Pathology specialties

Pathology is made up of several specialty areas. The following sections include information on the range of testing and services offered by ACT Pathology within each of the specialty areas:

Anatomical Pathology

Chemical Pathology

Cytogenetics

Haemotology

Immunology

Microbiology

Molecular Pathology

Anatomical Pathology

The Department of Anatomical Pathology provides diagnostic, consultative, research and teaching services to The Canberra Hospital, Calvary Hospital, National Capital Private Hospital and medical practitioners of the Canberra region and Southern Area Health Service.

The department is staffed by 8 Specialist Anatomical Pathologists with 6 registrars, 19 scientists , 2 mortuary staff and 5 secretaries.

The Canberra Hospital is a teaching institution hence the department is involved in teaching medical students, laboratory staff, Anatomical Pathology trainees and trainees in other specialties.

About the Department of Anatomical Pathology

The department encompasses the following areas:

1. Histology

Services provided by the Histology laboratory include:

  • Routine histology, including gross specimens, endoscopic and needle biopsies.
  • A comprehensive renal biopsy service including electron microscopy and immunofluorescent studies.
  • The laboratory performs immunohistochemical stains for a wide range of clinically relevant tissue markers. These include markers for tumour differentiation, lymphocytic markers, hormone receptors and viruses.
  • An immediate frozen section is provided at The Canberra Hospital, National Capital Private Hospital and Calvary Hospital.

2. Cytology

Cytological Specimens tested by ACT Pathology include:

Gynaecological

  • Cervical Pap Smear- all cervical smears are assessed by two cytologists to minimise interpretive errors.
  • Vaginal Vault Pap smear
  • Thin Prep liquid based cytology

Non-gynaecological

  • Urines- midmorning and catheter
  • Serous Effusions- pleural, peritoneal and pericardial fluids and cerebrospinal fluids
  • Respiratory specimens- deep sputum, bronchial washings and brushings
  • Oesophageal, Gastric and Colonic brushings

Fine Needle Aspiration Biopsies (FNAs)

  • FNAs on palpable superficial lesions by a Pathologist
  • FNAs on image guided lesions by a Radiologist with a Scientist to prepare and stain aspirated cells ready for immediate microscopic diagnosis

Semen

  • Post Vasectomy studies

The Cytology department aims to continually improve the quality of service by participating in internal and external quality assurance programs.

3. Electron Microscopy

The Electron Microscopy Unit (EMU) is a specialist unit within the Anatomical Pathology Department providing diagnostic and research services.

The diagnostic work includes specimens from a number of departments:

Anatomical Pathology

  • Renal Biopsy
  • Tumours
  • Other Tissue Specimens
  • Fine Needle Aspirates

Microbiology

  • A range of microbiology specimens can be examined for specific organisms as requested. The image above right shows Human Polyoma Virus under the electron microscope at 55,000 x magnification.

A number of research projects are undertaken in the EMU:

  • Within the Department
  • In Collaboration with other Departments
  • In Collaboration with External Research Groups

The projects can involve pure ultrastructure examination and/or the use of immunolocalisation techniques.

Chemical Pathology

Chemical Pathology provides a wide range of routine and specialised assays, as well as consultative, research and teaching services.

Most of the routine investigations are performed on a 24 hour basis with some specialised Endocrinology and Protein Chemistry testing offered seven days a week.

Routine testing

Routine testing such as renal and liver function tests, cardiac marker testing, lipid profiles, therapeutic drugs and blood gases (including co-oximetry) are available on a 24 hour basis.

Testing for Immuno-Suppressive Drugs

ACT Pathology also provides testing for immuno-suppressive drugs (cyclosporin and Tacrolimus) and offers a wide range of tumour markers to aid with the detection of tumours and monitoring of response to treatment.

Endocrine testing

A comprehensive range of endocrine testing is performed. This includes:

  • thyroid function testing
  • investigation of fertility/infertility
  • investigation of the adrenal axis

Protein testing

A full range of protein chemistry is also performed. The range of testing includes:

  • protein electrophoresis and immunofixation
  • immunoglobulins
  • serum free light chains
  • complement
  • cyroglobulin
  • haptoglobin
  • alpha-1-antitrypsin
  • angiotensin converting enzyme
  • CRP
  • beta-2-microglobulin.

Other testing

We also offer glycated haemoglobins 5 days a week (normal working hours).

For investigation of phaeochromocytoma we offer urinary adrenaline/noradrenaline and for detection of Carcinoid tumour we measure 5H1AA.

Some of our manual testing includes analysis of renal calculi, detection of reducing substances in urine and faeces and performance of LS ratios in amniotic fluid.

We have recently installed atomic absorption equipment and currently offer Aluminium analysis in body fluids. Over the coming months we will be widening the range of trace and heavy metals being performed (lead, selenium, cadmium, arsenic).

Related Links:

Australasian Association of Clinical Biochemists (AACB)
www.aacb.asn.au

Cytogenetics

Cytogenetics is the study of genetic material at the cellular level.

Specimens are accepted from hospital inpatients and outpatients as well as from outside sources.

Our services

The cytogenetics unit provides a high quality service in all areas of clinical cytogenetics, including testing for:

  • Haematological malignancies.
  • Solid tumours
  • Constitutional abnormalities including paediatric dysmorphic features, developmental delay, failure to thrive.
  • Multiple miscarriage or infertility.
  • Primary/secondary amenorrhoea.
  • Prenatal testing of amniotic and chorionic villus samples.
  • Products of conception.
  • Fluorescence In Situ Hybridisation (FISH) including Prenatal Fast FISH, Oncology FISH and Constitutional FISH

Haemotology

ACT Pathology provides a 24 hour Haematology and Transfusion service, offering a wide range of routine and specialised testing procedures.

The laboratory employs eight specialist haematologists with broad experience in both clinical and diagnostic fields, three registrars and a number of highly experienced scientific and technical staff with up-to-date specialised knowledge in the disciplines of Haematology and Blood Transfusion Medicine.

Our services

Some of the extensive services that we offer include:

  • All routine Haematological, Coagulation and Transfusion procedures.
  • Advice and clinical consultation in transfusion medicine and the appropriate use of blood and blood products.
  • Clinical Haematology consultations with advice on the interpretation of abnormal or unexpected results and other services including the collection and reporting of bone marrow aspiration and trephine biopsies.
  • Autologous haemopoietic stem cell transplantation.
  • Immunophenotyping by flow cytometry- for the diagnosis of leukaemia, lymphoproliferative disorders and immunodeficiencies. This technology is also used for a number of specialised tests and in the estimation of stem cell populations in patients undergoing stem cell transplantation.
  • Investigation of thalassaemia and other haemoglobinopathies.
  • Specialised assessment of haemostatic function including coagulation factor assays for the diagnosis of the haemophilias, von Willebrands disease and acquired bleeding disorders. A comprehensive range of testing for prethrombotic disorders including; lupus anticoagulant, anti-thrombin III, protein C and S , and Activated Protein C resistance (APC).
  • The molecular laboratory offers PCR testing for a range of conditions including leukaemia, lymphoma, Factor Va Leiden and prothrombin gene mutations.

Related Links:

Immunology

ACT Pathology offers comprehensive diagnostic Immunopathology testing.

The laboratory is staffed by highly skilled and experienced scientists and technicians.

It is supervised by three specialist Immunologists and a Specialty Registrar who are also available to provide clinical advice and interpretation of test results.

Routine testing in Immunology is performed Monday to Friday, and urgent requests will be processed at other times as clinically indicated.

Our services

Our services include:

Screening, characterisation and titration of autoantibodies used in the diagnosis of:

  • Systemic autoimmune diseases such as SLE, Sjogrens syndrome and rheumatoid arthritis, including ANA, dsDNA, ENA, rheumatoid factor, and phospholipid antibodies (cardiolipin, 2-glycoprotein I antibodies).
  • Organ-specific autoimmune disease such as Pernicious anaemia, bullous skin disease autoimmune liver disease, including smooth muscle, anti-mitochondrial antibodies, and skin antibodies
  • Systemic vasculitides such as Wegeners granulomatosis, including ANCA, cryoglobulins and complement studies.

Investigation of Coeliac disease

Gliadin, endomysial and tissue transglutaminase antibodies, total IgA and testing for HLA-DQ2 and DQ8 alleles.

Tests for immunodeficiency

Quantitative and qualitative analysis of immune function in vitro for the diagnosis of primary or secondary immune deficiency, including lymphocyte proliferation assay by flow cytometry, and measurement of specific antibody responses.

Links

Immunology organisations in Australia

Primary Immunodeficiency diseases

Systemic Vasculitis

Journals

Microbiology

ACT Pathology offers comprehensive microbiological testing.

The laboratory is staffed by highly skilled and experienced scientists and technicians.

It is supervised by a specialist microbiologist and a specialty registrar who are available to provide clinical advice and interpretation of test results.

Routine testing is performed between 8am and 9pm seven days a week.

Urgent tests may be performed outside these hours on request.

Our services

  • Bacteriology: isolation and rapid identification of pathogens.
  • Antimicrobial susceptibility testing and reporting.
  • Mycobacteriology - isolation and rapid identification of Mycobacterium tuberculosis complex and Mycobacterium avium/intracellulare group.
  • Mycology: isolation and identification of pathogenic fungi, including dermatophytes
  • Parasitology: microscopy for enteric parasites and helminths (including hydatids).
  • Virology: A limited service comprising testing for respiratory viruses and rotavirus by immunochromatography techniques. Electron Microscopy (EM) is available on certain specimens to detect viruses. Viral cultures are no longer routinely performed in this laboratory. See Molecular Pathology

Links

Molecular Pathology

Molecular diagnostic pathology is a rapidly expanding field.

ACT Pathology offers a comprehensive range of molecular tests for genetic disorders as well as the detection of various pathogenic organisms.

The Molecular laboratory is staffed by highly skilled and experienced scientists and technicians.

Routine testing is performed Monday to Friday.

Genetic testing:

  • Genetic Testing for Cystic Fibrosis
  • Genetic Screen for Fragile X (males only)
  • Factor Va (Leiden) and Prothrombin mutation studies
  • Hereditary Haemochromatosis Gene Mutations
  • Alpha Thalassaemia (SEA Deletion only)

Haematological lymphoproliferative disorders:

  • 9:22 translocation for CML
  • Clonality studies
  • Bcl-2 Translocation

Infectious Diseases testing:

  • Chlamydia and Gonorrhoea PCR screening
  • Detection of HSV1 & 2 by PCR in CSF and swabs
  • Qualitative Hepatitis C PCR and Hepatitis C Genotyping
  • HIV Viral Load
  • Detection of VZV by PCR in CSF and swabs
  • Detection of CMV by PCR in plasma and urine
  • Meningococcal PCR in CSF and blood
  • Molecular detection of methicillin resistant Staph. Aureus (MRSA) and vancomycin resistant enterococcus (VRE)

Links