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Surgical Pathology

Surgical pathology is the most significant and time-consuming area of practice for most anatomical pathologists. It includes Histopathology, Cytopathology & Immunohistochemistry.

Histopathology is “the branch of medicine concerned with the changes in tissues caused by disease” – the microscopic anatomical changes in diseased tissue. It helps in making the diagnosis, provides prognostic information and guides management of patients to ensure accurate and timely care of clinical problems encountered by patients. Histopathology is a rapidly changing specialty with new immunohistochemical and molecular methods coming into routine use on a continual basis.

Cytopathology is a discipline that involves the morphologic study of cells. It is broadly divided into exfoliative cytology and aspiration cytology. Exfoliative cytology involves examination of specimens that contain cells exfoliated from body cavities and surfaces. It is further subdivided into gynaecological cytology (Pap/cervical smears) and Non-gynaecological cytology (Pleural fluid, peritoneal fluid, cerebrospinal fluid, urine, bronchoalveolar lavage, sputum, brushing etc). Aspiration cytology involves examination of cells that are actively obtained by fine needle aspiration

Immunohistochemistry: It is the process of detecting antigen in cells of a tissue by exploiting the principle of antibodies specific to antigen in their biologic genome. It is a powerful tool with overlapping features among diagnosis, theranostic and genomic applications.

INHOUSE CONSULTANTS

Dr Anuradha Murthy
M.B.B.S., M.D.(Pathology)

AmurthyArmed with an MD in Pathology from Bombay University, Diploma in in Pathology & Bacteriology, College of Physicians and surgeons (1978), MBBS from Bombay University (1975), Dr Murthy has over 30 years of rich medical experience. She has served in various capacities in prestigious institutions such as Sir Hurkisondas Narrotamdas Hospital & Research Center, Reliance Life Sciences, Imperial College of Medicine, Pathology Department, Hammersmith Hospital, Jaslok Hospital, GSMC & KEM. She is currently working at Metropolis as a Senior Consultant and has special interest in Nephropathology, pediatric pathology, gastrointestinal pathology and Immunofluoresence for kidney disorders. She has numerous publications & presentations to her credit in national & international journals.

Dr. Vikas S. Kavishwar
M.D.(Path.), D.N.B.(Path.), D.P.B.
Vikas
Dr Vikas is currently serving as Senior Consultant Surgical Pathologist and Cytopathologist at Metropolis, Mumbai. He brings to the table over 20 years of rich clinical experience. He has also authored various publications in National and International Journals. His interest lies in Dermatopathology including Direct Immunofluorescence. He also serves as Additional Professor in Pathology at T.N.Medical College and B.Y.L.Nair Hospital, Mumbai

Dr Kirti Chadha
M.B.B.S., M.D.(Pathology), PDDC (Oncopath & Oncohemat)
Diplomate Oncosurgical Pathology & Oncohematology

KirtiCDr Kirti, completed her graduation & Post graduation from Pune University. She topped Pune University in MD Pathology in July 2002 with comprehensive residency training in Armed Forces Medical College. Thereafter, she trained in Tata Memorial Hospital , Sir Ganga Ram Hospital, P.D. Hinduja Hospital & Prince Aly Khan Hospital. She was awarded a Post Doctoral Fellowship in Oncosurgical Pathology & Oncohematology by the Indian Association of Pathologists & Microbiologists (IAPM). She is currently working in Metropolis Health Services, Mumbai heading the Oncology division. She has numerous publications & presentations to her credit in national & international journals. Her area of interest is Oncopathology / OncoHematology, LBC , Immunohistochemistry & Molecular Pathology.

SUB SPECIALTY EXPERTS

histopineAn initiative by Metropolis in the area of Histopathology which provides subspecialty expert consultation to pathologists for expert opinion on histopathology reports and other medical specialities to help doctors interpret Histopathology reports more effectively for their patients. Organ specific histopathology consultation services are fast catching up in the western world and we are pleased and proud to be the first movers to offer this value addition to our customers. These experts will also build a bio-registry of oncology cases that will serve as a reference point for the industry. Metropolis’s global network is well positioned to provide all background support to make this possible.

Dr Roshan Chinoy – Breast Pathology

Dr Roshan Chinoy served as the Professor & Head , Department of Pathology at Tata Memorial Hospital from 1999 till 2007. She also spearheaded the introduction of FNAC for the first time at TMH in 1985 and introduced the technology of IHC Hormone Receptor ER PR in breast cancer. She Pioneered and nurtured the “Bombay Breast Group”. She also set up the Molecular Pathology labs at ACTREC, and planned and initiated the first Tumour Tissue Repository in India at TMH.

Dr Uday Khopkar – Dermatopathology

Dr Uday Khopkar underwent training with legendary dermatopathologist, Dr. A. Ackerman in reporting of skin biopsy specimens. He has been providing expert opinion on over 5000 complicated cases year on year since 1996. He has also been responsible for initiating a one year University Fellowship course in Diagnostic Dermatology in 2009 for the very first time in India. He has been listed in Marquis Who’s Who in Health and Medicine (2006), Who’s Who in Asia (2006) and Who’s Who in World (2008). He is the Youngest Dermatology Section Editor of API Textbook of Medicine 2008. Apart from all this, he also Initiated and popularized IJDVL e-library project aimed at improving access of academic dermatologists to dermatology journals

Dr Amita Joshi – GI & Pancreatic – Biliary Pathology

Dr Amita Joshi serves as the Professor of pathology, Seth G S Medical College & K E M Hospital, Mumbai. She has also undergone special training in surgical pathology & liver transplant Pathology at USC Pittsburg, USA. She has been In charge of Gastrointestinal & Liver Pathology for over 20 years at K E M Hospital, Mumbai. She has contributed to over 70 papers, publications & guest lectures in National & international journals & conferences. Additionally, she is also an assessor for M B B S & M D (Pathology) Courses for MCI, New Delhi

Dr Deepak Mishra – Hematolymphoid Pathology

Dr Deepak Kumar completed his Post Doctoral Fellowship in Hematology from the prestigious All India Institute of Medical Sciences (AIIMS), New Delhi in 1998. He was a UICC Fellow at the King’s College School of Medicine, London, UK (2001); and at the Harvard Stem Cell Institute, Harvard Medical School, Boston, USA. He has been a visiting Fellow at the Mount Sinai School of Medicine, New York (2000), and at the MDS Centre in Stanford Univ School of Medicine, USA( 2003). He has been a visiting faculty at University of Massachusetts School of Medicine, Worcester, MA, USA (2006) and at the Dept of Haematology, Christian Medical College & Hospital, Vellore (2003).

Dr Mukul Vij – Renal Transplant Pathology

Having completed his MBBS & MD in Pathology, Dr Mukul Vij is also armed with a PDCC in Renal Pathology. Extensively trained in the UK as a transplant pathologist, he is now associated with the Global Health City. He specialises in Liver & Kidney Transplant and has national and international publications to credit.

WHY METROPOLIS?

  • Our Histopathology Department processes half a million samples annually across India and abroad.
  • The most exhaustive NABL and CAP accredited Directory of services with over 15 special stains & 120 IHC markers.
  • The 1st lab in India to establish Liquid Based Cervical Screening Co-test including Cytology & HPV with reflex to CISH “Molecular PAP”.
  • One of the few labs in India offering Multiplex IHC – 5 panels covering Lymphoma, Prostate carcinoma, Lung Carcinoma & Myeloma and probably the 1st to be NABL & CAP accredited in this modality.
  • One of the few labs in India offering Chromogenic In –Situ Hybridization (CISH) for EBV, HPV & CMV.
  • The only private referral lab in India to introduce the concept of SUBSPECIALITY EXPERT OPINION – for Transplant, Gastrointestinal , Hepatobiliary, Dermatopathology, Hematolymphoid & Breast Pathology.
  • One of the few labs in India to offer Automated FDA approved Liquid Based Cytology for Gynaecologic & Non-Gynaecologic specimens, since 4 years now
  • One of the 1st labs in India to start Automated IHC staining, since 3 years now. One of the few private Surgical pathology labs in the country to offer comprehensive & complete Oncology reports with Molecular tests such as Her 2 neu by FISH, EGFR mutation, K ras mutation, HPV and CISH & ALK 1 by FISH.
  • One of the few Surgical Pathology labs having the shortest Turn Around Time and excellent customer care support with minimal response time for technical & case related queries..
  • Regular CMEs, workshops, training programmes are organized by the organization in India & abroad.

FREQUENTLY ASKED QUESTIONS

What are the services offered by your laboratory?

We offer the following services

  • Surgical pathology
  • Cytopathology – Gynecologic – Conventional and Liquid based, including Cervical screening
  • Cytopathology – Body fluids, FNAC,Polarizing Microscopy for crystals
  • Immunohistochemistry Services – Over 120 markers
  • Second opinion / consultation
  • Expert Opinion – Subspeciality
  • Molecular pathology

Please refer the EDOS for individual test details

Do you perform a biopsy?

No, we do not perform a biopsy. This is a procedure performed either by a surgeon (Incisional, Excisional) or by a dermatologist in case of skin biopsies. Histopathologists examine the tissue obtained after a biopsy and issue a report based on their observations.

Do you perform FNAC procedure?

Yes, we do perform a procedure known as Fine needle aspiration Cytology (FNAC) which is performed in our premises. The prerequisites are basic investigations, complete clinical details and doctor’s prescription

Is your Laboratory accredited?

Yes our laboratory is accredited by the NABL (National Accreditation Board of Testing and Calibration of Laboratories) India & College of American Pathologists (CAP). This accreditation process is carried out every 2 years for NABL & annually for CAP with periodic internal audits carried out twice in a year. All our aforementioned tests are accredited by NABL & CAP.

How should one send Histopathology/ Cytopathology/Immunohistochemistry samples? What are their prerequisites?

Please refer to this PDF for complete details

Do you supply bottles or jars with the fixative?

No we do not supply formalin jars, but if needed we share the protocol for preparation of 10% NBF. We provide LBC container for LBC PAP & Michel’s medium for IF testing testing and gluteraldehyde for electron microscopy.

What is the turn around time for surgical pathology specimens?

The average TAT for our specimens is 3 days for a small specimen and 5 days for a large specimen.
Please refer the EDOS for details.

Do you offer slide preparation and technical services?

Yes, Metropolis Laboratories provides histologic preparation and immunohistochemistry in addition to comprehensive diagnostic services. We have the staining without interpretation option for this purpose. The pathologist can select the marker of choice and we stain the slide and send it back for the pathologist to interpret it. We check the stain quality before dispatch. The stained slide is dispatched along with the paraffin block.

Do you offer a slide consultation service for second opinion?

Yes. Our specialists offer consultative services that provide guidance for additional diagnostic workup, prognostic information, pathogeneic insight, and therapeutic direction. Please forward the slides, previous surgical pathology reports and, if possible, the paraffin blocks, along with the request.

We at our centre also offer Expert opinion for the following subspecialities: Dermatopathology, Breast, Hematolymphoid, Gastrointestinal, Hepatobiliary & Pediatric Pathology

How can I get my patients’ results?

Reports can be delivered via fax, mail, courier, or via the Internet with our secure web-based application that allows physicians 24/7 access to laboratory reports.
The material received in the from of slides and blocks for IHC or second opinion is returned along with the report copy

Do you accept samples in mediums other than 10 % Neutral buffered formalin?

10 % NBF offers a good result for routine and ancillary tests and hence is the most widely used fixative worldwide. However, Bouin’s fluid may be used to fix testicular biopsies which are accepted by our laboratory.

Do you retain patient material? Can we obtain our material once it has been reported from your laboratory?

Yes, the patient’s slides and blocks are retained by the laboratory and safely stored in the safe house. However, if a patient requires that material for a second opinion or further treatment decisions these can be made available. The paraffin blocks prepared can be handed over to the patient/relatives after duly filling a form citing the details.

For more queries on any assistance on samples and reports,
please call: 022- 30840791/022- 30840774/022- 30840772