Hacettepe University Faculty of Medicine
Department of Pathology
The Department of Pathology was first established as a unit within the Hacettepe University İhsan Doğramacı Children's Health Institute in 1958. The Department of Pathology at Hacettepe University Faculty of Medicine was formally established by Dr. Muharrem Köksal in 1963.
The Department of Pathology serves the patients for whom biopsy is needed for diagnosis and treatment during examination and investigation at Hacettepe Adult, Oncology and Children's Hospital together with the unit of cytology. In addition to that, re-examination and necessary additional investigations for the materials of patients diagnosed at a different pathology laboratory are also provided. The services provided at the department of Pathology are carried out by academic staff, research assistants, biologists and technicians.
Small biopsy materials taken from the patients at the outpatient clinic as well as different organs and tissues with different sizes are transferred to the department of pathology. Pathologist is a medical doctor specialized in the field of pathology. Pathology is the branch of medicine where the tissues and cells are analyzed with a microscope for diagnosis.
The methods of treatment offered to patients and the success of the treatment are very much related to the correctness of the diagnosis. In some cases, the diagnosis is completed by a pathologist by means of a biopsy. Especially for cancer, pathology has a specific importance.
For the diagnosis of cancer, the pathological diagnosis is the golden standard – only the pathologist can come up with an exact diagnosis. Whether the cancer exists or not and if it does exist what its type and classification is could only be detected by a pathological examination. And the most important step in cancer treatment is the correctness of pathological diagnosis (biopsy).
The correctness of pathological diagnosis is related to the education, experience and judgment ability of the pathologist.
The duty of the pathologist:
Diagnosis:
Macroscopic and microscopic analysis of the body tissues coming to the laboratory as well as carrying out certain special laboratory tests determined by the pathologist contribute greatly to the diagnosis carried out by the clinician and the surgeons.
Planning of the treatment (surgical treatment/medical treatment) and determination of prognosis (course of illness)
Pathologist takes part in determination of the treatment planning and patient prognosis by means of routine macroscopic and microscopic investigations (for instance, to detect the existence and degree of its expansion) as well as through certain tests determining whether a certain medication will be applied or not and whether certain biological symptoms exists or not (for instance, immunohistochemical or immunofleurescent tests, or those requiring FISH or molecular methods). In addition to this, the pathologist also helps shaping the course of the surgical operation through the process named intraoperative consultation ("frozen section") as well as urgent microscopic diagnosis during the operation.
For all these reasons, pathology and the pathologist play a very important role for the patient, the clinician, the oncologist and the surgeon.
Our department houses 8 professors, 3 associate professors, 1 assistant professor and 1 teaching assistant specialized on liver pathology, gastro-intestinal pathology, blood diseases pathology, gynecological pathology, lung pathology, head and neck pathology, skin pathology, neural system pathology, kidney pathology, cytopathology, uro-pathology, soft tissue and bone pathology, endocrine pathology, breast pathology, periodontal pathology, eye diseases pathology and molecular pathology.
Histochemistry, immunohistochemistry, immunofleurescent microscopy, fluorescent in situ hybridization (FISH) and molecular methods are used to help the processes of diagnosis, treatment and prognosis. In the special room within the operating room, intraoperative consultation ("frozen section") service is provided to help urgent diagnosis during the operation.
This is the name given to the serial procedures carried out to investigate the tissues under the microscope. Macroscopy room and tissue follow-up laboratory of our department are equipped with modern technical hardware. In these labs, where tissues are prepared for investigation, there are a lot of macroscopy cabins, autotechnicans, automatic painting devices, tissue burial devices and microtomes.
In addition to conventional hematoxylin-eosit method, special histochemical paintings as well as immunohistochemical and immunofleurescent studies are carried out in the histochemistry and immunohistorchemistry laboratories of our department. These are special methods used during the microscopic analysis. Immunohistochemistry studies carried out in our department are automated. Our immunochemistry panel includes more than 200 anticorps. The immunohistochemistry devices can laso undertake chromogen and silver in-situ hybridizations (CISH/SISH). Our laboratories offer services with high capacity. All the requests can be met on a daily basis.
Molecular methods play an important role in not only research and science production, but also in patient diagnosis and treatment. Molecular methods are required is some cases including hematological malignancies, soft tissue tumors, intestine, lung, thyroid cancers, breast cancer and brain tumors. The molecular pathology laboratory of our department is fully equipped with modern hardware and complete infrastructure and is actively used. The methods which exist and are used in our department are in-situ hybridization, DNA-RNA-protein extractions from tissues or fluids, PCS (polymerase chain reaction), real time PCR, southern/northern/western blot, gene chipping, pro-sequencing, laser microdissection and mutation analysis. Ploidy analysis and flaw cytometry are carried out in the Basic Oncology laboratory at the Oncology Institute. Advanced molecular investigations can also be applied to cytological materials in addition to tissues.
The original genetic changes detected via investigations (gene re-arrangements and mutations) direct the diagnosis, treatment and the prognosis. These methods are also used for infectious diseases in determination of the existence and type of tuberculosis and HPV in addition to malignancies. Molecular investigations are carried out not on a daily basis but upon request.
An average of 17.000 cases are evaluated at cytopathology unit. While 12.000 of these cases are composed of cervicovaginal cytology, the remaining 5000 cases include non-gynecological cases (fine-needle aspirations, serious effusions, abdomen washing fluids, bronchi and bronchoalveolar lavages, phlegm and urine cytologies and cerebrospinal fluids, etc).
In cervicovaginal cytology, water-based one layer thin preparate method is used. In preparation of body fluids, extension preparates, cytocentrifuge preparates and cell blocks (when there is enough material) are used. During the evaluation of all cytological materials, especially aspiration cytologies and serous effusions, immunohistochemical investigations are carried out when required.
In fine needle aspirations extracted from the organs and masses by radiologists, the staff at the cytology unit carries out a sufficiency evaluations for each patient and some of the superficial mass aspirations are carried out by the pathology specialists and assistants at the unit.
Intraoperative consultation service is offered at our operating room. For this service, freezer microtome (cryostat) is used. Tissues extracted from the patients during the operation are frozen with cryostat and cut ("frozen sectioning"). The sections are painted with a rapid method and histopathological diagnosis is provided within minutes. There are 1 cryostat, 1 multi-headed microscope and telepathology system in the room. "Telepathology" is a configuration which provides microscopic image transfer between the operating room and the main department when necessary and which renders intraoperative evaluation possible and safe by means of multi-participation.
Tissues and preparates of patients extracted at medical centers other than Hacettepe University are analyzed by our department for confirmation of the diagnosis and second screening; the comments of our specialists are provided with a written report. To this end, our patients must provide our department preferably with paraffin blocks or unpainted ready sections together with the pathology report given by the medical center. In cases where block or unpainted sections are not available, haemotoxylin-eosin painted ready perpetrates are also used for evaluation.
Patients do not need to arrange an appointment to benefit from the services offered by our department. Human materials which are requested to be examined are sent to our department by outpatient clinics, inpatient services and operating rooms of Hacettepe University by the authorized personnel. Pathology reports on the examined materials are sent to the relevant outpatient clinics and services online. Patients who wish to apply to our department by providing ready blocks and preparates must first get in touch with the secretary located on the 2nd floor of our department, where they can also receive their reports.
Department of Pathology
The Department of Pathology is located on the 2nd and 5th floors of the Morphology Building, the Rear Block, which is located in the Hacettepe University campus. At the Entrance Door B of Morphology Building, there is a help desk / secretary at the department of Pathology on 2nd and 5th floors. Laboratories (tissue follow-up, histochemistry, immunohistochemistry, FISH and molecular pathology laboratories), macroscopy room, block and lamina archives, rooms of assistants and academic staff as well as microscopy evaluation rooms. The fifth floor houses rooms of academic staff, meeting room, immunofleurescent microscopy and multi-headed microscopy rooms, report archive and report secretary.
Tel: +90 (312) 305 15 62
Cytopathology Unit
The Department of Cytopathology is located on the 4th floor of the Morphology Building, the Rear Block, which is located in the Hacettepe University campus. Cytopathology unit is located at the end of the corridor of the 4th floor of Morphology Building Entrance Door B. There is a secretary at the entrance. The unit is composed of report secretary, cytological material preparation and painting laboratory, rooms of academic staff, microscopic reading room, lamine and report archives.
Tel: +90 (312) 305 18 83