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Anatomic Pathology

Anatomic pathology is a medical specialty that focusses on the diagnosis and study of human disease through the examination of human tissues and cells. The Division of Anatomic Pathology in the Queen's Department of Pathology and Molecular Medicine provides subspecialty expertise in all major areas of surgical pathology, cytology and both medical and forensic autopsies.  Our pathologists provide diagnostic expertise to the academic hospitals associated with Queen's University and to regional community hospitals via our Lab Outreach program.  Consultation and second pathology reviews are an important part of our mandate and are currently provided through the entire south eastern Ontario area and beyond.  Consultations may be referred using this form.

 

An autopsy is a postmortem examination of the deceased body performed by a physician. Its purpose is to learn about the person's health during life, and to determine the cause of death. In a hospital autopsy, often the cause of death is known and the purpose of the autopsy is to determine the extent of the disease, the effects of therapy, and the presence of any undiagnosed disease. 

In Ontario certain autopsy cases that fall under the jurisdiction of the coroner.  Examples include sudden or unexpected deaths, deaths occurring to those in custody or deaths from violence.  These are called medico-legal or forensic autopsies. The Autopsy Pathology Laboratory at Kingston General Hospital performs both hospital autopsies and medico-legal autopsies. 

For further information on the autopsy service, please contact Dr. Jeffrey Tanguay

Posted 2015 Sept 22: Resuscitating the Autopsy: Why our current 7% rate of non-forensic autopsies is unacceptable (and a suggestion for a remedy) By David Hurlbut – presented at Dept. of Medicine Morbidity and Mortality Rounds

Breast Pathology is a subspecialty of Surgical Pathology that focuses primarily upon the diagnosis of benign and malignant breast conditions and the assessment of prognostic and predictive biomarkers in breast cancer. The breast pathologists actively participate in weekly Breast Tumour conferences in the regional cancer centre as well as the Breast Assessment Program at the Hotel Dieu Hospital and work as part of a multidisciplinary team in the provision of accurate, timely breast pathology reports. A busy local and regional diagnostic consultation practice complements an academic focus on translational research in the area of breast cancer novel biomarker identification and technical-clinical validation.

Cytology is the subspecialty of pathology that focuses on the diagnosis of disease through examination of isolated cells from fine needle aspirations, urine, sputum, cervical smears and similar specimens.  Diagnostic services included:

  • pap smear interpretation by cytopathologists certified in both conventional and liquid based preparations
  • all areas of non-gynecologic cytology
  • cell block preparation for immunohistochemistry
  • flow cytometry

Dermatopathology is a subspecialty of surgical pathology that is focussed on the laboratory diagnosis of skin disease.  The Dermatopathology service in Pathology and Molecular Medicine provides a full range of diagnostic services on inflammatory and neoplastic skin diseases.   The unit is also very active in teaching and skin cancer research.  The following services are available:

  • Routine slide interpretation
  • Immunofluorescence
  • Electron microscopy
  • Gene rearrangement studies
  • Consultative opinions

Gastrointestinal Pathology is a subspecialty of surgical pathology focused on the laboratory diagnosis of diseases of the human digestive system.  The Gastrointestinal Pathology service in the Department of Pathology and Molecular Medicine provides a full range of diagnostic services for non-neoplastic and neoplastic diseases of the gastrointestinal (GI) tract, liver, biliary tract and pancreas.  The unit is also very active in teaching and collaborative research on GI inflammatory disorders and cancer.  The following services are available:

  • Routine slide interpretation
  • Immunohistochemistry
  • Electron microscopy
  • Consultative opinions

Genitourinary pathology is a subspecialty of surgical pathology that is focussed on tissue diagnosis of diseases affecting the kidney, ureters, bladder, prostate, testis and related organs.  The GU service is heavily involved in teaching and research and provides a full range of diagnostic services including:

  • Routine slide interpretation
  • Immunofluorescence
  • Electron microscopy
  • Consultative opinions

Gynecologic pathology is a subspecialty of surgical pathology that is focussed on the laboratory diagnosis of benign and malignant gynecologic disorders.  The Gynecologic pathology service in Pathology and Molecular Medicine provides a full range of diagnostic services.   The unit is also active in teaching and cancer research.  The following services are available:

  • Routine slide interpretation
  • Immunohistochemistry
  • Electron microscopy
  • Gene rearrangement studies
  • Consultative opinions

Head and Neck Pathology is a subspecialty of surgical pathology focused on the laboratory diagnosis of disease involving the head and neck region of the human anatomy. The Head and Neck Pathology service in the Department of Pathology and Molecular Medicine provides a full range of diagnostic services for non-neoplastic and neoplastic diseases of the upper aerodigestive tract (oral cavity, nasal and paranasal cavities, pharynx, larynx), thyroid and parathyroid glands, salivary glands, ear, and other non-cutaneous tissues in this anatomical area. 
The following services are available:

  • Routine slide interpretation
  • Immunohistochemistry
  • Electron microscopy
  • Consultative opinions

Examination of biopsy tissues under the microscope has remained the cornerstone of surgical pathology for many decades. This approach relies on the ability of pathologists to recognize different cells or tissues based on their appearance. However, certain cells or tissues are difficult to recognize based on appearance alone. In particular, some cancer cells resemble normal cells and vice versa! Irrespective of appearance, different cell types contain different protein molecules. Immunohistology allows pathologists to see which cells express a particular protein molecule and which do not, thereby allowing confident distinction between similar-looking cells. Thanks to its power and relative simplicity, immunohistology is used heavily in surgical pathology and its role continues to grow.

Lymph nodes are small organs distributed throughout the body, often just under the skin, that are involved in the immunological protection of the body from infections. Lymph node pathology involves the diagnostic evaluation of lymph node biopsies by microscopic examination, immunohistology and other tests. This pathology subspecialty is especially concerned with the diagnosis of lymphomas, solid tumours of white blood cells including Hodgkin lymphoma and the numerous types of non-Hodgkin lymphoma. The following services are available:

  • Routine slide interpretation
  • Immunohistology
  • DNA-based studies, including:
    • Antigen receptor gene rearrangements
    • Fluorescence in situ hybridization
  • Consultative opinions

"Neuropathology is the pathological study of brain disease."

Ophthalmic Pathology is a subspecialty of surgical pathology that is focussed on the laboratory diagnosis of diseases of the eye and ocular adnexae that require tissue removal. The service in Ophthalmic Pathology in the Department of Pathology and Molecular Medicine provides a full range of diagnostic services on biopsy, excision, keratoplasty and enucleation/exenteration specimens. The unit is also very active in teaching. The following services are available:

  • Routine slide interpretation
  • Immunofluorescence
  • Electron microscopy
  • Gene rearrangement studies
  • Consultative opinions

The Pulmonary Pathology service provides diagnostic expertise focussed on neoplastic and non-neoplastic disease of the lungs but also includes related structures such as pleura and mediastinum. A full range of services are available including:

  • Routine slide interpretation
  • Immunofluorescence
  • Electron microscopy
  • Gene rearrangement studies
  • Consultative opinions

The Soft Tissue and Bone Pathology Service at Kingston General Hospital is focused primarily upon the histopathologic diagnosis of benign and malignant soft tissue tumours in core biopsies and excision specimens, with the help of ancillary diagnostic tools such as immunohistochemistry and cytogenetics. Due to the complexity and rarity of soft tissue and bone tumours, challenging cases are sent for external consultation and further workup, as indicated, to the Hospital for Sick Children or to Mount Sinai Hospital, Toronto, depending on the age of the patient.