Pathology for Pediatric Cancer and Blood Disorders

Pathology is a medical specialty that deals with the examination of organs, tissue biopsies, body fluids or cells in order to arrive at a diagnosis. It provides doctors with critical insights that help in the development a care plan. As treatment plans are carried out and completed, pathology helps the care team understand the effectiveness of treatments and determine if a change in course may be required.

Dana-Farber/Boston Children's Cancer and Blood Disorders Center has one of the largest, most sophisticated pathology services of its kind in the country. Having pediatric pathologists on our care teams allows us to respond quickly and effectively to patient needs. Our board-certified pediatric pathologists have further specialization in a variety of forms of cancer, including bone marrow and blood cancer and brain cancer. Rare pediatric tumors are our specialty. 

Pathology Overview

Pathology addresses four components of disease: cause (etiology); mechanism of development (pathogenesis); structural alterations (morphologic changes); and consequences of those changes (clinical manifestations).

There are two broad categories of pathology:

• Anatomic pathology – a subspecialty concerned with changes in the function, structure or appearance of organs or tissues, including  tissue biopsy and excision specimens and postmortem examinations  
• Clinical pathology – a subspecialty concerned with the diverse fields of quantitative and qualitative measurement of body fluid composition, blood transfusion, and microbiology

For cancer, an anatomic pathology diagnosis is the gold standard that indicates the presence or absence of a tumor, the type of tumor, and its classification or staging.

Most cancer patients undergo a biopsy or other procedure to remove a sample of tumor tissue for examination by a pathologist in order to diagnose their disease. A variety of methods are used to obtain these samples, including a typical biopsy, fine needle aspiration, endoscopic biopsy or bone marrow biopsy.

Once tissue is obtained, it is treated in a way that stops cells from degrading and prevents them from changing characteristics. The sample is then “stained” so the pathologist can see the cells’ structure under a microscope and determine whether it contains normal, precancerous or cancerous cells.

Our pathologists also review nearly 600 bone marrows and more than 1,200 cerebrospinal fluids from hematology and oncology patients each year, rapidly delivering diagnostic results critical for outlining effective treatment plans.

An oncologist will use pathology reports, along with other relevant tests, to determine an appropriate treatment strategy.