CELLULAR PATHOLOGY
Cytology
Diagnostic Cytology offers a service that looks at cells suspended in fluids removed from patients or extracted from whole organs under suction. By looking at the way that the cells are arranged and their appearance, it is possible to determine if a patient has cancer, inflammation or evidence of crystals.
Histopathology
Histopathology offers a diagnostic service that looks at cells of the body from within tissue samples. By looking at the way that the cells are arranged, how they have developed and how they are functioning, it is possible to determine if a patient has a disease, inflammation, a cancer or a non-cancerous growth.
Incredibly thin shavings are taken from tissue samples which are placed on glass slides and stained with haematoxylin and eosin. Diagnosis from a single stained tissue section can be sufficient, but often this is supplemented by additional special stains and/or immunocytochemistry, as deemed appropriate by the reporting pathologist.
BLOOD SCIENCES
Clinical Biochemistry
Clinical Biochemistry measures a wide range of substances in bodily fluids, predominantly blood (serum or plasma), urine and cerebrospinal fluid. A 24 hour, 7 day acute core clinical biochemistry service is provided on all Imperial College, Chelsea and Westminster and the Hillingdon Hospitals trust sites. Biochemistry tests are used to investigate or monitor:
- major organ function (liver, kidney, bones, heart, muscles)
- diabetes
- hormones
- malignancies
- proteins
- drugs.
The majority of these core clinical biochemistry tests are fully automated, although some are manual investigations. For information on our more specialist testing, please see Specialist Services. Clinical scientists or medical doctors are available as the Duty Biochemist on site during the working day to provide advice about the selection of appropriate tests and their interpretation.
Haematology
Haematology performs full blood counts and secondary testing to assist in the diagnosis and treatment of various disorders. The Haematology laboratories also offer additional tests to identify specific conditions, eg. malaria screening, infectious mononucleosis, and reviewing blood film morphology. The laboratories have access to specialist haematologists to assist in the diagnosis and treatment of complex haematological disorders.
Special Haematology offers screening tests to identify disorders of haemoglobin production, eg. sickle-cell disease and thalassemia. The laboratory participates in the NHS ante-natal screening programme and can arrange for testing for unexplained haemolysis and red cell enzyme studies, eg. G6PD, pyruvate kinase and other rare red cell studies.
Coagulation performs clotting screens for pre-operative and routine cases. Coagulation can provide tests for prognostic markers of deep vein thrombosis and the controlling of anticoagulant therapy. The Special Coagulation laboratories offer investigations of abnormal bleeding and clotting disorders, using the latest analysers and techniques.
Blood Transfusion
The Blood Transfusion department performs routine and urgent serological, pre-transfusion testing (eg of blood group and antibody status) for the issuing of blood components and blood products specific to the needs of an individual. The department offers a complete antibody investigation service and can arrange for secondary testing by the NHS Blood Transfusion laboratories for more complex investigations. The transfusion laboratory is also responsible for controlling the issue of anti-D, recombinant coagulations factors and Octaplex. Hospital staff training in blood transfusion is co-ordinated and supervised by experienced transfusion practitioners.
INFECTION AND IMMUNITY
Immunology
The Immunology department helps to diagnose patients with allergies, defective immune systems and autoimmune diseases. This includes testing for thyroid disease, coeliac disease and systemic lupus erythematosus (SLE). Immunology also performs tests which detect hidden tuberculosis (TB) infection, and there are numerous research programmes underway, looking at allergy, HIV infection, immune deficiency, vaccine responses and immune function.
The department provides a molecular service and is working with suppliers to develop an extensive sequencing service to assist in disease monitoring and response to therapies.
The Histocompatibility and Immunogenetics laboratory performs tissue typing and crossmatching for kidney and bone marrow transplant patients and donors. We test the blood of potential transplant recipients for antibodies and compare them with those of potential donors to avoid rejection of the organ. We also perform the HLA-B27 test to confirm a suspected diagnosis of ankylosing spondylitis or reactive arthritis.
This is a regional service, including out-of-hours donor typing, and we work closely with laboratories in other trusts to ensure the on-going support for transplant patients across the region. This extensive programme includes pre-and post-transplant testing, and monitoring of patients.
The clinical staff responsible for clinical advice, diagnostic and interpretative services are:
Immunology Clinical Lead:
Dr Peter Kelleher B.A. M.B. B.Ch. B.A.O: University of Dublin. M.R.C.P. (Ireland) Ph.D. Pathology: Imperial College University of London FRCPath
Histocompatibility & Immunogenetics Director:
Arthi Anand
Microbiology
Microbiology provides a full range of testing for bacterial and fungal culture, as well as the antibiotic sensitivity of pathogenic (infectious) organisms. This includes those that can cause urinary, respiratory, gastrointestinal, wound or skin infections, and meningitis.
We screen for a number of organisms that can cause cross-infection problems for hospitals, such as MRSA and Clostridium difficile (C. diff). We also perform intestinal parasite identification, testing for tuberculosis and screening for genitourinary infections, including chlamydia and gonorrhoea.
The department uses state-of-the-art molecular technology, enabling real-time, random access for diagnosis of C. diff, TB, chlamydia/gonorrhoea and other infections within 70 minutes of samples being placed onto the analyser.
Antimicrobial susceptibility testing
The laboratory employs the following methods for antimicrobial susceptibility testing:
- Disc diffusion
- MIC strip
- Phoenix broth dilution (awaiting UKAS accreditation)
Virology and Serology
The Virology and Microbial Serology department tests serum to detect antibodies and antigens in the blood, which can indicate the presence of a range of viruses and other organisms, including HIV, hepatitis B and C, and syphilis. The department provides a full diagnostic service, which includes supporting the management of infections during pregnancy, in infants, throughout the community, and in outbreak situations.
We can also check the level of immune protection against hepatitis B and rubella (German measles), and use advanced molecular techniques to detect the viruses that cause flu, herpes and other respiratory, gastrointestinal and central nervous system infections.
The clinical staff responsible for clinical advice, diagnostic and interpretative services are:
Virology Clinical Lead:
Dr David Muir MBChB, MSc, PhD, FRCPath (GMC 3327601)