genetic disorders and assess cancer mutations. Genetic testing encompasses a wide range of assays, including chromosomal analysis, fluorescence in situ hybridization (FISH), polymerase chain reaction (PCR), and next-generation sequencing (NGS). Molecular pathology encompasses the application of molecular techniques to diagnose diseases, predict treatment responses, and monitor disease progression. It involves the analysis of genetic mutations, gene expression patterns, epigenetic modifications, and molecular biomarkers associated with various diseases, including cancer, genetic disorders, infectious diseases, and autoimmune conditions.
Genetics and molecular pathology are also involved in the diagnosis and management of hereditary disorders caused by genetic mutations inherited from parents. Genetic testing can identify disease-causing mutations, carrier status, and risk factors for inherited conditions such as cystic fibrosis, Huntington's disease, hereditary cancer syndromes, and inherited cardiovascular disorders.
Blood banking is a specialized area within pathology focused on the collection, testing, preparation, and administration of blood and blood products for transfusion. Prior to transfusion, the compatibility of donor blood with the recipient's blood type must be determined to prevent transfusion reactions. Blood transfusion can involve the administration of specific blood components tailored to the patient's needs. Red blood cell transfusion is indicated for correcting anemia and improving tissue oxygenation, while platelet transfusion is used to manage thrombocytopenia and prevent bleeding. Fresh frozen plasma (FFP) and cryoprecipitate are administered to replace clotting factors in patients with coagulopathies or bleeding disorders.
Pathologists oversee the laboratory testing procedures involved in ensuring transfusion compatibility, including ABO and Rh blood typing, antibody screening, and crossmatching. Advanced techniques such as extended antigen typing and human leukocyte antigen (HLA) matching may be employed for specialized transfusion requirements, such as organ transplantation or rare blood phenotypes.
Pathology departments often include specialized transfusion medicine services that provide comprehensive support for blood transfusion practices within healthcare institutions. These services may include blood bank operations, transfusion guidelines development, adverse event reporting, transfusion support for surgeries and medical procedures, and education and training for healthcare providers.
Pathologists collaborate with clinicians to implement blood conservation strategies aimed at minimizing unnecessary blood transfusions and optimizing patient outcomes. These strategies may include preoperative anemia management, intraoperative blood salvage techniques, pharmacologic interventions to reduce bleeding, and patient blood management programs focused on optimizing transfusion practices and minimizing blood loss.
Immunopathologists study the immune system’s role in diseases. They analyze mechanisms of inflammation, allergic reactions, immune responses, autoimmune conditions, and immunodeficiencies.
Immunopathologists explore the development and application of immune-based therapies for the treatment of diseases, including cancer immunotherapy, which harnesses the power of the immune system to target and eliminate cancer cells. Other immune-based therapies include monoclonal antibodies, cytokine therapy, adoptive cell therapy, and vaccines.
Diagnostic immunology utilizes laboratory techniques to detect and measure immune-related molecules, such as antibodies, antigens, cytokines, and immune cells, in patient samples. Diagnostic immunological tests aid in the diagnosis and monitoring of infectious diseases, autoimmune disorders, allergic reactions, immunodeficiencies, and transplant rejection.
Cytopathologists analyze cells obtained from fluids or tissue samples, often through techniques like fine needle aspiration, to diagnose diseases such as cancer or infections. Cytopathologists analyze cell morphology, size, shape, nuclear features, and cytoplasmic characteristics to identify abnormalities indicative of disease.
Various diagnostic techniques are utilized to collect cell samples for examination, including fine needle aspiration (FNA), brushings, washings, scraping, and swabbing. These minimally invasive procedures allow for the sampling of tissues and organs without the need for surgery, enabling rapid diagnosis and treatment planning.
Cytology is widely used for the diagnosis and staging of cancer. Cytological examination of cells obtained from suspicious lesions, tumors, or metastatic sites can help differentiate between benign and malignant conditions, identify the primary site of malignancy, and assess tumor grade and stage. Common cancers diagnosed by cytology include lung cancer, breast cancer, thyroid cancer, cervical cancer, and pancreatic cancer. Cytology-based screening programs, such as the Papanicolaou (Pap) smear for cervical cancer and the sputum cytology for lung cancer, play a crucial role in early detection and prevention of cancer. These screening tests aim to identify precancerous lesions or early-stage tumors when treatment is most effective and prognosis is favorable. Liquid-based cytology is a technique that improves the quality and reliability of cytological specimens by preserving cells in a liquid medium, such as ThinPrep or SurePath. Liquid-based cytology reduces the presence of obscuring factors, such as blood, mucus, and inflammation, and allows for additional testing, including molecular and immunohistochemical analysis.
Cytology is not limited to gynecological specimens; it also encompasses the evaluation of non-gynecological specimens from various body sites. Non-gynecological cytology includes the examination of respiratory specimens (e.g., bronchial washings, bronchoalveolar lavage), gastrointestinal specimens (e.g., endoscopic brushings, fine needle aspirations), urinary specimens (e.g., urine cytology), and body fluids (e.g., pleural fluid, ascitic fluid, cerebrospinal fluid).
Telecytology involves the digital transmission and remote interpretation of cytological images for consultation or second opinion purposes. Telecytology facilitates collaboration between cytologists and clinicians, enables access to expertise from distant locations, and improves the efficiency of cytological diagnosis and reporting.
Cytology laboratories adhere to strict quality assurance and quality control measures to ensure the accuracy, reliability, and reproducibility of cytological interpretations. These measures include proficiency testing, interlaboratory comparison programs, continuous education and training, and adherence to standardized reporting guidelines.
Virologists develop and implement diagnostic tests to identify viral infections in clinical specimens, such as respiratory secretions, blood, cerebrospinal fluid, and tissue samples. They investigate the cellular and molecular mechanisms underlying viral replication, immune evasion, tissue damage, and host immune responses to viral infections. This includes techniques such as polymerase chain reaction (PCR), viral culture, serological assays, and nucleic acid sequencing to detect and characterize viruses in clinical specimens. Virologists in pathology laboratories identify and characterize viruses using various techniques, including molecular assays, electron microscopy, viral culture, and antigen detection tests. Accurate identification of viral pathogens is essential for diagnosing viral infections and guiding patient management.
Virologists contribute to epidemiological surveillance efforts by monitoring the prevalence, distribution, and genetic diversity of viral pathogens within communities and populations. Surveillance data help public health authorities track outbreaks, identify emerging viral threats, and implement control measures to prevent the spread of infectious diseases.
Virologists study the oncogenic potential of certain viruses and their role in the development of cancer. Oncogenic viruses, such as human papillomavirus (HPV), Epstein-Barr virus (EBV), hepatitis B virus (HBV), hepatitis C virus (HCV), and human herpesvirus 8 (HHV-8), can cause persistent infections and contribute to the development of various cancers, including cervical cancer, hepatocellular carcinoma, and lymphomas.
Virology includes the evaluation of antiviral drugs for the treatment of viral infections. Virologists assess the efficacy, safety, and resistance profiles of antiviral agents through in vitro testing, animal studies, and clinical trials. Antiviral therapy aims to inhibit viral replication, reduce viral load, alleviate symptoms, and prevent disease progression.
Virology plays a critical role in the development and evaluation of vaccines against viral pathogens. Virologists contribute to vaccine research by identifying immunogenic viral antigens, characterizing immune responses to vaccination, assessing vaccine safety and efficacy, and monitoring vaccine-induced immunity in populations. Vaccination is a key strategy for preventing viral infections and controlling outbreaks.
Virologists investigate the evolutionary dynamics and transmission patterns of viruses to understand how viruses adapt to new hosts, environments, and selective pressures. Studies of viral evolution provide insights into the origin of emerging viruses, the emergence of drug-resistant strains, and the potential for cross-species transmission.
Virologists adhere to biosecurity and biosafety protocols to prevent laboratory-acquired infections and accidental release of viral agents. Pathology laboratories implement stringent containment measures, personal protective equipment, and disinfection procedures to minimize the risk of viral exposure and transmission.