Medical Pathology

Medical pathology is one of the cornerstones of modern medicine. It has a central role in the understanding, diagnosis and treatment of health problems. It examines the underlying causes of diseases, their mechanisms of development and the changes they cause in the body. Thus, it provides the most accurate diagnostic information and treatment roadmap for patients.

The unit uses a wide range of methods, from naked-eye examinations to cellular detail under the microscope (microscopy) to molecular-level analysis.

What is Pathology?

The primary and most basic aim of medical pathology is to make a definitive diagnosis of diseases by analyzing tissue and cell samples obtained by various methods (biopsy, cytology, autopsy, etc.). It is especially indispensable in the diagnosis of serious and life-threatening diseases such as cancer.

Although physical examination or radiological imaging methods (X-ray, ultrasound, MRI, tomography, etc.) may raise suspicion of a disease or abnormality, in most cases a definitive diagnosis can only be made by pathological examination. However, the role of pathology is not limited to diagnosis:

• It helps to determine the type, subtype, aggressiveness and molecular characteristics of the disease.
• Especially in cancers, it clarifies the stage of the disease by assessing the size of the tumor, its spread to surrounding tissues and whether it has spread to distant organs (metastasis).
• It contributes to the evaluation of the effect of the treatment with samples taken after treatment.
• It can identify the risk of a future disease and enable preventive measures to be taken.
• It allows the examination of the underlying causes of surgically removed tissues that seemingly point to a specific diagnosis (e.g. appendicitis, gallstones).

Pathology does not only examine "what" the disease is (diagnosis). It is also a versatile and dynamic source of information that determines "how serious" it is (staging), "how it might progress" (prognosis) and response to treatment.

Which diseases does pathology cover?

Although pathology is often associated with cancer diagnosis, it actually examines a wider range of diseases. Pathological examination detects abnormalities at the cellular and tissue level in the body. Thus, it guides the diagnosis, follow-up and treatment of many different diseases. The main disease groups of interest in pathology are:

• Cancers (Neoplasms): Diagnosis, classification and staging of benign and malignant tumors (uterine cancer, etc.).
  
• Infectious Diseases: Diseases caused by bacteria, viruses, fungi and parasites. Special staining techniques (histochemistry) or immunohistochemistry can help in this identification.
  
• Inflammatory and Autoimmune Diseases: Autoimmune diseases, in which the body attacks its own tissues, can be diagnosed by pathological scans.
  
• Genetic and Metabolic Diseases: Diseases in which the body attacks its own tissues or diseases characterized by chronic inflammation (rheumatism, Crohn's disease, psoriasis, etc.). Molecular pathology techniques are becoming increasingly important in this field.
  
• Degenerative Diseases: Detect changes at the tissue level caused by aging-related diseases such as Alzheimer's disease.
  
• Transplant Pathology: Provides compatibility assessment prior to organ transplantation. Biopsy samples can also be used to diagnose organ rejection or other complications after transplantation.

Many critical decisions such as the definitive diagnosis of diseases, follow-up, and evaluation of response to treatment are based on pathological examination results. Therefore, pathological examination does not necessarily mean that the patient has cancer. It is part of a comprehensive evaluation process in which many different possibilities are investigated.

What are the Sub-Branches of Pathology?

Pathology has been divided into specialized sub-branches over time:

• Anatomical Pathology: The study of organs, tissues and cells (Surgical Pathology, Cytopathology, Autopsy Pathology)
  
• Clinical Pathology (Laboratory Medicine): Analysis of body fluids such as blood and urine (Hematology, Biochemistry, Microbiology, Immunology)
  
• General Pathology: Basic mechanisms of diseases.  
  
• Systemic Pathology: Diseases of specific organ systems (Neuropathology, Dermatopathology, etc.).  
  
• Molecular Pathology: Genetic and molecular basis of diseases.  
  
• Forensic Pathology: Investigation of the cause of death for legal purposes.  
  
• Hematopathology: Diseases of the blood and lymphatic system.

Which Tests are Performed in Pathology Laboratory?

The pathology laboratory is a specialized unit where biological samples are examined. The process consists of sample acceptance, macroscopic examination, tissue tracking (paraffin embedding), sectioning, staining, microscopic examination and reporting. Common tests are as follows:

• Histopathology: Examination of tissue (biopsy, surgical material).  
  
• Cytopathology: Cell (fluid, smear, fine needle aspiration) examination.  
  
• Intraoperative Consultation (Frozen Section): Rapid diagnosis during surgery.  
  
• Histochemistry: Stains showing special structures.  
  
• Immunohistochemistry (IHC): Detecting  specific proteins in cells.  
  
• Immunofluorescence (IF): Examination with fluorescently labeled antibodies.  
  
• Molecular Pathology Tests: Detection of genetic and molecular alterations (FISH, PCR, NGS).

The above tests range from simple examination to complex analysis and illuminate different aspects of the diagnosis.

Why is a pathology test ordered?

Doctors may order a pathology test for the following reasons:

• Making a definitive diagnosis (especially in suspected cancer).  
• Understanding whether a mass is benign or malignant.  
• Determining the stage and grade of cancer.  
• Planning appropriate treatment.  
• Predicting   the course of the disease (prognosis).  
• Monitoring response to treatment.  
• Early diagnosis and screening (e.g. Pap smear).  
• Assessing disease risk.  
• Identifying the agent of infection.
• Following organ transplantation processes.

Frequently Asked Questions

How Many Days Do Pathology Results Take?

The result time is variable. Routine biopsies usually take 2 to 10 days. Cytology may be slightly faster.

Why are Pathology Results Late?

Additional tests may be delayed due to difficult cases, insufficient material, special procedures or laboratory overload.

Is the Pathology Result Visible on E-Nabız?

Yes, E-Nabız system laboratory results can be accessed. Login with Turkish ID number and password. The results are available in the "My Tests" or "My Results" section. The interpretation of the report is made by your physician.

What does "pathological case" mean?

It refers to the sample or process under study, not a direct diagnosis.

What Does a Positive Pathology Report Mean?

It means that the sought finding (e.g. cancer cell) has been detected.

What Does a Negative Pathology Report Mean?

It means that the searched finding was not detected.

What does "unsatisfactory pathology result" mean?

It means that the sample sent is not sufficient for diagnosis, usually a repeat sample is required.

What Does "Neoplasm Undefined" Mean?

It is usually a coding term; it means that there is a tumor but the type is not specified. A neoplasm can also be benign.