Gastrointestinal pathology

Gastrointestinal pathology is a subspecialty of surgical pathology. It covers the diagnosis and characterization of diseases of the digestive tract and other organs, such as the pancreas and liver.

At Northwell Health, our gastrointestinal pathology team offers broad experience in adult gastrointestinal and pancreaticobiliary disease, including fine needle aspirations and biopsies, endoscopic biopsies and surgical resection specimens. We provide timely results; the diagnostic reports for endoscopic and needle biopsies are routinely completed in 24-48 hours. Our pathology group provides the highest quality GI pathology diagnoses, including second opinions, made exclusively by one of our seven fellowship-trained gastrointestinal and liver pathologists. As a group, we are available to answer your questions and concerns about diagnoses at all times. The gastrointestinal pathologists at Northwell Health are surgical pathologists who provide real-time consultations on challenging case materials. The service conducts routine intra-service quality review and maintains routine contact with clinical teams.

Histopathology

Surgical resections, endoscopic and laparoscopic biopsies and needle core biopsies for diseases including: gastroesophageal reflux, Barrett’s esophagus, gastritis, stomach cancer, enteritis, colorectal polyps and cancer, inflammatory bowel disease, chronic hepatitis, cirrhosis, hepatocellular carcinoma, pancreatitis and cancer, and biliary tract disease.

• Endoscopic gastrointestinal biopsies
• Liver biopsies
• Gastrointestinal, pancreatic, hepatobiliary tumor evaluation
• Surgical biopsies and resections

Cytology

• Brushings and washings
• Fine needle aspirations
• Liquid-based technology with cell blocks, allowing the performance of special stains, immunohistochemistry, and molecular studies

Special Stains

• Warthin Starry stain for Helicobacter pylori
• Complete liver panel (trichrome, reticulin, iron, PAS with diastase)
• Others (calcium, bile, mucins, copper, Congo Red, GMS, AFB, PAS/Alcian blue, etc.)

Immunohistochemistry and Flow Cytometry

Complete panels, including:

• DNA mismatch repair proteins for colorectal carcinoma (MLH1, MSH2, MSH6, PMS2)
• Therapeutic marker for colorectal carcinoma (EGFR, including in situ hybridization)
• Gastrointestinal stromal tumor (CKIT, DOG1)
• Organ-specific diagnostic markers (HEPPAR, CK7, CK20, CDX2, etc)
• Prognostic markers (Ki-67, p53, etc.)
• Complete lymphoma work-up including flow cytometry
• Infectious agents (H. pylori, HSV, CMV, Adenovirus, EBV in situ hybridization)
• DNA mismatch repair proteins for colorectal carcinoma (MLH1, MSH2, MSH6, PMS2)
• Therapeutic marker for colorectal carcinoma (EGFR, including in situ hybridization)
• Gastrointestinal stromal tumor profile
• Organ-specific diagnostic markers
• Prognostic markers (Ki-67, p53, etc.)
• Complete lymphoma work-up including flow cytometry
• Infectious agents (H. pylori, HBsAg, HBcAg, HSV, CMV, adenovirus, EBV in situ hybridization)

Molecular and Cytogenetic Testing

• Solid tumor panels (31 gene panel for all Stage 4 adenocarcinomas)
• C-KIT mutations
• Lymphoma workup
• Ploidy studies
• Southern blot, PCR, and FISH techniques for:
• Screening for microsatellite instability in colorectal cancer
• Typing of lymphoma
• Ploidy studies
• Irinotecan sensitivity (UGTIAI) [separate brochure available for specimen handling]