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What is Histopathology?

By A. Ribken
Updated May 17, 2024
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Histopathology is the study of diseased tissue, such as tissue obtained through a biopsy, by a specialized doctor known as a pathologist. Samples of tissue are studied under a microscope in order to identify how a disease develops. The tissue sample goes through a special process so it can be analyzed on a slide, as opposed to cytopathology, where samples are examined without being processed.

Samples for histopathology must be processed and fixed for examination. Two processes are used. The first is a chemical fixation procedure in which the tissue samples are immersed in a bath of paraffin, or wax, over a 12- to 16-hour period. This allows the tissue to be sliced into two to seven micrometer sections for examination.

The second process used is frozen sectioning. Tissue samples are frozen and sliced thin, as in the chemical fixation process. Frozen sectioning is quicker, although these samples are of lesser quality than the chemical fixation samples. Typically, frozen section is used to determine the borders, or edges, of a tumor while surgery is being performed.

In both processes, the tissue is often stained using pigments to help the pathologist identify the structure of the cells and pinpoint any abnormalities. With the improvement in recent technology, digital imaging is being used to aid in the scrutiny of tissue samples from surgeries, biopsies, and even autopsies to help find out the cause of death. Histopathology examinations can also help determine the cause of several health problems besides cancer, including pregnancy issues, by examining tissue from the placenta or the reaction of tissues to certain medications.

In the treatment of cancer, a histopathology examination of the tissue removed for biopsy or from surgery is very important in planning the proper course of treatment. The pathologist prepares the sample sent during surgery to examine and advise the surgeon whether or not to proceed or to inform the surgeon when the borders are clear. In a biopsy, the pathologist will determine what kind of cells are involved and their stage, which helps in deciding which course of treatment is best for the cancer identified.

Doctors specializing in histopathology have a long educational route. In addition to a college degree in a chosen scientific discipline, a pathologist also needs to complete a four-year doctorate degree followed by three to eight years in residency. He is required to continue his education over the course of his career.

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Discussion Comments
By Saraq90 — On Oct 02, 2011

Thank you to all the pathologists who are brave enough to go through the histopathology process to find out if there is disease in someone's tissue, and to find out what stage the disease is in, if there is a disease.

I am sure this process has relieved a lot of people who have had benign tumors. And in the patients who have found out they had a malignant tumor, at least they had a histopathology test ran so pathologists were able to determine that is what malignant, and to determine what stage the malignant tumor was in so the proper and most efficient care could be given.

By amysamp — On Oct 02, 2011

Histopathology seems like a very important part of pathology. It seems very crucial in diagnosing the problem, if there is one, and how far along the particular problem is. This is very important part of a pathologists job. I am sure they probably re-examine the results to make sure whatever they wrote down is correct. If they mess something up in the histopathology process, this could kill or severely injure a patient!

I do not think I could be a pathologist, because I would worry all the time if I did the histopathology process right. I would worry that my final analysis was wrong all the time. I could not deal with basically having someone else's fate and life in my hands!

By Clairdelune — On Oct 01, 2011

I've had to wait for a tissue sample to be evaluated. It seems to take forever. I always thought that there were just a lot of tissues samples that needed to be examined by a pathologist.

But I've learned from this article that the tissue sample has to sit in the wax for almost two days before it is ready for examination and then a report written. Now I know why it takes so long.

Maybe someday, scientists will figure out how to speed up the process. Then we patients won't have to spend so much time worrying about what the results will be.

By B707 — On Sep 30, 2011

The results of a pathologist's testing of tissue is so important, it's no wonder that so many years of training plus continuing education throughout his/her career are required.

I didn't know that doctors doing surgery for cancer patients, take some suspect tissues out and rush it to a pathologist to get information. They need to find out about the state of the tissue, so the surgeon can make a decision about what way to go with the surgery, or find out how far the cancer has spread.

It must be a pretty tense job for the pathologist to examine and make such important decisions about the tissue sample, especially when a doctor is anxiously waiting the results.

By honeybees — On Sep 30, 2011

I have had more than one biopsy done in the last few years. The first biopsy was done for a lump in my breast. The second biopsy was for a polyp found in my colon.

After both of these biopsies, the tissue was sent to a pathologist who studied them to see if they were malignant or benign.

The hardest part is the few days that you have to wait before you get the results back. They always tell you it will be 4-5 days, and until then it is hard not to worry.

Sometimes the doctor will give you a pretty good indication whether or not they think it looks suspicious or not. Other times, they don't say anything at all and you are just waiting for a phone call.

Both of my biopsy results returned back normal, but I was still anxious until I heard that everything was OK.

When it seems like so many people are getting cancer, I would think the health care field of histopathology would be one that is growing every year.

By julies — On Sep 30, 2011

I completed a summer internship when I was in college in the pathology department of a hospital. This was a major university hospital so there were a lot of tissue samples that were looked at over the course of one week.

One main aspect of my job was to record the results of those tissue samples. These histopathology results were from every tissue sample that was taken.

I had this job several years ago, so figure the process is more automated now than what it used to be. I would actually write the results in a log book and the pathologists would look at this log to find out what the results were.

It was important that I accurately record every result. It could be life changing for someone if the wrong result was recorded for someone.

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