Activity

ANATOMIC PATHOLOGY ACTIVITY

The Anatomic Pathology Unit processes and analyzes diagnostic specimens, including samples obtained at surgery, bipsy or fine needle for in-house patients and outpatients.

The laboratory offers immunohistochemical stains for diagnostic use, for example to highlight the presence of particular proteins thate are specific to certain tumor type or genetic changes. Among these are important predictive markers such as ER, PR, HER 2 PD-L1 and mismatch repair proteins (MSH2-MSH6-MLH1-PMS2). A number of chromogenic in-situ hybridization probes such as EBER, HER2, HPV high risk, kappa/lambda light chains are also available.

Our Unit also performs diagnosis using frozen sections if a quicker diagnosis is needed to guide or change a procedure while a surgeon is still in the operating room.

The Molecular Diagnostic Laboratory uses Next Generation Sequencing (NGS) technologies to provide comprehensive molecular testing useful for both standard of care and translational research (https://assets.thermofisher.com/TFS-Assets/CSD/Flyers/odxtt-eu-oncologist-flyer.pdf). This DNA and RNA based test enables detection of substitution and insertion/deletion mutations (35 genes) and gene fusions (21 genes).

Somatic BRCA1 and BRCA2 analysis are also performed with NGS in specific cancer subtypes to identify potential treatment strategies.

The Molecular Diagnostic Laboratory is also responsible for carrying out genetic testing essential to studies on susceptibility to hereditary cancer (Breast and Ovarian, Lynch syndrome, FAP, Pancreas, Prostate, Melanoma, Kidney, Stomach, Primary Hyperparathyroidism, Pheochromocytoma and Paraganglioma). Those molecular analysis are performed using specific NGS panels and MLPA analysis (containing cancer-predisposing genes such as BRCA1, BRCA1, BRCA2, MLH1, PMS2 etc..) that allows the identification of substitution, insertion/deletion mutations and copy number variations (CNVs) on peripheral blood extracted DNA. In this context our laboratory is part of the Genetic Counselling process.

Immunoglobulins and T-Cell receptor rearrangements are also identified with PCR and fragments analysis in lymphoid malignancies.

The Laboratory also performs test for high-risk HPV-DNA on cytologic and paraffin-embedded material using RealTime PCR assays.

All procedures follow strict internal and external quality controls of international validity.

UNE-EN ISO 9001:2008 and UNE-EN ISO 14001:2008 certifications. Furthermore, the Lab participates the EMQN International quality control for molecular testing.

In our Unit we also have a Digital pathology facility. Digital pathology is a dynamic, image-based environment that enables the acquisition, management and interpretation of pathology information generated from a digitized glass slide. The applications include primary diagnosis, diagnostic consulation, medical student and resident training, manual and semi-quantitative review of immunohistochemistry and slide discussion during multidisciplinary team (MDT) meeting.

MDT meetings are seated in our Unit. MDT comprises a core group of specialists from disciplines including medical oncology, radiation oncology, radiology, pathology, nuclear medicine, surgery, genetic and nursing. Regular MDT meetings provide a forum for this core group to discuss patient.

DELIVERY MODE OF SAMPLES TO BE ANALYZED

The admission of hystological/cytological samples by external users is carried out:

• From Monday to Friday 8.00am-3.00pm. On Saturday 8.00am-12.00pm
• From Monday to Saturday 8.00am-9.30am (only for urines and sputum. Containers and information for a proper collection of the material are available at the Secretary of Department)
• Booking is never required

You can access services with:

• health insurance card/fiscal code
• authorization
• specific request of hystological and/or cytologcal tests
• any documentation useful for the test (previous operations, current suspected pathology, indications of the specialist, etc.)

The tests may be performed:

• within the Italian National Health Service (with authorization)
• unassisted ‘payer’ rate (this may be provided simply submitting the request of test performing by the specialist). The services, by type and cost, are all listed in regional tariff nomenclature to which more specified details are referred.
• under the system of private practice. For the private practice services, rates, modes and times of test are available at the Service secretaryship.

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MEDICAL REPORT TIMES

TIME AND PLACE FOR MEDICAL REPORT PICK UP

The delivery of medical reports is made at the Anatomic Pathology Service secretaryship:
• From Monday to Friday 8.00am-1.00pm
• On Saturday 8.00am-12.00pm

In compliance with the “privacy” law the medical reports are delivered in a sealed envelope by the secretaryship staff to patient or his/her delegate, according to the indications given on the “form/receipt” delivered by the reception.

Alternatively, in case of loss or destruction of the form, the medical reports may be picked up:
– by medical report holder after showing an identity document
– by other person than holder, with personal identification document, authorization and identity document copy of the person which carried out the test.

In compliance with the privacy law no information on tests outcomes may be provided by phone.

The Medical Staff is available for any information and explanation regarding the report.

On patient request, the medical reports may be sent to home.

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