Pathological Anatomy (PA) studies the causes, effects and extent of diseases through the structural alterations they produce in cells and tissues, as well as their responses to treatment. Recent technological advancements now allow the evaluation of prognostic factors and the detection of target molecules of drugs specifically directed at neoplasms. The primary objective of clinical healthcare-oriented PA is to deliver timely and dependable patient care information while making efficient use of resources.

PA is key in education and research as it provides a vital link between fundamental scientific principles and their practical application, playing an indispensable role in understanding and advancing medical knowledge. PA was formally recognised as an academic discipline towards the end of the 19th century, when the activities of certain physicians as anatomopathologists were acknowledged, even though their concepts and procedures were only used for diagnosis. However, conceptual and technological advancements in Medicine, Surgery and PA itself, early in the 20th century, led to its clinical application, primarily in the United States: Surgical PA. This eventually became an essential part of medical practice. The evolution of diagnostic PA has been characterised by several technological milestones, in addition to the development of the microscope, most notably:

  • 1857: Use of microscope in diagnosis (Siloniz).
  • 1870: Introduction of surgical biopsy as an essential diagnostic element (Ruge and Veit).
  • 1880: Tissue embedded in paraffin to improve histological sections.
  • 1889: Demonstration of the need for prior histological diagnosis in tumour or mutilating interventions (von Esmarch).
  • 1891: First intraoperative biopsy studied in frozen tissue sections (Welch).
  • 1928: Diagnostic cytology for cervical cancer (Papanicolaou).
  • 1930-40: Introduction of fine needle biopsy.
  • 1935: Tissue culture applied to tumour sorting (Murray, Stout).
  • 1938: Development of cryostat for histochemistry and enzymatics (Linderström-Lang).
  • 1941: Development of immunofluorescence technique (Conns).
  • 1943: Application of morphometric methods in tissues.
  • 1950: Application of Electron Microscopy to study tissues and tumours.
  • 1961: Development of the cryostat for intraoperative use (Chang).
  • 1966: Introduction of enzyme conjugates and antibodies (Nakane and Pierce), as the basis for immunohistochemical techniques on frozen or paraffin-embedded tissue sections.
  • 1970: Application of microspectrophotometry, flow cytometry.
  • 1980 onwards: Development of molecular pathology: in situ hybridisation techniques, cytogenetics, PCR, microarrays, proteomics, applied to human pathological tissues.

The gradual integration of these innovations into daily practice has allowed the advancement of diagnostic capabilities in PA laboratories, enabling them to achieve the following goals:

  1. Diagnose diseases.
  2. Establish their prognostic factors.
  3. Select patients to receive certain treatments.
  4. Monitor and respond to treatment of certain diseases.
  5. Clinical research.
  6. Teaching.
  7. Quality control of clinical care.

Thanks to their central role, along with their adaptability and capacity to connect techniques developed by fundamental disciplines, PA services are a key part of the hospital structure. Bolstering them is absolutely necessary in order to respond effectively and promptly to the revolutionary changes brought by emerging knowledge from molecular biology and genetics.

As an example within our field, the FJD Cancer Research group was formed four years ago with the idea of helping to improve breast cancer treatment by studying the pathways involved in cell survival and cell death. It is made up of members of the Pathological Anatomy Department, with experience in research projects focused on studying cell survival and cell death mechanisms in cancer. Bringing together basic and translational researchers with more than fifteen years of scientific and clinical experience, the team aims to follow a well-defined translational approach.

General duties of the Pathological Anatomy service:

Study the aetiology, pathogenesis and morphological expression of diseases, and their correlation with the clinic. Its activity is divided into three well-defined, but often interconnected, functional areas:

  • Surgical pathology (diagnostic biopsies and study of surgical specimens).
  • Cytopathology.
  • Autopsies.

The methods used are mainly morphological, macro and microscopic, always based on clinical correlation. Techniques in specific laboratories are required (general, cytology, immunohistochemistry, electron microscopy, molecular biology). These activities are carried out by a range of people, distributed on different levels, with the following DUTIES:

Medical Pathologist:

  • Complete the macroscopic description and include biological samples for laboratory processing. Create their visual documentation.
  • Complete microscopic study of the samples.
  • Ask for special techniques.
  • Draw up a final diagnosis, set out in a report.
  • Complete necropsy studies.
  • Supervise all the above processes.
  • Take part in the Service's teaching and research activities.
  • Carry out actions, management or administration on the instructions of the head of the Service, mainly in relation to planning, organisation, control and decision-making within the scope of the Service.


  • Receive and control the samples and the request form, consulting the physician in the event of any doubts or problems.
  • Complete the macroscopic description and include biological samples for laboratory processing. Create their visual documentation.
  • Process different biological samples in the laboratories according to their characteristics.
  • Complete the complementary or fundamental techniques for diagnosis.
  • Prepare reagents.
  • Specifically, cytotechnicians also perform preparation and screening of cytological samples.
  • Keep an inventory of and maintain laboratory equipment and reagents.
  • Quantify daily activity.
  • Collaborate in the Service's different teaching and research programmes.

Administrative staff:

  • Transcribe reports in the different sections.
  • Create and maintain report files.
  • Deliver reports to the different requesting services.
  • Check and prepare external and internal correspondence.
  • Ask for archived Service documents
  • Attend to incoming calls.
  • Provide a personalised administrative service for members of the Pathological Anatomy Service.

Clinical auxiliary staff:

  • Clean and maintain general equipment.
  • Clean and maintain instruments.
  • Assist in the laboratory areas (register and transport paraffin blocks and reagents).
  • Control storerooms and order consumables.
  • Assist in delivering reports and correspondence.

Autopsy technicians:

  • Eviscerate and reconstruct the cadaver.
  • Transfer macroscopic pieces.
  • Maintain the autopsy room and its instruments.
  • Care for and conserve the "wet" room (specimens and biopsies temporarily preserved in formalin).
  • Dispose of organic waste.
  • File blocks, preparations and photographic material.
  • Control storerooms and order consumables.

Regardless of specific duties, all staff must have the right mindset and be fully committed to caring for patients directly. More specifically, administrative staff will attend to requests for information (of a non-clinical nature) requested by the Clinic's medical staff, with information of a clinical nature logically being the sole responsibility of the physician.