CPD ACCREDITED ARTICLE
Maximising
Histopathology
in Oncology
The 3 Pillars for Diagnostic
Success and Effective Therapy
Dr Rick Last (BVSc; M.Med.Vet(Path); MRCVS)
Specialist Veterinary Pathologist
Although surgical pathology forms only a portion
of veterinary oncology, if used correctly within the
framework of the veterinary team (clinician, veterinary
nurse, owner, pathologist), it provides the opportunity
for rapid accurate diagnosis and immediate
implementation of relevant therapy. The pathologist
reading the biopsy is removed from the patient and
outside the mainstream flow of medical information,
pertaining to the particular patient circulating within
the practice. The pathologist must therefore rely on
members of the clinical team to provide important
information which is almost always essential to
reaching a diagnostic conclusion or diagnostic rule
out’s. Surgical pathology is a prospective disease
investigation on a live patient under medical care and
whose disease course can theoretically be altered by
therapy. Therefore, a premium is placed on speed and
accuracy. However, there are numerous and significant
problems in surgical pathology that negatively impact
the desired result of a speedy and accurate specific
tumour diagnosis.
Effective veterinary oncology requires the import of
different skills of two different but related groups of
veterinarians. 1. The pathologist does not see the gross lesion. This
can be circumvented to some degree by more
efficient use of digital photography by clinicians.
2. There is often a poor or no history provided.
3. The pathologist does not select the tissue and
lesions to be examined.
4. Specimens submitted are often very small,
distorted and marginally adequate for a thorough
evaluation.
5. Tissues are sometimes improperly fixed and
partially autolyzed.
6. In many instances the pathologist cannot get
additional tissue to examine so they must make a
diagnosis with what they have before them.
7. The clinician needs an answer quickly so there is
minimal time for reflection.
What is a surgical biopsy?
This procedure is a temporary partnership between
a clinician and his support team of practice staff and
the pathologist acting on behalf of the patient to aid
the clinician in:
1. Making or confirming a diagnosis.
2. Assisting in the prognosis of the case by assessing
the progress of therapy, grading and staging of
neoplasms and determining the completeness of
surgical excision.
vet360
Issue 04 | SEPTEMBER 2018 | 4
The upside of surgical pathology is that there is usually
no or very minimal autolysis which facilitates accurate
identification of morphological detail and accuracy of
tumour marker stains. On the downside one needs to
consider the following: