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 2015 2016
Histopathology 5332 6038
Small Biopsy 959 1059
Medium Biopsy 2698 2993
Large Biopsy 1428 2561
Renal Biopsy 64 115
Liver Biopsy 1374 1405
Frozen Section 96 110
Cell Block 402 342
Cytopathology 1529 1359
Fluid Cytology 917 767
Brush Cytology 57 74
USG AND EUS Guided FNA 402 342
Pap Smear examination 152 163
On site cytological evaluation rapid staining and reporting 399 405

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.

Educational Activities

5th “Dr. V. Ramalingaswami Oration” and Hepatopathology Meeting, 2016 on 8th August, 2016

  • 5th Dr. V. Ramalingaswami Oration and Hepatopathology meeting was held on 8th August 2016, on the theme of "Autoimmune Liver diseases (AILDs)". This one day meeting was a rich academic session and included Oration and series of lectures by eminent National & International faculty. About 150 delegates turned up for this conference. The oration was delivered by the eminent autoimmunologist , Prof. Y Schoenfeld from Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center (Affiliated to Tel-Aviv University) Tel-Hashomer, Israel and an incumbent of the Laura Schwarz-Kipp chair for research of autoimmune diseases, Tel-Aviv University, Israel, Prof. Schoenfeld dicussed in detail an important aspect of liver autoimmune pathology and novel aspect of autoimmunity. Eight senior pathologist of repute added flavor in the conference by adding recent advances in the field and the diagnostic utilities of newer advances in autoimmune liver pathology. In the meeting various lectures
    on effect of systemic autoimmune diseases on liver, diagnostic approach to AILDs, approach to liver biopsy with AILDs, AILDs liver transplantation, primary biliary cirrhosis, primary sclerosing cholangitis, drug induced AIH, were discussed and appreciated. The main highlight of the program was learning about approach to AILDs in liver biopsy including the clinical aspects to it. Liver pathology conferences were desired more frequently by most of the delegates to fill the lacunae in liver pathology.

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 and liquid based cytology. Faculty presented research work in prestigious International conferences- AASLD, APASL, ILTS.
  • Faculty presented ILBS work in various National conferences & meetings- INASL, ISOT, IAPM, Transcon.
  • Faculty received travel grant support from ICMR
  • 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
  • Concept diagram of paper appeared at cover page of the Hepatology journal

Educational Activities

  • Details of the Educational activities (CME/Conf/workshop) hosted by the department in 2016 under following headings:.

Courses Offered

Course Candidates admitted Candidates passed
PDCC (Hepatopathology) Dr. Ayushi Agarwal Dr. Sachin Choudhari
  Dr. Neha Nigam Dr. Kanika Taneja

Department’s Achievements

  • Department of Pathology delivered excellent quality services as per NABL and NABH standards.
  • 5th "Dr. V. Ramalingaswami Oration" and Hepatopathology Meeting, 2016 on 8th August, 2016
  • Conducted PDCC Hepatopathology courses and entrance & exit examinations.
  • Department provided FISH training to lab technicians
  • Department provided support and service to various research projects
  • Department conducted Pathology part in the CPCs held in 2016
  • Training of internal & external DM (Hepatology) students.
  • Started new diagnostic panels for various malignancies & liver diseases. Faculty presented research work in prestigious International conferences- AASLD, APASL, ILTS.
  • Faculty presented ILBS work in various National conferences & meetings- INASL, ISOT, IAPM, Transcon.
  • Faculty received travel grant support from ICMR
  • 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
  • Concept diagram of paper appeared at cover page of the Hepatology journal

Visiting Faculty

Name Institution
Prof. Shoenfeld Yehuda Sheba Medical Center, Israel
Prof. Puja Sakhuja PGIMER, Chandigarh
Prof. Ashim Das GB Pant PGI, Delhi
Prof. Kim Vaiphei PGIMER PGIMER, Chandigarh
Dr. Arvind Ahuja RMLPGI, Delhi
Dr. Manav Wadhawan Fortis-Escorts, Delhi
Dr. Dheeraj Gautam Medanta, Delhi
Dr. Anna George NII, Delhi
Prof. Ravindra Kumar Saran GB Pant PGI, Delhi
Dr. Veena Malhotra BLK Memorial Hospital, Delhi
Dr. Kajoli Krishnan GE Global Research, Bangalore



 

Faculty

  • ECHO
  • ECHO
  • APASL
  • Acuteon
  • DORSO
  • NSI
  • HBSCE

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