Pathology provides an understanding of the process of disease and is multidisciplinary. It has five main specialties which have further sub-specialties.
- Chemical pathology
- Haematology (doctor)
- Histopathology (doctor)
- Microbiology and virology (doctor)
Chemical pathology
Chemical pathologists run and manage the biochemistry laboratory. Hundreds of samples are analysed each day for testing. The tests can be very wide-ranging but might include measurement of:
- Electrolytes (minerals) in the blood, to indicate heart and other diseases
- Liver function
- Tumour markers
Sub-specialties
Metabolic medicine is the only sub-specialty within chemical pathology. It includes the following clinical areas:
- Nutrition, including total parenteral nutrition (TPN) for intravenous feeding and nutrition following gastric surgery
- Cardiovascular risk
- Diabetes mellitus
- Metabolic bone disease , eg osteoporosis
- Inherited metabolic disease (IMD)
Haematology (doctor)
Haematologists diagnose and clinically manage disorders of the blood and bone marrow. They also provide clinical support for the haematology diagnostic laboratory including the blood bank.
Common procedures/interventions
These include:
- Delivering clinical care, often for life-threatening disease
- Formulating chemotherapy protocols and managing their delivery
- Managing haematopoietic stem cell transplantation procedures
- Providing advice on haematology laboratory results
- Sampling bone marrow and interpreting the morphology
- Performing diagnostic lumbar punctures and giving intra-thecal chemotherapy
- Haemato-oncology (acute and chronic leukaemias, lymphoma, multiple myeloma)
- Haemostasis/thrombosis (congenital and acquired disorders of haemostasis and blood coagulation and management of antithrombotic therapies)
- Disorders of blood production and destruction (including bone marrow failure, anaemias and autoimmune blood diseases)
- Transfusion medicine
- Paediatric haematology
Histopathology (doctor)
We diagnose and study disease using expert medical interpretation of cells and tissue samples. The specialty determines the cause of death by performing autopsies and is integral to cancer management through staging and grading of tumours.
Common procedures/interventions
- Examination and dissection of surgical resection specimens, to select the most appropriate samples for microscope slides
- Microscopic examination of tissues, with subsequent construction of clinical reports
- Carrying out fine-needle aspirations
- Carrying out autopsies
Microbiology and virology (doctor)
Microbiology and virology (MMV) involve the diagnosis, treatment and prevention of the spread of infection in hospitals and the community. Both these specialties are laboratory-based, but make a major contribution to clinical infection management.
Microbiologists use techniques that include:
- Traditional culture techniques such as microbiological stains
- Measuring antibody response to infection
- Detection of microbial antigens
- Nucleic acid amplification (polymerase chain reaction)
Virologists use techniques including:
- Antigen detection techniques
- High-throughput nucleic acid extraction techniques
Laboratory staff will then provide the results of cultures of blood and sterile fluids that have become positive overnight. Urgent and important results are communicated directly to clinical colleagues
