Pathology literally means "the study of suffering." Pathologists complete four years of medical school and then complete training in either anatomic pathology or clinical pathology. Anatomic pathology is the branch of medicine that studies tissues. Typical anatomic pathologists will perform and/or review surgical biopsies (tissue removed by a surgeon), cytology samples (such as fine needle aspirations and Pap smears) and autopsies.
Clinical pathology is the branch of medicine that studies fluids. Typical clinical pathologists oversee and interpret tests from laboratories such as chemistry, hematology, microbiology, immunology and blood bank. Both anatomic and clinical pathologists at the Brigham and Women's Hospital are, in addition to active daily patient care, involved with extensive teaching, research and community service.
If you would like a second opinion from the Department of Pathology on your diagnosis of tissue and fluid samples, your doctor must submit the request to us. We do not accept requests directly from patients, but we encourage you to speak with your doctor if you are interested in a second opinion. Here are instructions on how your doctor can submit the second opinion request to Brigham and Women’s Hospital.
The vast majority of fluid samples that are collected from patients are discarded after a specific period of time when all relevant testing is completed. Certain samples like gallstones or kidney stones may be sent out for chemical analysis to determine future treatment of patients.
In most cases, your primary doctor or the doctor who order the tests will discuss the results with you and what they mean. If you are unclear about the results, especially regarding tissue biopsies, you may contact the Pathology Department and make an appointment to speak with a pathologist specifically about your results and what they mean. However, only your primary clinical doctor (not the pathologist) can determine with you what the next treatment steps should be for your health.
Brigham and Women's Hospital uses an integrated laboratory system with interconnected tracks and machines so that one tube of blood can be moved seamlessly from machine to machine to perform the tests. In most tests, only a small amount of blood is needed to obtain the result.
The vast majority of human diseases can be diagnosed with some form of laboratory or pathology tests. Pathology is the art and science of exact diagnosis. However, the laboratory cannot diagnose all diseases. Many lab tests are performed to "rule out all other possibilities." Medicine, although based on solid proven evidence, is not an exact science and requires a competent physician supported by an excellent laboratory to provide you the best possible care.
Laboratory tests require variable amounts of time depending on the tests. Certain tests, called "point of care," take only a few minutes, such as an oral swab HIV test, a glucose, a rapid influenza test or a rapid strep test. Although these may need to be performed by the laboratory, they only take a few minutes to do so.
Other tests, such as a blood gas analysis run on critically ill patients in the hospital, are routinely reported in 7 to 9 minutes after collection. Routine laboratory tests that help you doctor determine what conditions you might have but are not time sensitive are usually run and available within 24 hours of your blood draw. Some exceptions to this include tests where another laboratory (a reference laboratory) needs to provide the test and that make take several days.
Your doctor may want to wait for ALL test results to be completed before contacting you; thus, it may take a week or more for a full battery of results to be available. Pathology tissue biopsies take approximately 48 hours to process and make into glass slides to be reviewed by the pathologist. Additional tests may be necessary on the tissue to make a final diagnosis. From the time of your surgery to the time the results are available to your doctor is usually 5 to 7 days.
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