Surgical Pathology Rotation

(1-2 Weeks)

The surgical pathologist has a critical role, as a prominent surgical pathologist (Dr. Juan Rosai) says, to "guide the surgeon’s hands". This is the area of pathology that most practicing pathologists spend the majority of their time. It is concerned with assessing the gross appearance of resected tissues (e.g. partial colectomy for colon cancer, breast lumpectomy, lymph node biopsies, etc.), selecting appropriate areas to sample for microscopic examination, and using microscopic examination along with immunohistochemical and molecular techniques to come to a final diagnosis, often including grading and staging in order to give valuable prognostic information to the surgeon or oncologist. Surgical resections from virtually every organ system will be reviewed. Daily activities include frozen sections for intraoperative consultations, gross anatomic dissection of tissue, and daily sign out of histopathologic cases.

A pathology resident carefully measures and dissects a renal cell carcinoma in a kidney resection. Careful dissection with microscopic evaluation will determine the next phase of patient treatment, chemotherapy or further surgery.
Frozen Section
A frozen section is prepared for rapid evaluation of surgical margins in a tumor resection.

During the rotation there will be exposure to immunohistochemical stains & the latest molecular techniques needed to make diagnoses. Quality assurance conferences are held daily to confirm new malignant diagnoses and to provide group input on difficult cases. There are also numerous clinicopathologic interdepartmental conferences where the pathologic diagnosis and clinical findings are discussed to formulate a treatment plan.

A lung resection is shown here with a squamous cell carcinoma with post obstructive pneumonia.
Lobular Carcinoma
A form of breast carcinoma called lobular carcinoma is shown in the photomicrograph above.

Surgical pathology is one of the busiest and most important laboratory services in UW Hospital. Students interested in any and all areas of medicine will benefit from this rotation. Those interested in surgery or any of the surgical specialties will likely benefit the most.