A pathological diagnostic method in which tissue samples obtained by surgery or biopsy are fixed in formalin, embedded in paraffin, sectioned, and evaluated under the microscope using H&E and special stains.
Indication
- Differentiation of benign vs. malignant tumors and definitive diagnosis
- Assessment of surgical margins in resection specimens
- Determination of the histological type of inflammatory diseases (Crohn, celiac, gastritis)
- Tissue-level assessment of autoimmune diseases
- Evaluation of rejection in transplant biopsies
- Subtyping of rare tumors such as lymphoma and sarcoma
- Demonstration of treatment response at the tissue level (especially in oncology)
Preparation
- Tissue sampling by the clinician through biopsy or surgical procedure
- Placement of the tissue specimen in 10% neutral buffered formalin in the operating room
- Complete transmission of patient information and clinical preliminary diagnosis to the pathology laboratory
- Sharing of previous pathology reports and imaging findings
How it's performed
- The tissue sample is fixed in formalin solution for 24-48 hours
- Macroscopic examination is performed by the pathologist, with measurements and sampling
- Samples are dehydrated in a tissue processor and embedded in paraffin (paraffin block)
- Sections of 3-5 micrometers in thickness are cut with a microtome and mounted on slides
- Routine staining with hematoxylin-eosin (H&E) is performed; special histochemical stains are applied when needed
- The pathologist evaluates the slides under the microscope, archives them with digital imaging, and issues the report
Post-procedure
- The pathology report is usually completed within 3-7 working days
- The result is explained to the patient by the clinician and integrated into the treatment plan
- Blocks are stored for additional sectioning, special stains, or immunohistochemistry when needed
- Pathology blocks are archived for the legally required period (generally 20 years)
- Cases requiring consultation are referred to a second pathologist for review
Risks
- Inadequate or non-representative sampling (re-biopsy may be required)
- Diagnostic difficulty due to fixation errors (incomplete fixation, crush artifact)
- Variability in interpretation of atypical or borderline lesions (a second opinion may be needed)
- Rare risk of block/slide mix-up (minimized by laboratory tracking protocols)
FAQ
How long does it take to receive the pathology result?
Routine biopsy results are usually completed within 3-7 working days. The time may be longer for cases that require immunohistochemistry or special stains.
How reliable is histopathological examination?
Histopathology is the gold-standard diagnostic method for many diseases. In disputed cases, the diagnosis is confirmed with a second pathologist's opinion or additional studies.
Is my tissue sample preserved?
Paraffin blocks and slides are archived for many years in accordance with legal regulations. Additional examination can be performed in the future if needed.
What happens if the result is different from what was expected?
When results are not consistent with the clinical findings, the clinician and the pathologist evaluate the case together; if needed, additional sampling or consultation is recommended.
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