What this test measures
Tissue specimens of moderate size — excisional biopsy of skin / lymph node / breast lump, wide local excision of melanoma, lumpectomy specimens, partial resections of small organs (e.g., gallbladder, appendix). Tissue is grossed (described, measured, margins inked), fixed, processed, embedded, sectioned, stained, and examined. Reports include gross description, microscopic findings, definitive diagnosis, grade / stage, margin status, and any IHC / molecular results.
Why it matters
Medium specimens form the bulk of surgical pathology in Indian practice — breast lumpectomies for early cancer, melanoma wide excisions, salivary gland resections, soft tissue tumour excisions, gallbladder / appendix removals. Margin assessment is often critical (e.g., breast cancer: positive margins → re-excision; melanoma: < 1 cm margin → wider excision). Diagnoses guide further treatment (chemotherapy, radiation, hormonal therapy).
How to prepare
Procedural prep depends on the surgery — typically outpatient or short admission, local / regional / general anaesthetic. Disclose anticoagulation (hold per surgical instruction), allergies, and current medications.
Markers & reference ranges
Reference ranges below are typical adult values. Your lab's reported range may differ slightly based on the assay platform and patient demographics — always read your report against the range printed on it.
| Marker | Normal range | If low | If high |
|---|---|---|---|
| Histopathology Diagnosis + Margins (Descriptive)[1] | Benign with clear margins | Benign + clear margins — no further surgical excision needed; clinical follow-up. | Malignant — diagnosis (entity), grade (1-3), TNM staging (where applicable), margin status (positive / close / negative), lymphovascular invasion, perineural invasion, receptor status (breast: ER/PR/HER-2; prostate: PSA), molecular markers (KRAS, BRAF, EGFR for treatment selection). Positive / close margins → re-excision; histology guides adjuvant therapy decisions. |
Common medium specimens + key reporting elements
| Specimen | Key elements |
|---|---|
| Breast lumpectomy | Diagnosis, grade, ER/PR/HER-2, margin distance, LVI |
| Melanoma wide excision | Breslow thickness, Clark level, mitotic rate, margin, ulceration |
| Lymph node excisional | Architecture (follicular / diffuse), IHC, monoclonality |
| Salivary gland | Tumour type (pleomorphic, mucoepidermoid), grade, margins |
| Soft tissue | Sarcoma type, grade, margins, IHC |
Frequently asked questions
How long does the report take?
Routine medium specimen: 5-10 working days. Complex cases needing extensive IHC / molecular: 2-3 weeks.
What if margins are positive?
Positive / close margins (< 1-2 mm) usually warrant re-excision. The pathology report guides the surgeon on which side / area needs revision.
Why is grade important?
Grade reflects how aggressive the tumour looks microscopically. It guides treatment intensity (e.g., breast cancer grade 3 → more aggressive chemo; melanoma grade by mitotic rate → sentinel node biopsy).
What is IHC for breast cancer?
ER (estrogen receptor), PR (progesterone receptor), HER-2 (growth factor receptor) status determines hormonal therapy (tamoxifen / aromatase inhibitor) and HER-2 targeted therapy (trastuzumab) eligibility.
Will I need additional surgery?
Depends on margins, lymphovascular invasion, and lymph node status. Discuss with your surgeon / oncologist.
Do you do molecular testing?
Molecular tests (Oncotype DX, MammaPrint, BRCA, NGS panels) may be ordered separately for treatment planning. They're reflexed on the same tumour block.
Related Histopathology / Cytology tests
Tests commonly ordered alongside HISTOPATH (MEDIUM), or that help interpret an unexpected result.
Sources & references
- Royal College of Pathologists · accessed 2026-05-30T00:00:00.000Z
- CAP — Histopathology Standards · accessed 2026-05-30T00:00:00.000Z
- Indian Association of Pathologists · accessed 2026-05-30T00:00:00.000Z
- WHO Classification of Tumours · accessed 2026-05-30T00:00:00.000Z
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