Surgical Pathology

GENERAL SURGICAL PATHOLOGY
The surgical laboratory handles diagnostic biopsies and monitors the removal of diseased tissues.  Pathologists with expertise ranging from cancer of the prostate to inflammatory diseases of the lung examine surgical material utilizing the latest techniques.  Specimens are analyzed by modalities ranging from traditional staining to esoteric probes from nucleic acids (the constituents of RNA and DNA).  Great care and rapid reporting are the keynotes sounded here.  Services are available seven days a week, 24 hours each day.  Frozen sections on intraoperative cases are performed regularly and consultation with our surgeons is always ongoing.

BONE AND SOFT TISSUE PATHOLOGY
The faculty provide for subspecialty expertise in Bone Pathology.  The chief of the soft tissue and bone diagnostic service is subspecialty trained and works closely with the emerging bone oncology surgical program at SBUMC and offers an expert consultation service. The department supports the Sarcoma Multidisciplinary Tumor Board. Customized protocols for handling bone tumor specimens are utilized for processing and reporting. Cancer excisions are reported utilizing CAP protocols.  The service is dedicated to the diagnosis of rare and challenging tumours and other Pathology of bone & soft tissue. In addition to diagnostic microscopy, immunohistochemistry, & genetic profiles; Clinical and radiologic correlation, along with a multidisciplinary approach to diagnosing each individual case is taken to optimize treatment and patient care accordingly.

BREAST PATHOLOGY
This specialty, headed by three Breast Pathology experts, supports the accredited Breast Center at Stony Brook University Medical Center. Customized protocols are utilized for handling breast specimens and diagnosis are provided within 24 hours for new cancer cases. Resources are allocated to support the application of College of American Pathologists/ ASCO guidelines for receptor studies. There is active participation in the Breast Multidisciplinary Team, with case presentations at the weekly conference held in the Anatomic Pathology conference room. The laboratory is enrolled in Her 2 neu and ER/PR proficiency testing.

DERMATOPATHOLOGY
The dermatopathology service is headed by a board certified Dermatopathologist and provides diagnostic expertise in both non-neoplastic and neoplastic dermatology specimens. Cancer excisions are reported utilizing CAP protocols. The department supports the Melanoma Multidisciplinary Tumor Board.


GASTROINTESTINAL PATHOLOGY
Multiple surgical pathologists participate in the GI service for both adult and pediatric cases and this service is headed by two pathologists. In addition, the cytopathologists in the department support an active EUS FNA service for pancreas and other GI neoplasms. Multiple GI biopsy and colorectal surgery conferences are held where cases are presented and decisions about clinical management made.

GYNECOLOGIC PATHOLOGY
This specialty, headed by three Gynecologic Pathology experts, supports the rapidly growing team of Gynecologic Oncology surgeons at Stony Brook University Medical Center. Customized protocols are utilized for handling gynecologic specimens. There is active participation in, and support of, the Gynecologic Oncology Multidisciplinary Team with case presentations at the Gynecologic Oncology and Benign Gynecology conferences held in the AP conference room. The department supports tissue banking for the Gynecologic Oncology Group (GOG) with many open protocols. There is also participation in the national conferences of the GOG.

HEMATOPATHOLOGY
This service is run by three board certified hematopathologists.  A comprehensive panel of immunohistochemical stains is available for the work up of cases along with support from the Flow Cytometry and Molecular Pathology Laboratories; CAP cancer protocols are utilized.  The department supports the Lymphoma Multidisciplinary Tumor Board and cases are presented for clinical management.

MUSCLE BIOPSY DIAGNOSTIC SERVICE
This is headed by an experienced board-certified neuropathologist.  Internal and referral cases are accepted. A battery of IHC and special stains has been customized and developed for this service and technical expertise exists in-house.

NEUROPATHOLOGY
Neuropathology staff specialize in the evaluation of nerve and muscle biopsies. In addition to providing the traditional laboratory services, selected studies range from histochemistry through immunohistology to ultrastructural analysis.  If requested, the section provides special equipment and consultation to ensure the optimal processing of material.


PEDIATRIC PATHOLOGY
Directed by a certified Pediatric Pathologist, this laboratory offer expert services and consultation in placental pathology and routine pediatric pathology.




PULMONARY PATHOLOGY SERVICE
This is headed by an experienced pathologist. Cancer excisions are reported utilizing CAP protocols.  The department supports multiple lung and thoracic conferences.




RENAL PATHOLOGY
The renal pathology service is headed by an experienced subspecialty-trained renal pathologist.  The renal transplant service at SBUMC is actively supported by the department. Technical expertise to process these specimens in an expeditious manner is available in-house. Standardization is obtained by utilizing special renal protocols on automated strainers.  The department supports the Renal Conference and cases are presented for clinical management.

SPECIAL HISTOLOGY
Adept in the use of immunocytochemical techniques and DNA/RNA probes applied to tissue, this laboratory specializes in the diagnosis of unusual tumors by immunologic techniques and encourages consultation with a specially skilled pathologist. Capabilities range from routine skin biopsies to renal biopsies and lymphocyte markers. The laboratory routinely classifies leukemias and lymphomas using the broadest available panels of accepted CD antigens and enzymes. If requested, same day turnaround is provided for special serologic studies such as anti-neutrophil cytoplasmic antigen (ANCA), used for the diagnosis of vasculitis and anti-basement membrane antigen (Goodpasture's disease).  Probes for viral nucleic acid (in situ and in sit u PCR hybridization) for CMV, herpes, papilloma virus among others are available.  Panels for melanoma, germ cell tumors, mesothelioma, soft tissue neoplasms and steroid receptors (used in carcinoma of the breast) are regularly performed.  The laboratory is enrolled in multiple proficiency tests for routine as well IHC stains.  It is highly automated and is supervised by an experienced histotechnologist.

THYROID PATHOLOGY
The active Thyroid Pathology service is supported in conjunction with the thyroid cytology fine needle aspiration service.  This is headed by a pathologist with decades of experience at SBUMC in this specialty.  The department also supports the Thyroid Conference.



QUALITY IMPROVEMENT AND PATIENT SAFETY
The Anatomic Pathology division has a strong commitment to continuous quality improvement and a focus on patient safety. This program is headed by the Vice Chair for Anatomic Pathology.  A Quality Improvement and Patient Safety plan has been devised for the division. Preanalytic, Analytic and Postanalytic aspects are covered. Standard Operating Protocols have been written and are updated as necessary.  The PDSA (plan, do study, act) model is utilized when updates are made.  Quarterly analysis of data is undertaken and reported. All faculty, trainees and staff are regularly made aware of the division’s focus on quality and patient safety.