Subspecialties

Since 1910, the Department of Pathology & Immunology has had a long and rich history of contributions to diagnostic pathology and patient care. Our subspecialty model provides you with the expertise you need to provide a diagnosis with confidence.

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Areas of subspecialty expertise

Autopsy

Bone & soft tissue pathology

The bone & soft tissue pathology group provides expert consultation for tumors of soft tissue and bone. We have particular expertise in relation to the diagnosis of sarcomas–rare malignant tumors for which precise classification and ancillary testing are becoming increasingly important. Correlative radiographic studies, interphase fluorescence in situ hybridization (FISH), immunohistochemistry, and molecular profiling are often essential parts of the workup. Our subspecialists have a close relationship with the Washington University Sarcoma Program.

Breast pathology

The breast pathology group provides consultation for benign and malignant diseases affecting the breast. There is particular expertise in relation to breast carcinoma where careful integration of diverse pathological and clinical data is essential for optimal patient management. Robust resources for ancillary immunohistochemical and molecular testing further insure that our team can provide physicians and their patients with the highest quality predictive and prognostic information.

Cytopathology

The cytopathology group is available to provide consultation for difficult and complicated cytology cases including fine needle aspiration biopsy, Pap tests and any non-GYN cytology specimen. Where it is appropriate, supportive and prognostic ancillary testing methods are available.

Dermatopathology

The Washington University Dermatopathology Center provides reliable superior interpretation of skin, hair and nail biopsy specimens with up-to-date expert diagnostic services. We offer a comprehensive array of dermatopathology diagnostic services performed in-house including routine histology, special stains and immunohistochemistry, and immunofluorescence and ELISA testing for diagnosis of autoimmune blistering diseases. With strong backgrounds in dermatopathology and clinical dermatology, our team is uniquely positioned to integrate clinical and pathological information at the highest level. Our consultation expertise includes complex inflammatory and lymphoproliferative skin diseases and melanocytic lesions.

Genitourinary pathology

The primary focus of the genitourinary pathology group is urologic malignancies in general, with a specific emphasis on prostatic adenocarcinoma. The group works closely with colleagues who take care of patients with urologic diseases. Research efforts include gene discovery and marker discovery in potential prostate cancer precursors and prostatic carcinoma via gene expression profiling and whole genome sequencing.

Gynecologic pathology

The gynecologic pathology group has broad expertise in the diagnosis of both benign and malignant gynecologic lesions, including tumors of the ovary, endometrium, cervix and vulva. Placental and trophoblastic pathology is a particular area of strength. The group enjoys a close relationship with the Division of Gynecologic Oncology.

Head & neck pathology

The head & neck pathology group is dedicated to this rich and unique subspecialty of pathology. A diverse variety of tissue types and organs including, skin and mucosa, odontogenic tissue, salivary and endocrine glands, bone and lymphoid tissues, converge in this small anatomic site. Consequently, a vast array of complex lesions and disease entities are encountered. Knowledge in this field is constantly developing and new entities are emerging just as others are becoming better defined. Cytogenetics and molecular genetics techniques are increasingly used in the identification and reclassification of several tumors.

Hematopathology

The hematopathology group includes subspecialty-certified hematopathologists who provide expert consultation services on hematologic disorders of peripheral blood, body fluids, bone marrow, lymph nodes, and other tissues. In addition to morphologic evaluation, we provide a full array of ancillary diagnostic testing including multi-color flow cytometry, immunohistochemistry, cytochemistry, molecular diagnostics (including next generation sequencing), cytogenetics and FISH to provide increased diagnostic accuracy and additional prognostic information.

Liver, GI & pancreas pathology

The liver, gastrointestinal and pancreas group interprets high complexity patients’ liver biopsies ranging from medical diseases such as non-alcoholic steatohepatitis to hepatocellular carcinoma. We have diagnostic expertise in patients who have undergone liver transplantation, patients with pancreatico-biliary carcinomas and all aspects of luminal gastrointestinal biopsies.

Medical renal pathology

The medical renal pathology group interprets high complexity patients’ kidney biopsies with all types of medical renal disease as well as biopsies from patients who have undergone renal transplantation. All cases are routinely examined using light microscopy, electron microscopy, and immunofluorescence microscopy.

Molecular pathology

The molecular pathology group includes pathologists who are American Board of Pathology certified in Molecular Genetic Pathology, and cytogeneticists and molecular geneticists who are American Board of Medical Genetics (ABMG) certified.  Our clinical genomics suite features molecular genetic testing including next-generation sequencing, along with cytogenetics, chromosomal microarray and FISH.

Neuropathology

The neuropathology group provides consultation in the interpretation of a wide variety of diseases of the central and peripheral nervous systems including nervous system neoplasms, neurodegenerative disease, developmental processes and neuropathies using neurosurgical- and neuroautopsy-derived material. Specimens may be analyzed using routine stains and histochemistry, immunohistochemistry, molecular analysis including fluorescence-in situ hybridization (FISH), one micron thick plastic-embedded sections and ultrastructure.

Ophthalmic pathology

Ophthalmic pathology is a highly specialized field, with only about 50 eye pathologists nation-wide, and accordingly multiple institutions and private practice physicians utilize our services. Our ophthalmic pathology group provides pathologic interpretation of specimens from all  parts of the eye, including ocular surface tumors; corneas from patients undergoing corneal transplants; and whole eyes with tumors or other blinding eye diseases such as severe trauma, end-stage diabetic disease, and glaucoma. Special analysis is utilized when needed, including immunohistochemistry, fluorescence microscopy, and molecular genetic testing.  Additionally, for vitreous biopsies performed for suspected intraocular lymphoma, our experts in conjunction with the cytopathology group have developed a thorough protocol to maximize diagnostic accuracy, which includes cytology, immunohistochemistry, cytokine testing, molecular genetic testing for gene rearrangement, and flow cytometry.

Pediatric pathology

Thoracic pathology

The thoracic pathology group provides expert consultation in relation to diseases affecting the respiratory system. There is particular expertise in relation to interstitial lung disorders where the systematic integration of pathological findings with radiographic and functional studies is often essential. In addition, state of the art resources for immunohistochemical and molecular testing help insure that patients with lung cancer will be provided with the highest quality of predictive and prognostic information.