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Pathology

Pathology

The motto of the pathology department at ILBS is in accordance with that of the institute which strives towards excellence in quality with patient care being of utmost importance. Dexterous technical team works in unison with dedicated and motivated pathologists to attain optimum standards in every test results. The department is actively involved in academic activities with PDCC candidates being enrolled every six months, who then participate in weekly discussions and presentations. There is in totality, a holistic environment with a perfect blend of both diagnostics as well as research oriented projects.

Services Offered

A. Histopathology Work

Liver and GI biopsies make up most of the chunk of small biopsies in this institute. In the last one year, there has been an increase in the number of renal, uro-genital biopsies (TURP and TURBT) along with skin biopsies. In addition, we also receive postmortem lung, kidney and brain biopsies. Beside a large number of cases of alcoholic, non alcoholic fatty liver disease and chronic viral hepatitis, there is exposure to rarer entities like hepatic vascular diseases, autoimmune hepatitis and its overlaps, hepatic amyloidosis and lymphomas. A spectrum of Paediatric liver pathology particularly biliary atresia, PFIC, metabolic and storage disorders including certain rare syndromes are encountered. We receive ample amount of neoplastic pathologies including unusual cases like hemangioendotheliomas, mixed adeno-neuroendocrine tumours of the GIT, adenosquamous carcinoma of gallbladder, inflammatory myofibroblastic tumour and mixed cholangio-HCCs.

B. Cytopathology

A dedicated team is assigned for guided FNAC (USG, CT and EUS) where an on-site evaluation of the material is done for adequacy. This is beneficial to the patient, clinician and the pathologist as it drastically enhances the yield of guided FNAs and proper segregation of sample for various ancillary investigations thereby increasing the rate and accuracy of diagnosis. Besides, superficial lesions are subjected to direct FNAC in the FNAC room of the department.

The services offered are :

  • Liver Biopsy
  • Endoscopic GI biopsy
  • Renal biopsy
  • Medium and Large resected surgical specimen of Hepatobiliary and Pancreas
  • Medium and Large surgical specimen of GI
  • Rapid and microwave tissue processing for urgent liver Tx donor biopsies
  • Explant liver analysis.
  • Post-Liver Transplant liver biospies
  • Post-Renal Transplant renal biopsies
  • Urological specimens
  • Cell block Preparation
  • Fluid cytology, Direct FNA and Indirect USG- EUS- and CT-Guided FNAs
  • Rapid on-site evaluation
  • Imprint smears
  • Frozen section examination
  • Hepato-pancreato-biliary specimen and GI Specimen
  • Donor Liver biopsy
  • Genitourinary system
  • Donor Liver biopsy
  • Imprint and Squash Smears
  • Cell Block preparations
  • Consultation, Second Opinion
  • Histochemical Stains
  • Routine- HE
  • Special-Masson trichrome, Reticulin, Orcein, Von Gieson, Perls Iron stain, PAS with Diastase, PAS after Diastase with Alcian Blue, Gomori’s Silver Methanamine, Mucicarmine, Victoria Blue, Oil Red O, Ziehl Neelson, Fouchet, Rhodamine, Congo red, Von Kossa, Masson's Fontana, Alkaline Congo Red, Congo red with Pot Permanganate, Standard Toluidine Blue
  • Immunohistochemistry
  • Automated and Manual
  • Immunofluorescence studies
  • IgG, IgM, IgA
  • Fibrinogen
  • C3, C1q Abs
  • C4d

 

Name of the Investigation 2017 2018
Histopathology 6329 6126
Small Biopsy 1093 987
Medium Biopsy 3244 2746
Large Biopsy 2553 2117
Renal Biopsy 95 38
Liver Biopsy 1482 1585
Frozen Section 156 142
Cell Block 316 400
Immunohistochemistry(markers of prognosis and molecular targets) 0 10
Cytopathology 1644 2109
Fluid Cytology 909 1151
Brush Cytology 114 73
USG AND EUS Guided FNA 552 534
Pap Smear examination 127   151
On site cytological evaluation rapid staining and reporting 552 534
Liquid based cytology 0 100

C. Liver and renal transplant workLiver and renal transplant work

Since the institute carries out a number of liver and renal transplants, we get access to a vast number of pre-transplant and post transplant follow up biopsies. Thus, pathologist’s role is crucial for patient management, diagnosis and grading of rejection. All the liver explants are stored in departmental repository. In addition, the department has rapid microwave tissue processing facility for urgent liver transplant donor biopsies. C4d immunohistochemistry as well as Immunofluorescence is used to aid in diagnosis of antibody mediated rejection.

D. Stem cell workStem cell work

The pathology facility at ILBS is actively involved with the research and clinical departments in the field of liver stem cell research. Various Government funded projects propel a multitude of research work related to stem cells and regenerative medicine. Employing an array of novel immunohistochemical markers has enabled the institute to define newer frontiers in the understanding of stem cell biology. These include CK7, SOX 11, Caspases, PDX1, Oct 4, NANOG and VEGF. This has culminated in many publications in journals of national and international repute.

New services & facilities

  • Expanded diagnostic services to cover the increasing needs of department like nephrology, urology, pulmonary medicine and oncology.
  • Interactive academic and teaching programmes for PDCC Course (2 batches every year).
  • Clinicopathological correlation monthly meetings in ILBS and in other Institutes as and when needed.
  • Expanded immunofluorescence panel.
  • Immunofluorescence studies for Autoimmune liver diseases as part of biochemistry- immunopathology services.
  • Expanded immunohistochemical markers for diagnostic and prognostic needs.
  • Expanded immunohistochemical markers for opportunistic infections.
  • Dual immunohistochemistry on formalin fixed paraffin embedded tissues.
  • Department started the procurement process for autopsy. 
  • Started liquid based cytology.
  • Immunohistochemistry based reporting of molecular markers of prognostic & therapeutic relevance

Educational Activities

7th Dr. V. Ramalingaswami Oration and Hepatopathology meeting was held on 8th August 2018. This one day meeting was a rich academic session and included Oration and series of lectures by eminent National faculty. About 150 delegates turned up for this conference. The oration was delivered by Irene O.L.Ng, Chair of Pathology and Head, Department of Pathology, Director, State Key Laboratory for Liver Research, The University of Hong Kong, Chief of Service, Department of Pathology, Queen Mary Hospital, Hong Kong, on Molecular pathogenesis of Hepatocellular carcinoma. Twelve senior pathologist of repute added flavor in the conference by covering ranging from metabolic liver diseases to biliary and autoimmune liver diseases to infective liver diseases and liver transplant pathology. Liver pathology conferences were desired more frequently by most of the delegates to fill the lacunae in liver pathology.

Courses offered by the Department

Names of candidates who are admitted/pass out this course in 2018

Batch 8: July 2017 to June 2018-- Dr Sowmya P.U, Dr Juhi Chawla

Batch 9:Jan 2018 to Dec 2018- Number of candidaDr. Gaurav Khanna, Dr Riti)

Batch 10: July 2018- Dr Shilpi Modi.

Department’s Achievements

  • Department of Pathology delivered excellent quality services as per NABL and NABH standards
  • 7th “Dr. V. Ramalingaswami Oration” and Hepatopathology Meeting, 2018 on 8th August, 2018
  • Conducted PDCC Hepatopathology courses and entrance & exit examinations
  • Department provided FISH training to lab technicians
  • Department provided LBC training to lab technicians
  • Started IHC based molecular marker expression as part of routine histopath reporting.
  • Department provided support and service to various research projects
  • Department conducted Pathology part in the CPCs
  • Training of internal & external DM (Hepatology) students
  • Started new diagnostic panels for various malignancies & liver diseases
  • Faculty presented research work in presitigious International conferences- AASLD, APASL, ILTS
  • Faculty presented ILBS work in various National conferences & meetings- ISOT
  • Faculty received travel grant support from ICMR, DST
  • Faculty received financial approval & grant for project from DST
  • Abstracts accepted for prestigious International conferences- AASLD, EASL, APASL
  • DBT Grant received for national biobank project

Visiting Faculty

Name Institution
Dr. Veena Malhotra BLK, Delhi
Dr. BH Srinivas, JIPMER Puducherry
Prof. Siddharth Duttagupta AIIMS, Delhi
Prof. Puja Sakuja GIPMER, New Delhi
Prof. Malini Eapen School of Medicine, Kochi
Prof. Ashim Das PGIMER, Chandigarh
Dr. Prasenjit Das AIIMS, Delhi
Prof. Irene O.L.Ng Queen Mary Hospital, Hong Kong
Dr. Prasenjit Das AIIMS, Delhi
Dr. Shashi Dhawan SGRH, Delhi
Dr. Dhiraj Gautam Medanta, Gurgaon
Dr. Rajni Yadav AIIMS, Delhi
Dr. Kaushik Majumdar, GBPH, Delhi
   



 

Faculty

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