Pathology

The Department of Pathology provides comprehensive diagnostic services with emphasis on accuracy, precision and prompt reporting to our patients thereby helping and guiding the clinicians in proper patient management. The department started in 1998 along with the inauguration Amrita Hospital, and since then is located at 6th tower, 3rd floor with easy accessibility to all the clinicians.

The various labs that function under this department are Histopathology, Cytology and Hematology.

All the Labs are most modernised and well-equipped with skilled personnel. The labs are all NABL accredited which puts them in a higher platform with regard to quality.

The Department of Pathology participates in the external quality assurance programmes on a regular basis, namely EQAS CBC- Christian Medical College, Vellore and EQAS coagulation in Haematology with AIIMS, New Delhi.. For Histopathology with Anand laboratories Bangalore & Cytology , Ranbaxy Lab Mumbai.

The samples are tested in Pathology Department and reports are made online. We accept samples / slides / paraffin blocks for special tests & review as part of the referral facility and provide a second opinion on them.

The pathology department has a 12-member faculty, assisted by 32 technicians,and 9 clerical staff

This department provides the diagnostic services of Histopathology including Fetal Autopsy ,

Cytology (including FNAC), and Hematolgy to Amrita Hospital as well as specimens and tissues brought from outside.

The Histopathology division is excelling itself due to the presence of a state-of-the-art histopathology lab aided with availability of special techniques like immunohistochemistry and immunofluorescence. A complete work up of tissue from various parts of the body can be studied in detail to arrive at “The Final Diagnosis” because of these advancements.

The tissue technologists are well trained senior staff members whose hand skill contributes to the excellent material provided to the pathologists for study. By adopting a system wise pattern of reporting in the department, the pathologists are fine tuned to excel in their chosen field.They are getting national and international training also for the same. A very efficient clinician pathologist correlation discussions that has been put into place is streamlining the study,and is helping the patient to get the best of treatment.

The Renal pathology section receives sample from all over Kerala and the neighbouring state of Tamil Nadu as well. The 10 headed microscope, one of its kind in whole of South India, used in the discussion of complex cases and is also a good tool for teaching purposes, especially for the post graduates of our department & few of the other specialities. The wide range of material received for study in the department from the various branches especially Oncology, Gastroentroology, Head & Neck to mention a few , are immensely aiding our post graduates to get the best of knowledge.

The role of pathologists in surgical transplantation team has helped the success of transplants in the hospital. The study of frozen section which is being provided by the department.is useful for surgeons to get an intraoperative consultation within a short span of 15 minutes.

Fetal autopsies conducted in our department is of immense help to perinatologists who do counselling for subsequent pregnancies.

Diagnostic services provide reports roughly on 15,000 pathology specimens, over 500 frozen sections, 900 second opinions, and 30 fetal autopsies every year.

Routine Tests

• HPE (small biopsies like endoscopic mucosal biopsies, curettings, punch biopsies of oral cavity, cervix, trucut biopsy from breast, prostate, thyroid and small incisional biopsies).
• HPE (big biopsies like hysterectomy, mastectomy, gastrectomy, thyroidectomy, APR,total colectomy,radical prostatectomy, Radical neck dissections, brain biopsy and other organs for histological evaluation.
• Frozen Sections and Sterotactic biopsy done on Cryostat machine and providing reports within 15 mins intraoperatively.
• Decalcification and processing for bone biopsies.

Special Tests

• Histochemistry – Reticulin, Masson’s Trichrome, Periodic Acid Schiff (PAS), Silver Methenamine, AFB (Acid fast bacilli), Von Geison, Perl’s, Orcein, PTAH, Luxol fast blue, cresyl violet.
• Immunohistochemistry- Using a large panel of antibodies we are providing comprehensive immunohistochemistry to aid our histopathological diagnosis & providing therapeutic & prognostic significance for the patient management.
• Immunofluorescence availability has helped us with our renal and skin tissue reporting.

The Hematology lab squipped with 4 fully automated 5 part complete blood count analyzers including the Beckmen Coulter, analyses more than 2500 samples daily.

The coagulation profile, complete with factor assays, mixing studies, inhibitor essays and platelet aggregation study, all done with Amax Destiny plus machine, along with the hematopathologist’s inference helps in solving various bleeding abnormalities. The availability of immunophenotyping is another feather in the work up of leukemia cases. The lab handles more than 5 lakh samples annually.

The various haematological parameters tested in this laboratory include the following –

Routine Tests

• Hemogram are done in automated blood cell counters.
• ESR, Reticulocyte count, Sickling test, Absolute eosinophil count,Peripheral smear study.
• Prothrombin time (PT)/ Activated partial thromboplastin time (APTT)-, D Dimer, Fibrinogen,Factor VIII ,IX & XIII assays, Mixing studies, Inhibitor assays, Lupus anticoagulant all done in 2 machines of Amax Destiny Coagulometers.
• LE cell.
• Parasites: MP, microfilaria.

Special Tests

• Bone marrow aspiration/ trephine biopsy.
• Fetal haemoglobin.
• Bone marrow Iron stain.
• Cytochemical stain: MPO, PAS, NSE.
• Osmotic fragility, G6PD.Hams.
• Platelet Aggregation studies.

Clinical Pathology

• Urine routine/microscopic/ pregnancy test/
• Urine RBC cytology, Eosinophils, Porphobilinogen, BJP, Hemosiderin.
• Stool, occult blood, fat, pH, reducing sugar.
• Semen analysis.
• Body fluids-cell count, crystals.

Analyzes cell strcture to diagnose disease. With a dedicated team of pathologists and cytotechnologists, diagnosis is reached for material obtained by fine needle aspiration and exfoliation. The cytocentrifuge, in this department is an important tool in observing the cerebrospinal fluid in leukemia / lymphoma patients and to also study urine samples.

Tests done :

FNAC (Fine Needle Aspiration Cytology).

Exfoliative cytology including PAP smears and body fluids, sputum, bladder and bronchial brushings.

Cell block studies.