Histopathology

The Histopathology department provides a full range of diagnostic surgical pathology including dermatopathology, gastrointestinal, pancreaticobiliary and hepatopathology, gynaecological pathology, breast pathology, renal pathology, neuropathology and paediatric pathology. Dedicated subspecialty groups are practicing at the SCGH site. Test turnaround times are of paramount importance and diagnostic reports are provided to clients according to individual requirements, including various modes of electronic report transmission to maximise timely report delivery. Anatomical Pathology also provides services for numerous formally registered clinical trial projects and provides specialist opinions on diagnostic cases referred from other pathology providers.

A frozen section service is available. This rapid diagnostic modality helps our clinical colleagues in guiding further surgical management intraoperatively.

 

Dermatopathology 

The Dermatopathology group is a subspecialist clinical and academic Dermatopathology service based at the QEII Medical Centre (Sir Charles Gairdner Hospital).  As such, the service has the following goals:

  • To provide a high quality and timely diagnostic service to patients with skin disease and their treating clinicians.
  • To conduct research in diagnostic dermatopathology and provide a histopathological basis for clinical and basic science research in skin disease.
  • To contribute to the post-graduate education of practitioners and trainees in Pathology, Dermatology, General Practice and other specialities dealing with skin disease.
  • To provide a consultative service for pathologists and clinicians dealing with unusual skin diseases.
  • To provide a referral service for complex cases in which cytogenetic, molecular and other ancillary testing may be of value.

Gastrointestinal, Pancreatobiliary and Hepatopathology

 

Gastrointestinal, pancreatobiliary and hepatopathology subspecialty at PathWest, QEII covers clinical and academic anatomical pathology services in relation to diseases of the gastrointestinal & pancreatobiliary tract and the liver. A wide range of material including endoscopic biopsies, excisions and resections as well as relevant cytological preparations are received for assessment from Sir Charles Gairdner Hospital (SCGH), QEII Medical Centre and various other healthcare facilities of WA. This service covers the following:

 

  • Routine diagnostic services
  • Dealing with specimens obtained by advanced endoscopic and surgical techniques such as endoscopic resections & cytological preparations obtained by EUS techniques.
  • Pathology services to the WA Liver & Kidney (SCGH) Surgical Transplant Service.
  • A referral centre for consultations for difficult and clinically challenging cases.
  • Participating in several multidisciplinary meetings contributing directly to clinical care.
  • Active undergraduate (UWA) and postgraduate teaching and advanced training as fellowships in the subspecialty.
  • Clinical and translational research as collaborations at local (clinicians & UWA), interstate, national and international level.
  • Leading and contributing to educational and development activities in the subspecialty collaborating with professional bodies such as the Royal College of Pathologists of Australasia (RCPA), International Academy of Pathology (IAP) Australasian branch, Australian Society of cytology (ASC) and relevant societies.
  • The designated centre of HER2 testing for gastric/GOJ cancers in WA (one of the 5 centres in the country).

Certain specimens such as endoscopic resections, specimens for molecular testing & testing focused on target therapy may need special handling and requirements. For any enquiry please contact one of the team members.

Respiratory Pathology

The Respiratory Pathology subspecialty group at the Queen Elizabeth II Medical Centre is a clinical service which provides high quality and timely diagnosis of diseases involving the lungs, pleura and related structures. Our pathologists work in a collaborative environment with respiratory physicians, cardiothoracic surgeons, oncologists and scientific staff to provide a patient centred service.
The group reports a range of neoplastic and non-neoplastic respiratory samples, including:
  • Surgical biopsies and resections
  • Bronchoscopic guided samples including those procured by endoscopic bronchial ultrasound guided fine needle aspiration
  • Exfoliative samples - sputum, pleural fluid
  • Direct and image guided fine needle aspiration biopsies
Molecular testing for epidermal growth factor receptor (EGFR) mutation status as a predictive marker in a subset of lung tumours is well established in our laboratory for both cytological and histopathology samples.
In addition to clinical service, the respiratory pathology subspecialty group is also involved in undergraduate and postgraduate teaching as well as ongoing research in the pathogenesis and diagnosis of thoracic disorders, with particular emphasis on mesothelioma research.
The group attends and presents at weekly multidisciplinary respiratory meetings to plan management of patients with respiratory malignancies.
Soft tissue and Bone Pathology 
Sarcomas of bone and soft tissue are a remarkably diverse and complex group of malignancies, affect both paediatric and adult populations, and are rare when compared with other forms of human malignancy. Their diagnosis and management requires a coordinated team approach from a multidisciplinary team which includes, amongst others, Surgeons, Pathologists, Radiologists, Medical Oncologists, and Radiation Oncologists. Pathologists play a key role in this process. Management decisions in patients with sarcomas rest upon tissue diagnosis. The principal concern of the diagnostic biopsy procedure is to obtain sufficient viable and representative material for accurate diagnosis and classification, but this must be offset by considerations regarding therapeutic / surgical options and possible procedure related complications. Without careful planning, biopsies may adversely effect patient treatment and outcome as a result of misdiagnosis or procedural complications. Pre-Biopsy Planning by the treating multidisciplinary team (Surgeon, Pathologist, Radiologist, Oncologist, Radiotherapist) therefore is essential. Inappropriate biopsy technique and assessment leads to significant problems in patient management and adversely impact on prognosis. Errors in diagnosis may lead to inadequate or incorrect treatment.
PathWest pathologists are active in multidisciplinary teams involved in the management of patients with sarcoma in Western Australia, including a weekly multidisciplinary meeting.
Uropathology
Genitourinary pathology is a subspecialty in anatomical pathology which deals with the diagnosis and characterisation of diseases involving the urinary system and male reproductive systems, such as kidneys, bladder, ureter, prostate and testicles. A wide range of conditions, both neoplastic and non-neoplastic, can be encountered and accurate diagnosis often requires close collaboration between Pathologists, Radiologists and Urologists. PathWest have a team of Pathologists with particular interest in this area, who provide a full range of diagnostic services including interpretation of biopsies and comprehensive evaluation of surgical resections. We actively participate in multidisciplinary teams involved in the management of patients with urologic disorders, including regular attendance at the fortnightly multidisciplinary meeting.
Haematolymphoid
The Haematolymphoid Pathology division provides a multi-disciplinary diagnostic service in neoplastic and non-neoplastic diseases of the lymphoreticular system.  The division delivers a comprehensive and specialised diagnostic service that integrates morphology with latest molecular diagnostic techniques, immunohistochemistry, flow cytometry, cytogenetics and FISH for the diagnosis, prognostication and targeted treatment of lymphoid malignancies.  The unit is supported by state-of-the-art diagnostic facilities including PCR-based assays, immunohistochemistry and in-situ hybridisation technologies and offers a fellowship in lymphoma pathology.  Further, the division provides a consultancy diagnostic service at a wider state, interstate and international level.
Paediatric and Perinatal Pathology
Paediatric and perinatal pathology is located at Princess Margaret Hospital for Children where it serves the state Child and Adolescent Service, and the fetal and neonatal needs of the Women’s and Newborn Service largely based at King Edward Memorial Hospital for Women.  Paediatric pathology is a distinct discipline based on the understanding of the genetic and cellular mechanisms of disease and its morphologic expression in the fetus and placenta, the newborn, and in children.  The service receives approximately 3700 biopsy and surgical specimens and 400 fetal, perinatal, neonatal and paediatric autopsies, annually.  There are active programs in children’s gastrointestinal disease, fetal, genetic and neonatal disorders and oncology.  It is one of only a few international members of the Children’s Oncology Group based in the USA.  The service is staffed by internationally and locally trained and recognised subspecialists with active clinical, educational and research interests, and it provides consultation services for the women and children of the public and private hospitals across Western Australia.
 
Gynaecological Oncology Pathology
 
King Edward Memorial Hospital is a Women’s Hospital and is a referral centre for WA state gynaecological oncology services. 
 
The laboratory at KEMH provides anatomical pathology services for both routine and gynaecological oncology specimens from KEMH hospital and also receives referral pathology specimens from other pathology laboratories in WA.  The Laboratory is currently staffed by 4 FTE pathologists and offers histopathology, cytopathology, frozen section services, as well as ancillary studies including immunohistochemistry, molecular studies amongst others.  
 
Regular teaching sessions as well as Multi-Disciplinary Tumour Board meetings (weekly) and Cervical cytology review meetings (monthly) are held.  The Department encourages research into pathological aspects of gynaecological cancers and is part of the postgraduate programme for registrar training.

 

Page last updated: 18 Mar 2015