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Anatomic Pathology

Histology

Histology offers a full suite of services to aid in the diagnosis and treatment of diseases of the tissues. We offer processing of Cytology non-gyn specimens (body fluids), grossing of wet tissue, processing of tissue samples, embedding of tissues, and the preparation of slides for rendering diagnosis and aiding in therapy decisions by routine and special staining, as well as, specialized staining by immunohistochemistry (IHC) and in situ hybridization (ISH).

Histology also provides state-of-the-art scanning of slides by Philips Digital Pathology System which allows for immediate slide review by a pathologist once scanning is complete.

Digital Pathology

Alverno utilizes the Phillips IntelliSite Digital Image Management System and Phillips digital scanners for most of its pathology cases. Digitizing glass slides and allowing for case review on a computer screen allows pathologists to easily review cases and use digital image tools to make measurements and mark areas of interest. Digitizing the glass slides also reduces the frequency at which glass slides are retuned back to a remote location, since the images can be viewed immediately after scanning. Images of cases can also be easily shared among pathologists for quicker intradepartmental consults.

Alverno has recently partnered with Ibex to provide AI assistance tools to help pathologists with reading certain case types, such as prostate, breast, and gastric biopsy, enhancing the overall digital pathology workflow.

Women’s Health/Gynecologic Cytology 

Cervical cancer was once one of the most common causes of cancer death for women. Now, most cervical cancers are found in women who have never had a Pap test or have not had one recently.  The original method of smearing cells that have been scraped or brushed off the uterine cervix onto a glass microscope slide is called a “conventional” Pap smear. After liquid preservative media were approved for Pap tests, the cells are swished off the collection devises into the medium, and the laboratory processes the specimen in a machine that makes a glass slide for microscopic review. These Pap smears have a more evenly distributed layer of cells representative of the entire population of cells collected. They are then stained using the Papanicolaou staining methodology.

With the advent of liquid-base Pap specimens, the FDA has approved testing the same specimen for other infectious organisms: GC/Chlamydia, trichomonas vaginalis, and especially the strains of human papilloma virus known to cause cervical cancer.  In the Pap smear, cytotechnologists can also identify certain fungal infections, Herpetic cell changes, and sometimes cancer originating from the uterine lining or ovaries that finds its way into a Pap.

To get the most accurate results for these tests, there are ways patients can prepare for this test:

  • Try not to schedule an appointment during the menstrual cycle
  • Do not use tampons, foams, jellies, vaginal creams, moisturizers, or lubricants for up to 7 days prior to the appointment
  • Do not douche for 2-3 days before the Pap test
  • Do not have vaginal sex for 2 days before the Pap test
  • Please provide the laboratory with information that will help the Cytopathology department interpret the Pap smear: menstrual history, previous abnormal Pap history, previously diagnosed cancer, radiation, or chemotherapy.
  • If a lubricant must be used on the speculum during the pelvic exam, the provider should use only a water-soluble brand approved for the type of Pap being done and use very sparingly.

Non-Gynecologic Cytology

Cells that have exfoliated into body fluids, scraped off lesions, or aspirated from lumps and lesions with a needle can be processed for reviewing under the microscope for the identification of cancer. CytoLyt is a liquid preservative that can be added to urine, or into which aspiration specimens, brushings, or discharges are added.  CSF specimens are best kept refrigerated and undiluted, until delivery to the laboratory.  An anal Cytology specimen is best collected in a PreservCyt ThinPrep vial. Anal cytology is processed and reported much the same way as a cervical Pap specimen.