Gynecologic Pathology

What is Gynecologic Pathology?

Gynecologic pathology is a medical sub-specialty focusing on diseases of the female reproductive system, including gynecologic cancers, pregnancy complications, and conditions that cause infertility or pelvic pain.

A gynecological pathologist is a type of doctor with highly specialized training who analyzes tissues and focuses on diagnosing diseases of the reproductive system, including those that affect the:

• Cervix
• Endometrium
• Fallopian tubes
• Ovary
• Uterus
• Vagina
• Vulva

They examine tissues obtained from biopsies and surgically-removed samples using techniques like histopathology, immunohistochemistry, and molecular pathology to diagnose various conditions.

Gynecologic pathology can be a subspecialty for doctors certified in gynecology or pathology. While gynecologic pathologists don’t directly treat patients, they work closely with gynecologists and gynecologic oncologists to help diagnose conditions from sexually transmitted infections to cancers and many others.

What Do Gynecologic Pathologists Do?

Gynecologic pathologists use different types of microscopes and other specialized tools to examine tissue samples, including those from Pap smears, surgically-removed tissue, urine, and rectal and vaginal swabs.

They have extensive schooling and training to identify cancers, infectious diseases, immune system disorders, and more.

If cancer is found, a gynecologic pathologist can also provide individualized information about the cancer to help establish a treatment plan.

What’s The Difference Between a Gynecologist and a Gynecological Pathologist?

A gynecologist is a doctor you’ll see for preventive care, diagnosis, and treatment of many female reproductive system conditions. You might see a gynecologist for irregular or heavy periods, abdominal pain, vaginal pain or bleeding, family planning, contraception, pelvic floor issues, miscarriage, menopause, hormone replacement therapy, pregnancy, and more.

They’re specially trained to examine and diagnose disorders of the female reproductive system. They may also care for patients with reproductive cancers.
When a diagnosis can’t be made with a visual exam and medical history, or when more information is needed, a tissue sample can be sent to a gynecological pathologist for study under a microscope.

Gynecological pathologists are experts in diagnosing and providing detailed information about cancers, immunological conditions that affect the reproductive system, infectious diseases, lesions, rashes, and more from tissue samples.

What Types of Tissues Do Gynecological Pathologists Study?

Gynecological pathology is a study of the changes that occur in the female reproductive system due to disease. Some conditions that a gynecological pathologist may study include tissue samples taken from:

• Fluids
• Fungus
• Lesions
• Organs of the reproductive system
• Polyps
• Rashes
• Smears collected from the cervix
• Tumors

A gynecologic pathologist is an expert in conditions like:

• Cancers of the vulva, ovaries, endometrium, uterus, and cervix
• Infertility
• Uterine bleeding
• Cervical dysplasia
• Sexually transmitted diseases
• Endometriosis
• Complications of pregnancy

Techniques to Identify Gynecological Conditions

After a tissue sample is obtained and processed, a gynecological pathologist uses specialized techniques, tools, and processes to investigate its condition.

If the microscopic examination doesn’t provide clear answers, gynecological pathologists are experts in other testing techniques that may provide more information. Some methods and tools they use include:

Stains – Chemicals or stains can be applied to tissue samples to highlight signs of disease or cell abnormalities. Different stains are used to identify causes, foreign substances, and other markers that identify characteristics of the specimen.

Direct immunofluorescence – A special type of staining that helps identify autoimmune diseases.

Frozen section – A sample can be frozen and examined at once if a diagnosis is needed quickly, like during surgery.

Immunohistochemistry – This technique uses the body’s own antibodies to help identify the interaction between the antibodies and antigens triggering the immune system.

Electron microscopy – A special type of microscope that uses a beam of electrons instead of light, which allows pathologists to examine cell structures not otherwise visible.

Flow cytometry – A technique of analyzing the identity and quantity of a type of cell or particle. Samples are suspended in fluid and passed through different light sources, lenses, and filters to generate wavelength data. Flow cytometry can measure characteristics like cell size, total DNA, and more.

What Do Results Look Like?

The results of a gynecological pathological examination are documented in a biopsy or pathology report, which includes information like:

• A diagnosis
• A description of the tissue sample
• A microscopic description of the disease process discovered
• Clinical data that helped support the diagnosis
• Additional information to help determine treatment
• If cancer is found, it may also include information to help form a treatment plan
• Comments from the gynecological pathologist

The report is sent to the treating doctor, who will discuss the results with the patient.