The Role of Histopathology Specimens

Histopathology specimens are a vital cornerstone in patient care. They not only establish a tissue diagnosis but are crucial in clinical management decisions and provide important prognostic data. They are nodal events in a patient's illness, shaping the choice of relevant medical and surgical therapies and determining follow-up routines. The data they provide are used to assess the efficiency of current and new treatment regimes and to monitor the impact of population screening programmes. Clinical governance has recognised their key role in auditing not only individual clinicians but the patterns and quality of overall health care provision. Biomedical research with advances in investigations and therapy would flounder without them. They are therefore a precious resource to be handled with great care by sufficient numbers of appropriately trained and experienced personnel. The data generated are of a confidential nature privy to the patient, consultant clinician or general practitioner and the reporting pathologist. This information may be shared as appropriate with other directly involved health care professionals, e.g., in the context of multidisciplinary team meetings, but laboratory practice (e.g., telephoned results, report authorisation) must be geared to protect patient confidentiality at all times. The patient not only has a right to see and have explained the information in his/her specimen but must undergo a process of informed consent prior to the clinical procedure. Thus the nature, purpose, extent and side effects of the procedure are explained in understandable terms. This process extends to the laboratory as contemporary surgical consent forms require to seek from the patient permission for disposal and use of the tissue not only for diagnosis but also educative, audit and research purposes. Additionally, research projects should be verified by an appropriate research ethics committee. Patient denial of any of these uses must then be communicated to the laboratory and incorporated into the handling and disposal procedures. The histopathology specimen report forms a permanent part of the patient's medical record and as such may be used as medico-legal evidence in negligence and compensation cases. These various factors serve to emphasise the importance of the care that should be taken with these specimens by histopathology laboratory personnel.

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