11 Tissue and molecular diagnosis

ACKNOWLEDGEMENTS The authors are very grateful to the following contributors for assistance with ...

ASSESSMENT Light microscopy Most tissue assessment depends on conventional light micros - copy . ...

AUTOPSY In the past, autopsies (postmortems) allowed physicians and scientists to improve their k...

BRAF V600E mutation for detecting antigens in haematological neoplasms, usually in - blood sampl...

Basic methods in diagnostic molecular pathology In situ hybridisation H. In situ hybridisation (I...

Cancer ‘precision medicine’ This refers to the development of individualised cancer care plans, ...

Cytogenetics and fluorescence in situ hybridisation Conventional cytogenetics is the microscopic s...

Cytological assessment A cytological preparation consists of a sample of cells only . Assessmen...

Cytology specimen Samples for cytology can be smeared immediately onto glass slides, fixed (usuall...

Cytology There are various approaches to the procurement of a cytol ogy sample. Some samples are...

DIAGNOSTIC MOLECULAR PATHOLOGY The broad heading of diagnostic molecular pathology refers to m...

DIGITAL PATHOLOGY AND ARTIFICAL INTELLIGENCE The term ‘digital pathology’ usually refers to the e...

Deeper levels and extra blocks The pathologist may request ‘deeper levels’, whereby the BMS cuts ...

Detection of clinically relevant abnormalities in genes There are two broadly related areas of ...

Detection of clinically relevant abnormalities in genes There are two broadly related areas of ...

Detection of clinically relevant abnormalities in genes There are two broadly related areas of ...

Electron microscopy Electron microscopy allows visualisation of tissue at very high magnification,...

FURTHER READING Brierley JD, Gospodarowicz MK, Wittekind C. TNM classification of malignant tumour...

FURTHER WORK Pathologists request further stains or other tests on a signif - icant minority of ...

Flow cytometry Flow cytometry is a laser-based or impedance-based technique used for cell countin...

Fresh tissue The most common indication for submission of a fresh tissue sample (i.e. without th...

Genomic changes in tumours In normal circumstances, there is precise control of the divi - sion ...

HER2 gene amplification HER2 status influences the selection of therapy for breast cancer and meta...

Histological assessment In a histological preparation, the microscopic structure of the tissue r...

Histological types of malignancy A malignant tumour showing features of epithelial di ff erentia ...

Histology specimen On arrival in the pathology laboratory , specimens receive a unique identificat...

Histology Specimens for histology are classified as biopsies and resec - tions, although strictly ...

Immunohistochemistry: tumour pathology Immunohistochemistry has multiple applications in tumour p...

Immunohistochemistry Immunohistochemistry emerged in the 1970s and has had a major impact on hist...

INTRODUCTION Pre-nineteenth century tissue diagnosis depended on naked eye examination of autops...

Learning objectives To understand: The value and limitations of tissue diagnosis • Approaches to ...

Microscopic features of inflammation Acute inflammation is characterised histologically by neutro -...

Mismatch repair gene abnormalities in tumours High levels of microsatellite instability (MSI-H),...

Molecular changes and drug therapy An increasingly common reason for molecular testing and relate...

Molecular profile: examples of specific tumours Colorectal carcinoma In CRC, the anti-EGFR monoclon...

Non-neoplastic and inflammatory conditions The diagnosis, assessment and management of non-neopla...

Other terms Other specific tissue abnormalities are also detectable by microscopy . Histopathologi...

PRINCIPLES OF MICROSCOPIC DIAGNOSIS Diagnosis of malignancy Neoplasia is a broad term that includ...

PRINCIPLES OF MICROSCOPIC DIAGNOSIS Diagnosis of malignancy Neoplasia is a broad term that includ...

Polymerase chain reaction The polymerase chain reaction (PCR) amplifies DNA, yield ing millions of...

Prognosis Tests that help determine the selection of therapy for tumours may also have additiona...

Prognostic factors for malignant tumours Tissue assessment is important for cancer prognosis. Sta...

REASONS FOR ASSESSMENT OF TISSUE The contributions that tissue analysis makes to clinical - manag...

RISK MANAGEMENT Safety and risk management are priorities in the labora - tory . The use of warn...

SPECIMEN PROCESSING SPECIMEN PROCESSING SPECIMEN PROCESSING

Special stains A ‘special stain’ is a stain that is not routine, i.e. not an H&E stain. Immunohis...

Specimen adequacy There are many reasons for an inadequate specimen. The operator may fail to sam...

Storage Resection specimens are generally stored for about 4–6 weeks. Tissue blocks and slides ar...

TISSUE SPECIMENS Routine tissue specimens received by a histopathology depart - ment include thos...