Cellular pathology laboratory

Key personnel

Laboratory Service Manager

Alex Javed

Cellular Pathology Manager

Joanne Brook

Consultant Lead

Grant Stenhouse

Typical roles

The histopathology department receives tissue specimens from patients, taken at either surgical operations, outpatient or GP clinics, or at post-mortem examination. Specific pieces of tissue or biopsies are taken that are associated with the condition under investigation and sent to the laboratory, usually in a fixative solution to prevent degradation of the tissue, so that when the microscopic examination of the tissue is made it resembles the state of the tissue as close as possible to what it was when still within the patient.

Diseases such as inflammatory diseases, benign abnormal growth, infections and cancer are diagnosed by this method.

Once received, the specimens are processed into paraffin wax blocks and thin slices or sections are cut and stained for microscopic examination to determine the underlying disease process. Further staining techniques may be required to identify a specific tissue component not readily seen in the first stained section, by using a more specific staining technique, one example would be for the detection of the presence of a micro-organism such as TB. Other specialised techniques such as immunocytochemistry can be used to identify a tumour or variant of a tumour.

Very rapid results (within minutes) can be obtained by freezing the tissue in Cryospray and cutting sections in a refrigerated cabinet called a cryostat. This technique is often used when the patient is still in the operating theatre and enables a surgeon to determine the progress or course of a particular operation, especially when they are removing tumours. This can give broad answers to specific questions, such as whether the tissue is benign or malignant but still usually requires processing into a paraffin block for a more definitive diagnosis.

There are four groups of staff within histology:

Consultant Cellular Pathologists

Medically qualified Consultant Cellular Pathologists carry out the microscopical examination and diagnosis of the tissue samples. They are also involved in the work of mortuaries and provide a post-mortem service for HM Coroner and their Health Authority. They often have advanced roles involving management, medical research, consultancy, media and education.

Biomedical scientists

This HCPC-registered group of staff carry out the scientific processes and techniques to produce the material that the pathologist examines when making the diagnosis. This involves preparing tissue for processing into paraffin embedded blocks and then cutting the sections for staining. The recent development of advanced roles in specimen dissection has seen many biomedical scientists taking on some of the roles traditionally carried out by the pathologist within the specimen dissection room.

This staff group also carry out the staining techniques to demonstrate the tissue components, infective agents etc and also carry out immunological staining of tumours and tissues to identify specific proteins within the tissues which, once identified, can aid in the diagnosis of the disease condition.

In more recent times, with the advent of molecular biology techniques, biomedical scientists also carry out molecular techniques to identify specific proteins, hormone receptors, viruses and enzymes in tissues, which enhance both the diagnosis and the treatment of the patient. The demonstration of the Her2 receptor site is especially important in determining which breast cancer patients are suitable for Herceptin therapy.

Associate practitioners and medical laboratory assistants

This group of staff provide a variety of support activities to both the pathologists and biomedical scientists and in some cases perform advanced roles in some areas traditionally covered by biomedical scientists.

Mortuary or anatomical pathology technicians

This group of staff is responsible for providing support to pathologists during post mortems and organising the mortuary services. They also liaise with the Procurator Fiscal and undertakers with regard to burials and cremations of the deceased, ensuring that the deceased and the relatives of deceased receive a respectful bereavement service.

Laboratory services

Blood sciences, microbiology and cellular pathology laboratories.
Blood sciences laboratory

About the blood sciences departments in NHS Highland, and key personnel.
Cellular pathology laboratory

Comprising histology, cytology and andrology.
Microbiology laboratory

Including toxoplasmosis, Lyme disease and tick-borne infections.
Lyme disease and tick-borne infections

Scottish Lyme Disease and Tick-borne infections Reference Laboratory (SLDTRL).
Toxoplasmosis

Scottish Toxoplasma Reference Laboratory (STRL).