Division of Anatomic Pathology

We offer advanced pathology services across a wide variety of subspecialty areas, including:

Cancer Pathology and Specialty Surgical Pathology

At BIDMC, our world-class pathologists are dedicated to providing expert interpretation of tissue samples and the subtle nuances that help make accurate diagnoses. Our pathologists are internationally regarded for their expertise in all types of cancer and benign diseases.

Surgical Pathology is the rendering of pathologic diagnoses on tissues removed from patients. It includes the immediate evaluation of specimens in the operating room by frozen section to assist surgeons in making important intraoperative decisions.

In addition to routine assessment by hematoxylin-and-eosin staining of paraffin-embedded sections, specimens are also evaluated by special techniques as appropriate. Tissue removed at surgery is examined grossly and portions are fixed, dehydrated, cleared, embedded, sectioned, mounted on slides and stained in preparation for microscopic examination.

Our team is especially adept at identifying factors that may:

• Influence a risk of cancer recurrence
• Foreshadow the development of subsequent cancer from benign disease
• Indicate disease progression
• Indicate the presence of a genetic risk for other diseases in the patient or their family members

Our work has impacted cancer care and management in multiple areas including breast, gastrointestinal pathology, gynecologic pathology and thoracic pathology, to name a few (our pathologists are routinely consulted on difficult cases, nationally and internationally). Our work in the care of non-cancer patients is also impactful; examples include the ongoing monitoring of organ transplant recipients and patients with chronic inflammatory diseases.

Cytopathology

Cytopathology is the practice of pathology that makes diagnoses based on the microscopic examination of individual cells, mostly obtained through non-invasive and minimally invasive procedures.

The 35,000+ cytopathology specimens we examine annually include:

• 25,000 gynecologic specimens
• More than 10,000 non-gynecologic specimens, including fine needle aspiration (FNA) specimens

We provide a fine-needle aspiration (FNA) service on request, where the cytopathology faculty and cytopathology fellows perform FNA procedures and can render immediate diagnoses on superficial palpable nodules.

In addition to processing and interpreting cytologic specimens, we provide on-site specimen adequacy evaluations for radiologic procedures, increasing diagnostic yield and ensuring proper specimen triaging.

For gynecologic specimens, our laboratory interprets both conventional smears and liquid-based preparations (ThinPrep). The screening of the liquid-based preparations is computer assisted using the Hologic ThinPrep Imaging System.

Pathology Autopsy

Pathology Autopsy helps determine the cause and manner of death of an individual. We perform ~100 postmortem examinations per year.

The decision to perform an autopsy after the death of a family member can be a difficult and stressful one for loved ones. Families may struggle to understand why an autopsy is needed or what the procedure entails.

If patients have questions, they can contact Patient Relations at 617-975-9750.

Multidisciplinary and Coordinated Approach

Our surgical pathologists have joined with colleagues in several clinical departments to form multidisciplinary clinics that are designed to optimize the care of patients with various types of malignancy.

Examples include collaborations with the breast clinic and cutaneous oncology. In these forums, clinicians, radiologists and pathologists join together to provide seamless care for all new patients as well as for patients whose initial diagnostic procedures were performed elsewhere.

In this manner, we are integrating pathology into a coordinated approach that significantly enhances patient care.

We are committed to training the next generation of anatomic pathologists, providing education and training opportunities to allow them to develop their skills and expand their clinical expertise.

Our education programs include:

Our research professionals are world leaders in anatomic pathology research, driving new discoveries in this critical area of medicine. As part of our research activities, the division offers access to human tumor resources and supports collaboration among research and clinical faculty.