Services

We Offer

Fields Of Expertise

Surgical Specimen Services

PML performs general surgical pathology services to include frozen sections. We also provide special expertise in the areas described below.

Dermatopathology (Skin)

• PML Pathology provides primary evaluation of skin biopsies and excisions, including evaluation of inflammatory and neoplastic conditions. Routine light microscopy, and direct immunofluorescence are available. When necessary, immunoperoxidase stains and molecular testing can be performed on the tissue we obtain from the biopsies submitted.
• We also examine oral mucosal biopsies where immunobullous, inflammatory or neoplastic processes are suspected.
• Our Dermatopathology services include frozen section examinations.
• PML is dedicated to providing our dermatology clients with the highest level of service and exceptional quality with advanced diagnostic technologies. Specimens are read only by our board-certified Dermatopathologists. We provide 24-hour turnaround time for most routine cases and the Dermatopathologists are always accessible for consultation.
• Immunohistochemistry services provided within PML allow for rapid turnaround time for cases requiring this additional testing.

Gastrointestinal Tract

• PML provides outstanding service to our gastroenterology clients with active endoscopic / histologic correlation, personal interaction with the GI pathologists, and 24–hour turnaround time for routine cases. PML offers board-certified pathologists with fellowship training in gastrointestinal pathology and advanced diagnostic technologies. The physicians provide consultative review of difficult and unusual cases and are always accessible for consultation.
• Immunohistochemistry services within PML allow for rapid turnaround time for special stains. Routine special stains are performed immediately on gastric and esophageal biopsies and reviewed with the H&E stained sections.

Breast

• PML understands the complexity of diagnosing breast cases. We ensure timely and dependable results using state-of-the-art technology.
• With the ever-changing technologies and treatments available for patients diagnosed with breast cancer, PML pathologists work closely with their surgical, radiological, and oncological colleagues to offer the latest testing available by anatomic pathology laboratories in addition to routine histopathologic interpretation. Our pathologists provide consultative review of difficult and unusual cases and are always accessible for consultation.
• All breast cases are reviewed by at least two pathologists

Gynecologic Cytology

PML provides a full spectrum of cytopathology services for gynecologic specimens including routine screening and diagnostic testing.

Gynecologic Cytology Services

• Our laboratory processes approximately 49,000 Pap tests annually, the majority of which are performed by the liquid-based method (ThinPrep®). PML has also implemented the ThinPrep® Imaging System, an automated image analysis system that aids cytotechnologists with primary screening. The computer imaging has been shown in multiple large studies to increase the detection rate of high grade pre-malignant lesions compared to manual screening alone. All Pap tests are rescreened by experienced, licensed cytotechnologists. All abnormal Pap tests are signed out by board certified cytopathologists. Chlamydia and Gonorrhea assays are also part of our in-house testing menu. HPV (high-risk) and HSV testing are performed at an approved reference laboratory. Cystic fibrosis testing is also available upon request.
• Every effort is made to report gynecologic cytology results within two working days of specimen receipt in the laboratory. However, turnaround times for Pap tests may occasionally exceed this time frame during periods of high specimen volume. Pap tests requiring reflex HPV/infectious disease testing may have a turnaround time of three to four days.
• PML employs a rigorous quality assurance program with 100% rescreening of all Pap tests on patients with abnormal histories in addition to the 5% random rescreening. Correlation studies of non-gyncytology and follow up surgical cases are performed quarterly. Correlation data for ASCUS / HPV findings with surgical biopsies are also tracked regularly.

Cytology Services (Non-gynecologic)

• PML cytopathologists interpret over 5,000 non-gynecologic specimens annually. The cytopathology laboratory provides a full spectrum of non-gynecologic cytology services, including the processing and evaluation of the following specimen types:
  • Pulmonary: fine needle aspiration, sputum, bronchial brushing/washing and bronchial lavage (including evaluation for opportunistic infections; cell differentials)
  • Urologic: voided/instrumented urine; washings/brushings of urinary tract/bladder/urethra.
  • Body Cavity Fluids: pleural, pericardial, peritoneal, and synovial fluids, pelvic washings.
  • Cerebrospinal Fluid
  • Gastrointestinal: brushings/washings of alimentary canal and biliary tract
  • Fine needle aspirations of palpable and US-guided lesions (breast, thyroid, lymph nodes, etc.) Flow cytometry on suspicious lymphoid processes is performed at an approved reference laboratory.
  • Other Sources: breast nipple secretions and ductal lavage, skin scrapings (including Tzanck smears for detection of herpetic infection), ophthalmologic specimens, anorectal cytology.
• The turnaround time for non-gynecologic specimens is generally one working day after laboratory receipt of the specimen unless special studies or consultation is required for final interpretation.
• We will provide consulting services for any gynecologic or non-gynecologic cytology case performed at an outside laboratory.

Urology

• PML’s pathologists see an ever-increasing number of urologic cases, including everything from urine cytology and fine needle aspirates of renal masses, to prostate needle biopsies and bladder biopsies, to resection or radical procedures such as prostatectomies, radical nephrectomies, and orchiectomies. Because of our hospital affiliations in Western North Carolina, we are able to correlate the results of current biopsies with a patient's previous results available in our database. This historical information is clearly advantageous in providing the highest levels of diagnostic care.
• The growing volumes of cases referred to PML in urologic pathology supplies our doctors with a wealth of new experience, knowledge, and training. At PML, we are your partner in patient care. Our physicians are available for consultation and personal service to help care for your patients.

Molecular Cytology

PML currently offers in-house molecular pathology testing services for numerous analytes using nucleic acid amplification (NAAT) on the Panther system. PML also performs testing for bladder cancer with fluorescence in situ hybridization (FISH)

• High risk human papillomavirus (HR HPV) assay test detects 14 high risk types of the virus including: 16, 18,31,33,35, 39, 45, 51, 52, 56, 58, 59, and 68. If the HR HPV is positive and it is significant to identify the type, PML also offers HPV 16 18/45 genotype tests. This test can differentiate between HPV 16 and HPV 18/45. The HR HPV and HPV 16, 18/45 test can be performed on cervical specimens in ThinPrep Pap vials containing PreservCyt solution and collected with broom-type or cytobrush/spatula collection devices.
• Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) are both tested with a single assay to assist in the diagnosis of chlamydial and gonococcal disease. This test can be performed on a cervical specimen in ThinPrep collection device, Aptima® Unisex Swab Specimen Collection Kit for Endocervical and Male Urethral Swab Specimens, Aptima Urine Collection Kit for Male and Female Urine Specimens, and Aptima Multitest Swab Specimen Collection Kits.
• Trichomonas vaginalis assay detects ribosomal RNA of Trichomonas vaginalis to aid in the diagnosis of trichomoniasis. The test may be used on clinician collected endocervical swabs, clinician-collected vaginal swabs, or specimens collected in PreservCyt solutions and for women who are symptomatic or asymptomatic.
• In addition to nucleic acid amplification (NAAT) on the Panther System, PML performs testing for bladder cancer with fluorescence in situ hybridization (FISH). The UroVysion Bladder cancer kit detect aneuploidy for chromosomes 3, 7, 17, and loss of the 9p21 locus in voided urine specimens. This test is intended for use, in conjunction with and not in lieu of current standard diagnostic procedures, as an aid in initial diagnosis of bladder carcinoma in patients with hematuria and subsequent monitoring for tumor recurrence in patients previously diagnosed with bladder cancer.