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Beth Israel Deaconess Medical Center Laboratory Manual |
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ANATOMIC PATHOLOGY
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Director: |
Stuart Schnitt, MD |
617-667-4344 |
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Clinical Manager |
Donna Fayad, |
617-667-7831 |
Go directly to: Autopsy, Cytopathology , Surgical Pathology , Histology , Electron Microscopy
The Division of Anatomic Pathology, which covers East
& West campuses, is located on the first floor of the East Building.
There are many areas within the division (including Electron Microscopy,
Immunohistochemistry, and Special Procedures) but the areas of most concern
for ordering physicians are the Cytopathology and Surgical Pathology services.
Autopsy Services are available on both the East and West campuses.
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Director: |
Jonathan L. Hecht, MD, PhD |
617-667-5759 |
The autopsy service functions in its traditional role of determining the causes of deaths of patients, providing quality control of medical practices, particularly new treatments, diagnostic techniques and procedures and furthering the understanding of human disease. It plays a vital part in experimental clinical trials and in the education of physicians in training in pathology as well as the clinical and diagnostic specialties. Clinico-pathological education exercises are an integral part of this service and include presentations at the weekly gross autopsy conference, the monthly gross-micro conference, and cardiothoracic and medical/surgical morbidity and mortality conferences.
An autopsy begins after a permission form signed by the next of kin is obtained. The Admitting Department can assist you with any problems or questions you may have regarding the permission form (call 617-754-2210).
Autopsies are done each day from approximately 8:00 a.m. to 3:00 p.m. An autopsy requested after 3:00 p.m. is done the following morning. Autopsies are available after hours if there is a special (i.e., religious) need. The autopsy is a non-mutilating, non-defacing procedure. Funeral preparations and open casket funerals are not hindered in any way. A routine autopsy takes approximately one to two hours.
Autopsy reports are sent to all clinicians listed in the patient's medical record. The gross diagnosis is sent approximately three days after the autopsy, the final diagnosis approximately four weeks after the autopsy, and the CNS diagnosis (if the brain is examined) approximately ten weeks after the autopsy. It is the responsibility of the clinician to communicate autopsy findings to family members of the deceased.
House staff are encouraged to attend the Autopsy Gross Conference each Thursday at 12:30 p.m. in the Autopsy Suite (ES-112), and the Autopsy Gross-Microscopic Conference the last Tuesday of each month at 12:30 p.m. in the Pathology Department Conference Room. A list of cases to be presented will appear in your computer mail a day or two before each conference.
CYTOPATHOLOGY
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Director: |
Helen Wang, MD |
617-667-2629 |
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Lead Technologist: |
Linda Rinaldi, CT(ASCP) |
617-667-5756 |
The services provided by the Cytopathology section include evaluation of Papanicolaou stained smears of cervix, body cavity fluids, sputum, bronchial and gastrointestinal brushings or washings, urine, and fine needle aspirations. Regular laboratory hours of operation are Monday-Friday, 8:30 a.m. - 5 p.m.
Specimen collection materials (including Cytolyt™ liquid fixative and Cell-Fixx™ spray fixative) are available by calling 617-667-4342 or coming to the laboratory at ES-109. For additional assistance, please page the Anatomic Pathology resident or staff pathologist on-call.
A cytotechnologist or cytopathology fellow is available to assist all fine needle aspiration procedures during regular laboratory hours but we request scheduling 24 hours in advance with the Cytology Department at 617-667-2950. This service includes help with adequacy determination of the specimen wherever the specimen is obtained. A cytopathologist may be called to render an immediate interpretation if necessary. It is also important to notify the laboratory, in advance, of any special requests.
Additional collection guidelines for Cytopathology
specimens are included in the Collection Guidelines Appendix (see "Guidelines
to Cytopathology Specimens").
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Director: |
James Connolly, MD |
617-667-4344 |
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Pathology Assistant: |
Gail Howe |
617-667-4083 |
Most biopsies may be submitted fixed in formalin but certain specimens should be submitted fresh or in a different fixative. Examples are: tissue requiring culture or immunologic examination, tissue in which crystal deposition is suspected, etc. If you have any doubt about the way in which to submit a specimen, please call 617-667-4344. Certain specialized procedures (such as electron microscopy) definitely require advance notice.
Surgical specimens may be delivered to the
department’s Surgical Pathology Laboratory in the SL-171. This room is open
8:30 a.m. - 6 p.m., Monday-Friday. After 6 p.m. (or if the room is closed),
please leave any specimens in Lab Control – Finard 3rd floor. There is always
a pathologist on-call for operating room consultations and frozen sections.
The department maintains two frozen section rooms. The frozen section room
on the East Campus is located in FD-326. The frozen section room on the
West Campus is located in CC-534. Call the operator (East or West) for the
anatomic pathologist on call.
Specimens must be examined, sampled, fixed, dehydrated, cleared, embedded,
sectioned, mounted and stained - a process which usually takes between 12-18
hours. Generally speaking, we begin to examine the slides in the morning
of the day after the specimen was submitted. However, unless there is great
clinical concern, you are urged to wait until the following day (when most
of the cases will be formally signed out) to inquire about diagnoses.
Rush biopsies during the week must be received in pathology by 10 AM. The surgical pathologist covering the East Campus O.R. should be paged. On Saturdays, the specimen must be received in histology by 11 AM. No rush service is available on Sundays. If there is a rush specimen after 11 AM on Saturday or on Sunday, the pathology resident on call (for the East or West as appropriate) should be paged. The specimen should be placed in the O.R. frozen section refrigerator and it will be processed on Monday morning.
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Director: |
Elizabeth Genega, MD |
617-667-4344 |
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Lead Technologist: |
Gail Howe |
617-667-4083 |
Pathology assistants and anatomic pathology residents
cut tissues for over 40,000 cases per year. The histology laboratory is responsible
for fixation and embedding of tissue and for preparing and staining slides
for review by pathologists. The histology laboratory processes over 240,000
blocks of paraffin-embedded tissue to prepare slides for review by staff
and consulting pathologists.
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Director: |
Ann Dvorak, MD |
617-667-4344 |
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Lead Technologist: |
Rita Monahan-Early |
617-667-5777 |
In the routine assessment of renal, heart, muscle and nerve biopsies, ultrastructural imaging is an essential contributor. Some applications include the identification of microorganisms in tissues and the special evaluation of bone disorders. In addition to its primary role in diagnostic pathology, electron microscopy plays an important role in education and research.
Reviewed/Revised: 9/14/2009
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