The Department of Pathology provides the basis for determining the treatment policy, prognosis, and appropriateness of treatment by supporting the accurate and prompt diagnosis of the patient's disease. The records of pathology reports serve as the basis of disease classification, registration, and statistics, and are the foundation of disease research.
At the Department of Pathology of Seoul National University Hospital, more than 100 employees, including 18 professors, carry out examinations. We not only perform accurate and prompt diagnoses, but also cultivate excellent medical staff through a range of educational programs. In addition to this, we publish excellent research results on the causes, pathogenesis, and biomarkers of diseases.
Histopathology (surgical pathology)
Histopathology is the field of discovering and diagnosing diseases by using a microscope to observe the morphological changes of human tissues collected from biopsy and surgery using an endoscope. The final diagnosis of a patient believed to have cancer is made through a biopsy or histopathologic examination of the surgical tissue, and based on the result, a future course of treatment such as surgery or chemotherapy is determined, and the patient's prognosis is predicted. In addition, with the help of recent testing techniques such as immunohistochemistry, molecular pathology, and electron microscopy, more accurate histopathological diagnoses are being made. Performing an emergency histopathologic examination during surgery provides important information to help determine the surgical method and scope.
Cellular pathology is the field of detecting and diagnosing diseases by examining cells in human tissues. It includes exfoliative cytology using shed or desquamated cells from cervical, sputum, urine, pleural, and plural, and fine-needle aspiration (FNA) cytology that aspirates cells directly from lesions caused by of the thyroid, breast, lymph nodes, and the pancreas using a syringe needle. The advantages of the cytology method include the following: it is less invasive compared to a biopsy, so there are fewer side effects caused by the test; it is economical; the result can be known quickly. Recently, the introduction of liquid-based cytology, allowing for a more accurate observation of the morphology of cells, has increased the preservation of the specimen and the accuracy of diagnosis. In addition, combined with the molecular cytopathology test, auxiliary testing techniques such as cell-mediated immunity tests and genetic tests are also actively conducted.
Molecular and Genomic pathology
Molecular and Genomic pathology is identifying the alteration of DNA or RNA in pathological tissue or cells using molecular analysis methods such as PCR (polymerase chain reaction), FISH (fluorescent in situ hybridization), sequencing, and MSI (microsatellite instability), and with the more recently introduced gene panel test using NGS (next-generation sequencing). Using specialized panels developed by Seoul National University Hospital, such as FIRST-PanCancer panel (for colorectal cancer, breast cancer, stomach cancer, gynecological cancer, pancreatic cancer, and various rare cancers), FIRST-Lung Cancer panel (lung cancer) and FIRST-Brain tumor panel (brain tumor), we discover patient-specific target markers and provide essential information for prognosis and diagnosis. After the results are discussed by the Molecular Tumor Board, which includes pathologists, clinicians, bioinformatics, and coordinators, the patient's treatment direction is determined. As a key field of precision medicine and patient-specific treatment, Molecular and Genomic pathology is useful for diagnosing patients, predicting prognosis, and treatment response. It is also a field of pathology testing that is developing rapidly, changing the paradigm of diagnosis and treatment.
Immunohistochemical staining is a method of diagnosing a lesion by reacting an antibody against a specific antigen expressed by the abnormal tissue and observing its pattern. Immunostaining is very helpful in differential diagnosis due to its high specificity and sensitivity. In cancer patients, it enables personalized treatment through accurate diagnosis, prediction of prognosis, and prediction of reactivity to treatment by examining various antigens expressed by tumors.
Electron microscopy is a method of observing and diagnosing minute morphological changes in cells by expanding tissues from thousands to tens of thousands of times using electromagnetic waves. It is used for kidney pathology, liver pathology, brain tumor biopsy, muscle, and peripheral nerve biopsy.
An autopsy is a process of dissecting a body after death and investigating it under a microscope to identify the cause and course of a disease. A hospital autopsy is performed with the consent of the bereaved family, and is the best method of achieving a systematic analysis of deceased patients. Through an autopsy, it is possible to diagnose deceased patients, the progress of disease and cause of death, and comprehensively determine treatment effects. It is the field that has contributed the most to the development of medicine thus far.