Table of ContentsView AllTable of ContentsWhat Is Histopathology?ImportanceHow It’s PerformedReport ComponentsInterpretationOther Sampling Techniques
Table of ContentsView All
View All
Table of Contents
What Is Histopathology?
Importance
How It’s Performed
Report Components
Interpretation
Other Sampling Techniques
Histopathologyinvolves using a microscope to look at human tissue to check for signs of disease. The term is derived from “histology” (meaning the study of tissues), and “pathology” (meaning the study of disease).
A histopathology report describes the findings of a specialist known as apathologist. Examples include the accumulation ofwhite blood cellsseen with infections,crystallized depositsthat occur withgout,granular lumpscharacteristic oftuberculosisorsarcoidosis, or abnormal cell formations seen withcancer.
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Histopathology is not the same thing ascytopathologywhich looks at individual cells. With histopathology, the pathologist not only evaluates cell structure but also how cells are grouped.
Why Is Histopathology Important?
Without histopathology, it would be difficult, if not impossible, to diagnose many diseases. It is essential to the diagnosis of many conditions, chief of which includescancer.
Along with abiopsy(the extraction of tissues for lab evaluation), histopathology remains the gold standard for diagnosing many solid-tumor cancers. Histopathology can differentiatebenign tumors from cancerous onesand is also central tocancer staging(determining how advanced a cancer is) andcancer grading(determining how aggressive a cancer is).
Other diseases for which histopathology is central to the diagnosis include:
Histopathology is also important for the management of diseases. It can help monitor fororgan rejectionaftertransplant surgeryor check for the response to treatment ofinflammatory bowel disease (IBD).
Histopathology also contributes to advances in our understanding of diseases, leading to the development of new treatments. It can also look for new genetic or immunologicalbiomarkersfor diseases so that they can diagnosed earlier when they are most treatable.
How Is Histopathology Performed?
Pathologists and their team of laboratory professionals, such as histology technologists and technicians, perform histopathology. They process and cut tissue into very thin layers called sections. Then, they stain and examine it with a microscope. Using a microscope, they can observe and document the tissue’s details.
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Frozen Section
For some diseases, a sample of the tissue can be interpreted very quickly using frozen sections (also called a cryosection) that are obtained during surgery. Frozen sections are examined immediately in the lab to provide a result within about 20 minutes.
This type of pathology is most commonly used to evaluate tumor margins during surgery so that a surgeon can decide if more tissue should be removed for the full removal of cancer. The use of frozen sections during surgery depends on the type of cancer being removed and other factors.
Lymph and Blood Cancers
Lymph nodesare often biopsied to evaluate for certain types of blood cancer and to identify metastases of solid tumors (such as breast cancer and lung cancer).Abone marrow biopsymay also be required for a definitive diagnosis of many types of blood cancers.
What Hodgkin Lymphoma Looks Like Under a Microscope
Components of a Histopathology Report
Histopathology reports on surgical specimens can be complex. They may include:
Histopathology reports can be challenging to understand, so it’s essential to go over them with a healthcare provider. Knowing which components are going to be included in your report may help you prepare for your appointment.
Interpreting the Results
Many of the pathologist’s findings are used to help determineprognosis, especially in cases of cancer. Prognosis is the prediction or estimate of survival or recovery from a disease.
Prognostic indicators may include:
Grading systemsdiffer depending on the kind of cancer. In general, the cells are scored based on how abnormal they appear under the microscope. The more abnormal the cells look, the higher the grade.
For example, Grade 1 tumors appear nearly normal, whereas Grade 4 tumors reflect more abnormalities.
In addition to histopathology, pathologists may use other techniques to assess the presence of cancer in the tissues.
Immunohistochemistry
Often in lymphomas and other cancers, pathologists useimmunohistochemistryto help assess the tumor type, prognosis, and treatment.Immunohistochemistry involves using antibodies to stick to particular tags or markers outside the cancer cells.
Chromosomal Studies
Pathologists may perform molecular and chromosomal studies to look at gene rearrangements and specific changes to the chromosomes. Sometimes inserted or deleted genes correlate to prognosis. Genetic changes present in a cancer tissue sample may be hereditary or acquired.
For instance, in CLL, a specific piece of a chromosome (17p) is lost. Along with the missing chromosome, a gene that helps suppress cancer is often lost.
The 17p deletion is found in about 5% to 10% of people with CLL overall. The 17p deletion CLL is a form of CLL that is harder to treat with conventional chemotherapy.
Putting It TogetherPathologists may use additional pathology techniques to diagnose cancer. For example, molecular techniques look at proteins, receptors, and genes, which help identify cancer subtypes. Immunohistochemistry looks for markers on cancer cells to narrow down what type of cancer a person has and chromosomal studies look at gene differences to develop a prognosis.
Putting It Together
Pathologists may use additional pathology techniques to diagnose cancer. For example, molecular techniques look at proteins, receptors, and genes, which help identify cancer subtypes. Immunohistochemistry looks for markers on cancer cells to narrow down what type of cancer a person has and chromosomal studies look at gene differences to develop a prognosis.
Summary
Histopathology is the study of tissue to look for disease. Pathologists and their team of lab professionals perform histopathology in a lab. They examine tissue under a microscope and develop a report of their findings.
Histopathology reports can include descriptions of the tissue, diagnosis, and prognosis. In addition to evaluating the shape and structure of cells, pathologists may also use other techniques to assess and diagnose cancer and other conditions.
10 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Cancer Institute.NCI dictionary of cancer terms.Royal College of Pathologists.Histopathology.Underwood JCE.More than meets the eye: the changing face of histopathology.Histopathology.2017;70(1):4–9. doi:10.1111/his.13047National Cancer Institute.Pathology reports.Dogan NU, Dogan S, Favero G, Kohler C, Dursun P.The basics of sentinel lymph node biopsy: anatomical and pathophysiological considerations and clinical aspects.J Oncol.2019;2019:3415630. doi:10.1155/2019/3415630Tomasian A, Jennings JW.Bone marrow aspiration and biopsy: techniques and practice implications.Skeletal Radiol. 2022;51(1):81-88. doi:10.1007/s00256-021-03882-wCollege of American Pathologists.How to read your pathology report.Schafer KA, Eighmy J, Fikes JD, et al.Use of severity grades to characterize histopathologic changes.Toxicol Pathol. 2018;46(3):256-265. doi:10.1177/0192623318761348Ho C, Rodig SJ.Immunohistochemical markers in lymphoid malignancies: Protein correlates of molecular alterations.Semin Diagn Pathol. 2015;32(5):381-91. doi:10.1053/j.semdp.2015.02.016Yu L, Kim HT, Kasar S, et al.Survival of Del17p CLL depends on genomic complexity and somatic mutation.Clin Cancer Res. 2017;23(3):735-745. doi:10.1158/1078-0432.CCR-16-0594Additional ReadingTaylor J, Xiao W, Abdel-wahab O.Diagnosis and classification of hematologic malignancies on the basis of genetics.Blood. 2017;130(4):410-423.
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Cancer Institute.NCI dictionary of cancer terms.Royal College of Pathologists.Histopathology.Underwood JCE.More than meets the eye: the changing face of histopathology.Histopathology.2017;70(1):4–9. doi:10.1111/his.13047National Cancer Institute.Pathology reports.Dogan NU, Dogan S, Favero G, Kohler C, Dursun P.The basics of sentinel lymph node biopsy: anatomical and pathophysiological considerations and clinical aspects.J Oncol.2019;2019:3415630. doi:10.1155/2019/3415630Tomasian A, Jennings JW.Bone marrow aspiration and biopsy: techniques and practice implications.Skeletal Radiol. 2022;51(1):81-88. doi:10.1007/s00256-021-03882-wCollege of American Pathologists.How to read your pathology report.Schafer KA, Eighmy J, Fikes JD, et al.Use of severity grades to characterize histopathologic changes.Toxicol Pathol. 2018;46(3):256-265. doi:10.1177/0192623318761348Ho C, Rodig SJ.Immunohistochemical markers in lymphoid malignancies: Protein correlates of molecular alterations.Semin Diagn Pathol. 2015;32(5):381-91. doi:10.1053/j.semdp.2015.02.016Yu L, Kim HT, Kasar S, et al.Survival of Del17p CLL depends on genomic complexity and somatic mutation.Clin Cancer Res. 2017;23(3):735-745. doi:10.1158/1078-0432.CCR-16-0594Additional ReadingTaylor J, Xiao W, Abdel-wahab O.Diagnosis and classification of hematologic malignancies on the basis of genetics.Blood. 2017;130(4):410-423.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Cancer Institute.NCI dictionary of cancer terms.Royal College of Pathologists.Histopathology.Underwood JCE.More than meets the eye: the changing face of histopathology.Histopathology.2017;70(1):4–9. doi:10.1111/his.13047National Cancer Institute.Pathology reports.Dogan NU, Dogan S, Favero G, Kohler C, Dursun P.The basics of sentinel lymph node biopsy: anatomical and pathophysiological considerations and clinical aspects.J Oncol.2019;2019:3415630. doi:10.1155/2019/3415630Tomasian A, Jennings JW.Bone marrow aspiration and biopsy: techniques and practice implications.Skeletal Radiol. 2022;51(1):81-88. doi:10.1007/s00256-021-03882-wCollege of American Pathologists.How to read your pathology report.Schafer KA, Eighmy J, Fikes JD, et al.Use of severity grades to characterize histopathologic changes.Toxicol Pathol. 2018;46(3):256-265. doi:10.1177/0192623318761348Ho C, Rodig SJ.Immunohistochemical markers in lymphoid malignancies: Protein correlates of molecular alterations.Semin Diagn Pathol. 2015;32(5):381-91. doi:10.1053/j.semdp.2015.02.016Yu L, Kim HT, Kasar S, et al.Survival of Del17p CLL depends on genomic complexity and somatic mutation.Clin Cancer Res. 2017;23(3):735-745. doi:10.1158/1078-0432.CCR-16-0594
National Cancer Institute.NCI dictionary of cancer terms.
Royal College of Pathologists.Histopathology.
Underwood JCE.More than meets the eye: the changing face of histopathology.Histopathology.2017;70(1):4–9. doi:10.1111/his.13047
National Cancer Institute.Pathology reports.
Dogan NU, Dogan S, Favero G, Kohler C, Dursun P.The basics of sentinel lymph node biopsy: anatomical and pathophysiological considerations and clinical aspects.J Oncol.2019;2019:3415630. doi:10.1155/2019/3415630
Tomasian A, Jennings JW.Bone marrow aspiration and biopsy: techniques and practice implications.Skeletal Radiol. 2022;51(1):81-88. doi:10.1007/s00256-021-03882-w
College of American Pathologists.How to read your pathology report.
Schafer KA, Eighmy J, Fikes JD, et al.Use of severity grades to characterize histopathologic changes.Toxicol Pathol. 2018;46(3):256-265. doi:10.1177/0192623318761348
Ho C, Rodig SJ.Immunohistochemical markers in lymphoid malignancies: Protein correlates of molecular alterations.Semin Diagn Pathol. 2015;32(5):381-91. doi:10.1053/j.semdp.2015.02.016
Yu L, Kim HT, Kasar S, et al.Survival of Del17p CLL depends on genomic complexity and somatic mutation.Clin Cancer Res. 2017;23(3):735-745. doi:10.1158/1078-0432.CCR-16-0594
Taylor J, Xiao W, Abdel-wahab O.Diagnosis and classification of hematologic malignancies on the basis of genetics.Blood. 2017;130(4):410-423.
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