The Cellular Pathology Services comprise the Histopathology and Cytopathology department at St Thomas’ Hospital, the Dermatopathology department at St John’s Institute of Dermatology, St Thomas’ Hospital, and the Oral Pathology department at Guy’s Hospital.
The main Histopathology and Cytopathology laboratories operate alongside each other on the 2nd floor, North Wing, St Thomas’ Hospital. The department is accredited to ISO standards by Clinical Pathology Accreditation (CPA). Staff are appropriately qualified and trained and actively participate in continuing professional development (CPD) and external quality assurance schemes (EQA).
Our specialist histopathologists and cytopathologists are all consultants on the staff of Guy’s and St Thomas’ Hospital and work closely with their clinical colleagues.
Histopathology provides a comprehensive tissue diagnostic service and serves the regional Cancer Centre. The department receives approximately 20,000 specimens per year providing a clinical diagnostic service to Guy’s and St Thomas’ Hospitals, the Evelina Children’s Hospital, and local General medical practitioners. Our specialist pathologists receive regional, national and international referrals. Our specialist diagnostic and technical teams aim to deliver the best possible service. Examples of the services we offer include:
In addition to routine processing of fixed tissue, the department offers a frozen section service at both the Guy’s and St Thomas’ sites, incorporating receipt of fresh tissue for enzyme histochemistry, lymphoma studies, tissue banking, etc. Molecular techniques are performed on both fresh and formalin fixed, paraffin embedded tissue samples.
Within the department is a specialist, fully automated, immunocytochemistry laboratory that serves both the Histopathology and Cytopathology departments and is a referral centre for HER-2 testing. As well as traditional immunocytochemistry methods the laboratory also employs in situ hybridisation and direct immunofluorescence techniques. Our dedicated renal histopathology laboratory offers attendance at wards for assistance with biopsy taking and also an on-call Saturday service.
The department is also committed to research and development and is always seeking to expand and develop its expertise and diagnostic repertoire.
The laboratory offers the following services:
Gynaecological exfoliative cytology
The department is fully converted to Liquid Based Cytology (LBC) and acts as the processing hub for inner south-east London, processing approximately 80,000 gynaecological samples annually, 36,000 of which are reported internally. Molecular diagnostic (genetic) testing for Human Papilloma Virus (HPV) is also undertaken.
Non-gynaecological exfoliative cytology
This includes evaluation of body cavity fluids, and washings and brushings from various parts of the body. The ability to prepare cell blocks and treat fluid samples like tissue blocks has remarkably improved the effectiveness of this technique in the detection of primary and metastatic cancer and also in the determination of the primary site of metastatic cancer.
Fine needle aspiration cytology
This is a quick, minimally invasive and cost-effective method of reaching a cellular diagnosis on mass lesions and offers the opportunity to collect material for ancillary studies at the same time. The cytopathology consultants hold clinics for palpable mass aspiration and offer a mobile ward based FNA service. The laboratory provides Biomedical Scientist (BMS) support for radiologically aspirated lesions. In the vast majority of instances, adequacy is determined during the procedure to ensure that sufficient diagnostic material is available and to allow collection of additional material for ancillary studies like microbiology, immunocytochemistry, flow cytometry and cytogenetics. This approach often allows for a rapid confident and complete diagnosis, obviating the need for a surgical biopsy in a large number of cases.
Semen analysis
This includes routine semen analysis for infertility cases as well as evaluation of post-vasectomy samples.
Team Profiles
M Middleton
DU Manager Cellular Pathology
Dr Ashish Chandra
FRCPath DipRCPath (Cytol)
