There are about 17,000 pathologists in the United States. 6 Pathologists evaluate a specimen by direct macroscopic (visual examination with the unaided eye) and microscopic examination of tissues, and through the use of additional studies such as molecular pathology to render a definitive diagnosis of cancer. In addition, the pathologist determines tumor characteristics including organ of origin, histologic type, grade, pathologic stage, and other characteristics that determine prognosis and guide therapy.
2.2.1 Roles and Responsibilities of Pathologists
Pathologists play a pivotal and expanding role in the diagnostic process. They are responsible for drafting reports of their findings from tissue removed from patients by other physicians (e.g. radiologists, surgeons). Tissue samples vary from small biopsies such as image-guided needle biopsies to large surgical specimens. Once the specimen is received in the pathology laboratory, pathologists and their assistants grossly evaluate, process, and prepare slides for histologic microscopic evaluation. When needed, pathologists perform ancillary studies that help define diagnostic and therapeutic options. The pathology report, which becomes part of the patient’s medical record, is released to the patient’s referring clinician, who is responsible for informing the patient of the results.
To summarize, radiologists localize and characterize lesions through imaging studies, and may remove tissue for pathological diagnosis, while pathologists receive the tissue, sample it, and determine whether or not a malignant disease is present. Both radiologists and pathologists must rely on the adequacy of accompanying clinical information in rendering his or her diagnosis. Additionally, both specialists must create and release reports of their findings.