Working out of Yale New Haven Hospital and Smilow Cancer Hospital, the Gynecologic Pathology program is a fundamental component in the prevention, diagnosis, and treatment of diseases of the female genital organs. Our pathologists are subspecialty-trained and highly experienced, with a passion for patient care. The program emphasizes diagnostic tissue evaluation, oncological biomarker identification, and clinical applications, as well as understanding the pathogenesis of various gynecological cancers. We encounter a high volume of complex, neoplastic gynecologic surgical specimens from the Yale Gynecologic Oncology Service and biopsy specimens from many outpatient clinics in the greater New Haven area. Beyond routine tissue diagnosis, team members actively participate in the real-time decision-making process for patient management, including daily intraoperative consultation, weekly gynecologic tumor conferences, and many ongoing cancer clinical trial programs. We have a national and international reputation as experts in the diagnosis of gestational trophoblastic diseases (complete and partial hydatidiform moles, gestational trophoblastic tumors) and endometrial cancer. We are among the few institutions to offer molecular genotyping as part of the routine diagnostic algorithm for molar pregnancies. Our services include examination of the following: Ovarian cancer, endometrium, and cervix Infertility, placental evaluation, endometrial hyperplasia, dysfunctional uterine bleeding, cervical Pap smear, sexually transmitted diseases, cervical dysplasia

Whereas laboratory scientists typically analyze blood or other fluids from patients, anatomic pathologists evaluate tissue specimens, which include cervical scrapings (i.e., PAP smears), biopsies, surgical resections, and whole-body evaluations at autopsy. Anatomic Pathology has three major divisions: Surgical Pathology. This is the examination of tissue removed as a biopsy or as part of a surgical procedure. When a biopsy is done (typically a small sampling of a lesion by incision or by an invasive technique like a core needle biopsy or endoscopy), the pathologist determines what disease process is present, and/or the extent of disease. In all cases, pathologists make their diagnoses by examining thin slices of the lesion under a microscope. Pathologists often also use a variety of specialized molecular techniques to further refine the diagnosis and to predict how the disease may respond to various types of treatment. In this way, the pathologist helps guide any subsequent therapy the patient may need. Cytopathology: This is the examination of very small amounts of tissue removed by scraping a surface, or by aspiration through a fine needle. Obtaining a cytopathology specimen is typically less invasive than obtaining a surgical pathology specimen, so these procedures can be performed in a clinic or a physician’s office. Cytopathologists examine individual cells and small collections of cells to assess for the presence or absence of malignancy. Autopsy Pathology: This is the anatomic examination of a deceased patient to determine what diseases were present and how extensive they were, and to assemble these findings into an explanation for why the patient died. Autopsy examination can answer questions family members may have about the patient’s death, but can also increase understanding of disease for the physicians caring for the patient.

We provide preparatory and diagnostic services for all fluid, smear, and aspiration specimens. We also provide pathologist-performed fine-needle aspiration service at the request of physicians, and offer complete cytopathology consult services including preparation, analysis, and ancillary studies for cervical cancer and other diseases. Our Cytoprep Lab processes and reads more than 70,000 specimens per year. Since the introduction of the Pap smear test for the early detection of cervical cancer in 1941, there has been a 70% reduction in the cervical cancer mortality rate, the most significant reduction of mortality attributable to any modern medical test. The latest developments in cervical cancer detection technology promise to reduce this rate even further. Our goals are to: Maintain excellence in specimen preparation and diagnostic accuracy Provide the highest quality consultative services to our clinical colleagues, both within our institution and elsewhere Support and incorporate advanced diagnostic techniques to improve diagnostic accuracy Pioneer new molecular techniques to increase the amount of information obtained from the minimal amounts of tissues received in routine specimens