• HISTOLOGICAL EXAMINATION

The histological examination process is done in three stages.

In the 1^st stage the laboratory receives samples for testing. These samples are recorded and codified in the laboratory's registry, to facilitate tracking during the examination and afterwards. The referring doctors-institutions are responsible for submitting referrals with accurate and complete information, as well as for providing instructions on the safe transport, packaging and labelling of samples.

The 2^nd stage involves the macroscopic processing of the samples and constitutes the first step in the medical procedure. When the materials involve organs or large specimens, additional cross-sections are taken, in accordance with the guidelines, from the area of clinical interest.

This is followed by the chemical processing of the tissue, embedding in a paraffin block, division into micro-sections and application to slides, staining with HE staining, covering, and quality control. The slides are documented per case together with the corresponding referral.

Finally, each case (slides, referral) is brought before the pathologist, who performs the microscopic examination (observation of the slides under an optical microscope). 

Microscopic examinations are a qualitative and not quantitative method, and are based on the medical examination and evaluation of the tissue image rather than on machine measurements.

The data produced by the above examination are taken into consideration together with the clinical history of the examined patient (referral note), the macroscopic findings, and the results of individual examinations undergone by the patient (laboratory and imaging results), in order to determine whether the patient will require further auxiliary examinations.

Based on all the above, the pathologist makes the pathological/histological diagnosis.  

The 3^rd stage involves the procedures of notifying the patient of the diagnosis and archiving the material. The final findings are dictated by the doctor, documented by the secretary, checked for errors and then certified by the doctor, who informs the treating doctor.

The findings/histological reports, slides and paraffin blocks are then archived.

Collection of material from outpatients

Outpatients who wish to submit biopsies to the Pathology Laboratory of Mediterranean Hospital of Cyprus may do so at the department secretariat Monday to Friday, from 09:00 to 17:00. Providing the following will ensure prompt and proper service:

1. Bioptic material stored in a container with formaldehyde (neutral-buffered formalin 10%) 
2. Referral note with the following information:

• Patient surname
• Patient name
• Hospital/clinic admission number (if available)
• Date of birth (full)
• ID card number
• Patient address and contact details
• Type of requested examination - doctor’s referral for histopathological examination through the General Healthcare System
• Clinical information (patient history, type of sample, localisation, etc.)
• Total number of containers that comprise the case
• Time/date of sample collection
• Name and surname of referring doctor

PDF: Registration form

It is crucial that the above are filled in as exactly and clearly as possible. Otherwise, there may be a risk of error or delays in producing the results.

For your convenience, please inform the secretariat of the Department by calling 00357 25 200 222 before sending/delivering any material.

• FROZEN SECTIONS

This examination is performed during surgery in order to take a therapeutic decision and select the most appropriate type of surgical approach.

Reasons for performing frozen sections and questions that require a rapid answer by the pathologist:

• Identification of tissue (e.g. parathyroid, lymph nodes, etc.)
• Whether there is evidence of neoplasm/malignancy
• Whether there are metastases to lymph nodes or distant foci
• Whether the surgical margins are infiltrated or not (positive or negative) 

During this process, the surgeon removes tissue to be examined, which is sent immediately to the pathology laboratory. This is followed by macroscopic examination and then freezing of the sample in the cryostat, from where a section is taken on a slide. This section is then rapidly stained with HE staining. Finally, the tissue sample is assessed microscopically. 

The results of this examination are given to the surgeon 15-25 minutes after delivery of the sample to the laboratory.

Frozen section biopsies subsequently go through all the stages of the histological examination, after which the final diagnosis is given.

• AUXILIARY EXAMINATIONS

After assessing the first findings from the initial microscopic examination of a case's slides, the pathologist must then decide whether to recommend and perform further, auxiliary examinations. 

These involve: 

• Histochemistry
• Immunohistochemistry

Mediterranean Hospital of Cyprus offers all the necessary auxiliary examinations to provide as much data as possible for the histological diagnosis, based on modern diagnostic practices.

• ADVISORY (2ND) OPINIONS

The Mediterranean Hospital of Cyprus pathology laboratory accepts histological/cytological material for advisory (2nd) opinions, for confirmation of initial diagnoses and/or examination for additional information regarding targeted, personalized therapy.

To provide an advisory (2nd) opinion on material that has already been examined at another laboratory, the doctors at our department require patients to provide the following:

• Slides of all examined sections
• Slides with special stains (histochemical or immunohistochemical), if extant
• Paraffin block or blocks from the most representative site of the lesion, to perform additional ancillary tests (e.g. histochemistry, immunohistochemistry etc.), if necessary
• Copy of the histological examination report

The above material will be returned to the patient after processing at our laboratory is complete. Slides with special stains prepared at our laboratory shall remain in our archive.

Fragile material, histological slides in particular, must be packaged with great care, in special, sturdy cases of the kind usually available at pathology laboratories. 

For your convenience, please inform the secretariat of the Department by calling 00357 25 200 222 before sending/delivering any material.

Pathologists play an often-overlooked role in medical care.

Most patients are unlikely to ever meet their pathologist, despite the crucial role these doctors play, in close collaboration with their colleagues of other specialties, in diagnosing the disease, and providing information on its prognosis and treatment.

The pathology laboratory at Mediterranean Hospital of Cyprus is the first private pathology laboratory to be designed and function as part of a hospital environment, thus contributing to the hospital’s provision of rapid, comprehensive patient care. The laboratory has all the most cutting-edge technological equipment required to prepare and conduct histological and auxiliary examinations.

Advanced machinery and computers allow faster more efficient pathological examination procedures and improved staff and environmental protection.

The pathology laboratory is an active participant in the scientific meetings and oncology councils of the hospital. It has well-trained medical and paramedical staff who further their knowledge based on international literature and guidelines. 

The hallmarks of the pathology laboratory of Mediterranean Hospital of Cyprus are:

• Rapid processing of examinations
• Diagnosis by experienced pathologists
• High-quality, high-level services, medical equipment, technical and administrative support
• Α broad spectrum of diagnostic services (diagnoses, - auxiliary examinations - advisory (2^nd) opinions)
• Keeping of patient archives
• Protection of personal data 
• Availability of medical staff for discussion of incidents and patient concerns