Histology Overview

Histology Overview

In today’s medical world, almost everyone talks about the most recent “scan” that they had at the hospital. These scanning devices make detailed pictures of internal body structures that cannot otherwise be seen without performing surgery. CaT scans (computed tomography) use X-rays, MRI scans (magnetic resonance imaging) use a magnetic field and radio waves, ultrasound tests use sonic waves, and bone scans use radioactive markers to image and mark areas of interest in the patient. These scans can show abnormalities in patients, however, current methods in histology are often required to confirm specific diagnoses. This is required in order to determine the patient treatment and prognosis.

In histology what are we looking for in the final slide?


Figure 1. Malignant melanoma. Spindle cell by H&E method x 600

Figure 2. Prostate needle biopsy PIN4 staining by IHC method x 600

Figure 2. Prostate needle biopsy PIN4 staining by IHC method x 600

Virtually every specimen that comes through the histology laboratory is routinely processed into a paraffin block, and a hematoxylin and eosin (H&E) slide is made. Pathologists are trained to render diagnoses by reviewing H&E slides. Even when frozen sections are made, at least one slide is stained with H&E.

Hematoxylin stains nuclei and nuclear material varying shades of blue, while eosin stains red blood cells and connective tissue varying shades of pink. The resulting tinctorial patterns are evaluated by a pathologist to render a diagnosis.

In Figure 1, a skin section shows malignant melanoma cells in a spindle cell form, including dark brown melanin deposition. If this original specimen was received as an excisional procedure, the surgical margins would have been inked during the surgical grossing procedure. In this way, the pathologist can also assess the surgical margins and advise the clinician as to whether more tissue must be removed from the patient. Malignant melanoma is a skin cancer that must be completely removed in order to cure the patient. Any malignant melanoma cells left behind in the patient may metastasize to other organs, ultimately causing the patient’s death.

There are times when the H&E slide does not provide enough information to make a complete diagnosis. In these instances, additional procedures such as immunohistochemistry (IHC) need to be performed. While the H&E and other special stains rely on tinctorial results for evaluation, IHC uses specific antibodies to bind and localize specific proteins that may be present in the tissue section.

Figure 2 shows a section of prostate tissue from a prostate needle biopsy, in which the H&E slide did not show prostate cancer – but was suggestive of it. An IHC stain named “PIN 4” was performed, to show any “prostatic intraepithelial neoplasia (PIN) and/or any prostate carcinoma. This stain utilizes a “cocktail” of different antibodies to demonstrate basal layers in the prostate (dark brown) along with any neoplastic and/or cancer cells (red chromogen). The abundance of red staining in the figure clearly demonstrates the presence of proteins that are made by prostate cancer cells.

Figure 3. FISH staining of malignant melanoma nucleus.

Figure 3. FISH staining of malignant melanoma nucleus.

While IHC techniques use antibodies to localize specific proteins made by cells, the fluorescence in situ hybridization (FISH) procedure uses labelled probes to bind to specific sites within the nuclei of cells. Figure 3 shows one nucleus of a malignant melanoma cell binding four different colored probes. The probes are made to bind on specific DNA sequences on chromosomes. The probes are labelled with fluorescent tag molecules which fluoresce different colors when excited by different wavelengths of ultraviolet light. In this way, information can be obtained regarding the presence or absence of aberrant genes within the nucleus. This information can then be used to help establish specific diagnoses.

In summary, we can see that the histology laboratory has at its disposal an arsenal of routine and special procedures to probe the structure, function and genetic make up of cells obtained from the human body. This information is vital in helping determine patient diagnoses, treatment, and ultimate prognosis. In addition, the use of proper surgical grossing techniques on dermatopathology specimens (i.e. inking of surgical margins) help establish if all cancer cells have been removed, thereby helping to ensure patient survival.

Digital Pathology Market is Expected to Reach $5.7 Billion, Globally, by 2020 – Allied Market Research

According to a new report by Allied Market Research titled “Digital Pathology Market – Global Industry Analysis, Size, Growth Trends, Share, Opportunities and Forecast 2012-2020,” the global digital pathology market was valued at $2.2 billion in 2013, is estimated to reach $5.7 billion by 2020 at a CAGR of 14.3% during 2013-2020. North America led the overall digital pathology market, closely followed by Europe. The two regions accounted for about 79% of total revenue in 2013. However, their collective share will be reduced to 2/3 rd of the total revenue generated in 2020, largely due to the growing dominance of Asia Pacific region.

To request a sample of the report, visit http://www.alliedmarketresearch.com/digital-pathology-market

Digital pathology is an emerging technology in the pathology field, where the glass slides are converted into digital images for easy viewing, analysis, storage and management of the data collected. The development and recent technological findings in the digital pathology market would push the conventional pathology to more advanced and strategic levels. Due to the advancement in the technology, concerns such as lack of qualified pathologists would be addressed more effectively. “The decentralization approach in the digital pathology market will make huge difference in the field of pathology. The major factors influencing the market growth are cost efficient diagnosis, efficiency in mundane workflow and analysis,” according to Allied Market Research analysts Debbie Shields and Rohini Patil. “These factors are impacting the outcome of the overall diagnosis process. The efficient technology impacts time, productivity and the level of patient care. However, the factors restraining the market growth are the lack of reimbursement policies by the governments, inefficient infrastructure and delayed approvals,” explained the analysts.

The digital pathology market is segmented based on components, namely whole slide imaging (WSI), image analysis – informatics & storage, and communication & integrated platforms. The WSI segment is largest contributor to the overall global digital pathology market revenue in 2013. Though the segment will partially lose market share over the next seven years, it will continue to be the largest digital pathology product segment throughout the forecast period. This is largely due to its capability to convert and share glass slides digitally with ease, safety and at lower cost. The image analysis-informatics market is expected to have the highest potential during 2013-2020, when compared to the other components. The gradual refinement of analysis software to provide higher accuracy in the analysis of digital slides will enable the faster growth of the segment.

To browse all Medical Devices Market reports, visit http://www.alliedmarketresearch.com/medical-devices-market-report

The end users segment of the digital pathology market is segmented into pharmaceutical research, clinical organizations and educational institutes. The pharmaceutical research accounted for the largest revenue in 2013 and will continue to dominate the global pathology market throughout the analysis period at highest CAGR of 16.9% during 2013 – 2020. The rise in revenue is due to the increase in the use of digital pathology systems (DPS) for drug development and discovery.

The report segments the global digital pathology market into four major regions namely North America, Europe, Asia and Row. North America is the largest segment due to the higher adoption of DPS in most of the labs across the region. The Asian market is expected to have the highest CAGR compared to the other regions during the analysis period. The rise in the Asian market is due to the demand for better infrastructure and need for skilled pathologists.

The key strategies that are implemented by the manufactures to increase the adoption, development and sales of the DPS are product launches, agreements and partnerships. Most of the product launches target product up-gradation with new and improved benefits, example- 3DHISTECH, in 2013, launched Pannoramic 250 Flash – a next generation slide scanner, which has high speed and faster scanning capacity.

The key companies profiled in the report are Definiens AG, Digipath, Inc., Leica Microsystems Gmbh, Ventana medical systems, Inc., Nikon Corporation, Visiopharm, Philips healthcare, Indica Labs, Inc, Omnyx LLC and 3DHISTECH, Ltd.
Read more at http://www.broadwayworld.com/bwwgeeks/article/Digital-Pathology-Market-is-Expected-to-Reach-57-Billion-Globally-by-2020-Allied-Market-Research-20140312-page2#eHTJo5m60wevZiBk.99