Pathology lab finds answers

  • Published
  • By Ilka Cole
  • Team Eglin Public Affairs
EGLIN AIR FORCE BASE, Fla. --  On any given day, the pathology and histology lab professionals here handle approximately 125 patient specimens such as kidneys, livers, pieces of skin, ovaries, prostates, and tonsils.

They evaluate, prepare and transform tissue onto microscope slides studied by pathologists. These doctors study tissues to make a diagnosis or determine the stage of a disease. This is where Eglin Hospital patient tissue and organs come to be studied.

"We get everything. Our purpose is to find out what happened," said Lt. Col. Rolando Ramos, medical director of pathology and laboratory services. "When doctors or surgeons remove tissue or body parts, we determine if the disease is malignant or benign, so clinicians or surgeons can apply proper treatment."

Before doctors can accomplish their research, histology lab technicians begin the detail-oriented process of sample verification and accessioning.

"It is extremely meticulous work. We check and double check names, numbers with corresponding specimens to avoid risks. We kid that to work in this lab you almost have to have obsessive compulsive disorder," said Ramos.

For example, if two biopsies from the same woman, Part A is the left breast, Part B is the right breast are inadvertently switched, doctors may remove the wrong breast, noted Ramos.

The two day, complex multi-step process preserves and dehydrates the tissue to prepare it for a complete examination. The tissue is then cut and encased into numbered cassettes. The larger organs are examined by lab pathologists, and smaller samples like pieces of skin are handled by histology technicians.

The technicians then stabilize the tissue by pouring paraffin wax in the cassettes. Once each block of tissue hardens, it is sliced with a machine that looks like a miniature deli slicer. The thin ribbons of cut tissue are immediately soaked in water to ensure they don't break apart before technicians can scoop it with tweezers and place it on a submerged slide.

Lab technicians here are experienced and well trained. Their tissue preparation work is essential according to Maj. Michael McFall, pathologist. Without them to process the tissue and make the glass slides, pathologists would be unable to examine the tissue under the microscope to make a diagnosis. Although they don't interact face to face with patients, their expertise is critical to treatment and to the patient's outcome, said the Major.

"Doctors look for specific things, such as the size and shape of the cells. If we mishandle or cut the tissue the wrong way, we could miss something and the pathologists won't see what they need under the microscope," said Airman 1st Class Emily Bodden, histology lab technician. "You have to get it right the first time."

To learn this, Airmen attend a nine-month technical school and train daily to hone their skills. At the end of the school they test for a histology certification, according to Bodden.

The final product, are small glass microscope slides with patient tissue the pathologists review under a high-powered microscope.

"Pathology is recognizing tissue patterns, seeing what is different from what is normal and figuring out how to classify it," said McFall. "The human body is complex and fascinating. To be able to see all of that and combine it with book knowledge and apply is the best part."

Pathologists and a transcriptionist input the findings in the patient's electronic file and notify primary physicians.

Eglin's pathology lab is manned by four pathologists, one contractor and five active duty histology technicians and a transcriptionist. Lab personnel are on call every day to respond to emergencies or process early morning specimens for clinicians.

"I like knowing what I do helps someone," said Bodden. "It's very interesting work and the doctors here are great at educating and exposing us to unusual samples when they can."