Pathology

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Pathology is a specialty of medicine, with graduate medical education beyond medical school being a prerequisite. Pathologists deal with the diagnosis, prognosis, and recommendations for treatment of diseases obtained from laboratory analysis of entire bodies, tissues, and bodily fluids. There are two major divisions, anatomic pathology and clinical pathology, and a variety of subspecialties. A physician may certify in either or both divisions, a division alone, or in division(s) and subspecialties.

Main divisions

Anatomic pathology, concerned with the examination of tissues and body parts (i.e., in biopsy and autopsy)

Clinical pathology is focused more on the analysis of body fluids in the clinical laboratory.

Subspecialties

Blood Banking and Transfusion Medicine

Subspecialists in this area maintain an adequate blood supply (i.e., a blood bank) and ensure blood donor and patient-recipient safety. They may advise on the most appropriate blood components to use for specific purposes. Blood banking specialists direct the preparation of blood components, such as packed red cells, coagulation factors, platelets, bone marrow and stem cells, and, where appropriate, whole blood.

The subspecialty is closely linked to the hematology and oncology subspecialization of internal medicine, as well as supporting surgery, gastroenterology, and other specialties in which patients commonly have major blood loss.

Chemical Pathology

Members of this area have deep understanding of human biochemistry, how it changes in disease, potential means of correcting abnormalities, and monitoring the progress of therapy. Many clinical specialties have need for such insight, among them being endocrinology, nephrology and gastroenterology. Pathologists in this field work with nuclear medicine physicians in developing techniques that correlate chemical reactions with anatomical information, such as single photon emission computed tomography (SPECT) and positron emission tomography (PET).

Chemical pathologists may supervise clinical chemistry laboratories, with staff including medical technologists concentrating on biochemical analysis, and specialists in biomedical sciences, including analytical biochemistry and toxicology.

Cytopathology

This is a subspecialty of anatomic pathology that works at a more micro level than, for example, the examination of slices of tissue samples. Cytopathology analyzes cells obtained from cell-containing body fluids such as blood, transudates and exudates, and by cells retrieved from the surface of lesions, or aspirated with a fine needle. Such aspiration often is guided by ultrasonography, X-ray, computerized tomography and other techniques in which the cytopathologist works with an interventional radiologist.

One of the most common cytopathological examinations is supervising, and analyzig in complex cases, results of Papanicolaou-stained cells of female reproductive organs (the “Pap” test), which makes them close partners with specialists in obstetrics and gynecology.

Dermatopathology

Members of this subspecialty use specialized techniques to interpret diseases of the skin, using samples obtained with specialized biopsies, scrapings, and smears. This subspecialty obviously is closely related to the specialty of dermatology.

Forensic Pathology

Forensic pathologists apply medical knowledge to death or injury caused in a manner of interest to legal authorities. Pathologists certified in this area may hold governmental positions such as medical examiner and coroner; they often are exprt witnesses in court.

When multiple deaths result from a common cause, they may work closely with specialists in public health (i.e., epidemiology), who may call on other specialists in infectious disease, occupational medicine, toxicology, health physics, and other disciplines. They may supervise the work of certain police evidence technicians, as well as assistants in the forensic laboratory.

Hematology

A Hematopathologist is expert in diseases that affect blood cells, blood clotting mechanisms, bone marrow and lymph nodes. This specialist has the knowledge and technical skills essential for the laboratory diagnosis of anemias, leukemias, lymphomas, bleeding disorders and blood clotting disorders.

As with transfusion method, there are mutual interests with hematology and oncology.

Medical Microbiology

In this subspecialty are both the techniques for isolating, culturing, and identifying microbial pathogens, and determining their sensitivity to antibiotics or immunotherapy. They may prepare products of immunity for diagnosis and therapy. They are expert in the ways in which microorganisms, and chemicals and antigens produce cellular damage.

Corresponding to this subspecialty is the internal medicine subspecialty of infectious disease.

Molecular Genetic Pathology

Pathologists subspecializing in this area focus on the understanding of human genetics at a molecular level. They may confirm or rule out suspected genetic diseases, support obstetricians in assessing genetic problems in utero, and have an ever-increasing role in pharmacogenetics and genetic therapy.

Neuropathology

Neuropathologists perform specialized laboratory examinations of central and peripheral nerves, and the interaction between nerve and muscles, as well as the autonomic effects of nerves on glands and organs. Pathologists in this subspecialty complement the clinical specialties of neurology and neurosurgery.

Pediatric Pathology

Physicians in this area specialize in laboratory analysis supporting obstetricians and pediatricians in diagnosing diseases of the fetus, infant, and child. They have much insight into growth and development, and the cellular and chemical mechanisms that control them.