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Nature of the work

Histopathology is the diagnosis and study of disease by expert medical interpretation of cells and tissue samples. The specialty determines the cause of death by performing autopsies and is integral to cancer management through staging and grading of tumours.

Working in histopathology

Histopathologists work in the laboratory, both in partnership with laboratory scientists and doctors from other clinical specialties. They have an in-depth knowledge of both pathological and clinical aspects of disease. The histopathologist is a member of the multidisciplinary team, assessing cancer patients and planning their further investigation and treatment. He or she also has key responsibilities for cancer screening – currently for breast and cervical cancer but with bowel and prostate cancer screening on the horizon.

In many hospitals, biomedical scientists are undertaking more of the ‘routine’ cut-up of smaller specimens, and in some cases are also conducting microscopic examination and report writing of cytological samples. With an increasing ability to automate and mechanise laboratory processes, there is the possibility that histopathology departments will no longer be necessary at smaller hospitals, and work may be managed centrally in dedicated histopathology centres with larger throughput capacity.

Common procedures/interventions

Common procedures and interventions include:

  • examination and dissection of surgical resection specimens, to select the most appropriate samples for microscope slides
  • microscopic examination of tissues, with subsequent construction of clinical reports
  • carrying out fine-needle aspirations
  • carrying out autopsies.

Associated sub specialties

Associated sub specialties include:

  • cytopathology
  • forensic pathology
  • neuropathology
  • paediatric pathology.

The Royal College of Pathologists (RCPath) is drafting a proposal to obtain approval from the GMC for dermatopathology as a sub specialty, and developing a curriculum and qualification to support this. It is likely that other sub-specialty groups will follow a similar route in coming years.

A number of other sub specialties exist in terms of special interests, such as:

  • colorectal pathology
  • upper GI pathology
  • breast pathology
  • urological pathology.

There is already increasing sub specialisation in histopathology, as in other specialties, with a decline in the traditional generalist histopathologist.

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