Rapid-response, molecular-friendly surgical pathology: a radical departure from the century-old routine practice

Currently, surgeons have to wait for at least 1 day to receive the pathology report of a biopsy or other surgical excision. This delay is mandated by the overnight tissue-processing methods that have been in use for more than a century. Patient anxiety and delay in treatment are consequences of this practice. Here we report the impact of a tissue-processing system on the turnaround time of surgical pathology reporting and its potential effect on overall patient management. This technique provides the feasibility for performing molecular assays on the same sample used for pathologic diagnosis.

Biopsies and other surgically removed specimens from patients treated at the University of Miami, Jackson Memorial Hospital during calendar year 2005 were processed by an automated, microwave-assisted rapid tissue-processing method. Turnaround time for surgical pathology reports was calculated and compared with that of year 1996, the last year before the new technology was phased in.

Total tissue-processing time was reduced from 8 to 10 hours to 67 minutes, resulting in the availability of slides in less than 3 hours. In 80% of the patients, diagnoses were reported on the same day they were received in the laboratory. The 1-day turnaround for the reports in 1996 was < 1%. Histology of rapidly processed tissues and their histochemical and immunohistochemical properties were comparable with those of the traditionally prepared material.

The rapid turnaround capability of the new tissue-processing system has allowed the pathology laboratory to render the final report in the majority of specimens on the day they are received. The feasibility of preserving macromolecules in the same clinical samples used for diagnosis is a timely advantage in the era of molecular medicine.