Anatomic Pathology - Suburban Diagnostics

SubUrban Icon Anatomic Pathology (Histopathology And Cytopathology)

Histopathology and cytopathology have been a strong forte among the services offered by Suburban Diagnostics. Under this vertical, we offer a wide range of specialized testing, under all major therapeutic areas. Our histopathology team interacts closely with clinicians to understand case histories, correlate the findings clinically and lend themselves as an extended arm of the practising clinician in the process of decision making. We also offer a accurate bouquet of IHC markers for comprehensive diagnosis.

ONCOPATHOLOGY (EPITHELIAL, MESENCHYMAL & HEMATOLYMPHOID NEOPLASMS)

Comprehensive grossing and reporting according to standard CAP guidelines and updated tumour classifications.

All related diagnostic and predictive IHC markers available

GI PATHOLOGY (ENDOSCOPIC BIOPSY & LIVER BIOPSY)

Detailed and accurate reporting of GI endoscopic biopsies with appropriate special stains and IHC, where required.

Reporting of liver biopsies with all required special stains (PAS, PAS-AD, Reticulin, Masson’s Trichrome, Prussian Blue, Rhodanine)

NEPHROPATHOLOGY & UROPATHOLOGY

Detailed and accurate reporting of renal biopsies with all special stains (PAS, Silver, Masson’s Trichrome and Congo Red) and Direct Immunofluorescence (IgG, IgA, IgM, C3, C1q, kappa and lambda light chains, and C4d)

Electron Microscopy (outsourced).

Reporting of prostatic tissue (TURP specimens and Needle biopsies), bladder biopsies (TURBT) and resection specimens (nephrectomy, prostatectomy and cystectomy)

OROPHARYNGEAL, LARYNGEAL & BRONCHIAL/PULMONARY PATHOLOGY

Oral mucosal biopsies, salivary gland biopsies/excisions, maxillary/mandibular tumours and non-neoplastic lesions, laryngeal biopsies, bronchial biopsies, transbronchial lung biopsies and core biopsies from lung and mediastinal lesions

GYNAEC PATHOLOGY

Endometrial and cervical biopsies, resection specimens

OTHERS

Biopsies from any part of the body (viz. ocular, skin, ear, CNS, peritoneal etc)

IHC (Immunohistochemistry)

Immunohistochemistry (IHC) combines anatomical, immunological and biochemical techniques to identify discrete tissue components by the interaction of target antigens with specific antibodies tagged with a visible label.

IHC makes it possible to visualize the distribution and localization of specific cellular components within the cells and in the proper tissue context.

UTILITY OF IHC:

  • Diagnostic applications
    • Poorly differentiated malignant tumour
    • Malignant small round cell tumour
    • Typing / Subclasssification of lymphomas
    • Identification of primary sites in metastatic adenocarcinoma
    • Typing of mesenchymal tumours
  • As prognostic markers in malignancy
    • To predict the prognosis of tumours by identifying enzymes, tumour-specific antigens, oncogenes, tumour suppressor genes and tumour cell proliferation markers
  • Prediction of response to therapy
    • Predictive markers for breast carcinoma (ER, PR and HER2) and gastrointestinal stromal tumours (CD117), B-cell non-hodgkin’s lymphoma (CD 20) etc
  • Infections
    • Immunohistochemical methods are applied to confirm infectious agents in tissues by use of specific antibodies against microbial DNA or RNA e.g. in Cytomegalovirus, Hepatitis B virus, Hepatitis C virus, H. Pylori, BK Polyoma virus (SV40) etc.
Cytopathology (Gynaec and Non-gynaec)

Gynaec – Liquid based cytology (LBC) (SurePath) and conventional Pap smear

Non-gynaec cytology – Includes FNAC, fluid cytology and exfoliative cytology

  • FNA performed in-house by experienced pathologists
  • Facilities for USG-guided FNA available for non-palpable lumps/lesions
  • Liquid-based cytology for fluids
  • Diagnosing malignancy in fluids by cell block preparation and immunohistochemistry
Following fluid / samples are processed:
  • FNAC fluid from serous cavities (ascitic/peritoneal/pericardial)
  • BAL
  • CSF
  • Urine Cytology
  • Cyst fluid
  • Nipple discharge
  • Anal cytology
  • Bronchial brushings
  • Oral scrapings
  • Conjuntival scrapings
  • Oesophageal / gastric / colonic brushings
  • CBD brushings
  • Wound scraping
LBC (Liquid-based cytology)
  • An altered slide preparation technique using state-of-the-art technology
  • Cells preserved in fluid (Cytorich) forming cell suspension
  • Suburban uses cell-enrichment based BD SurePath
  • Most commonly used for Pap smears
Advantages of liquid-based cervical cytology over conventional PAP

Enhances diagnostic reliability of Pap smears by

  • Optimal cell fixation:
    • LBC – Cells are fixed in a standard liquid medium before smear preparation. Hence optimal cell morphology available for evaluation
    • Conventional – Fixation after smear preparation using non-standardized fixatives (spray/alcohol)
  • Optimal smear preparation:
    • LBC – Automated /thin-layer of cells. Selected cell population available for evaluation and obscuring factors such as blood and mucus are removed
    • Conventional – Manual smear of variable thickness
    • No cell selection – Morphology often obscured by blood and mucus
  • Optimal Staining:
    • LBC – Automated and standardized
    • Conventional – Lab function
  • Ancillary specialized diagnostic techniques such as HPV and molecular testing possible on LBC samples
  • Leading medical bodies like ACOG, ACS, ASCP, & ASCCP* recommend that PAP (LBC) + HPV be done together (co-testing) as the preferred approach for Cervical Cancer screening

For any further information, please email Dr. Ratika Aggarwal at drratika@suburbandiagnostics.com


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