Department of Pathology and Cytology

The activities of the Department of Pathology and Cytology include autopsies, the processing of biopsies and cytological material from intraoperative biopsies, immunohistochemical and immunocytochemical diagnostics, molecular tissue diagnostics – in situ hybridization (CISH, SISH, FISH) and PCR, flow cytometry, immunofluorescence and electron microscopy.

All activities are performed by highly educated pathologists and clinical cytology specialists who have received subspecialty training in Croatia and abroad.

The Division of Surgical Pathology is the leading center for head and neck pathology in Croatia, one of the leading centers for breast pathology, colorectal and gastropancreatic pathology, skin and soft tissue tumors, and for the last ten years also for thoracic and pulmonary pathology. Since 2003, the morphological and immunohistochemical diagnosis of biopsied sentinel lymph nodes has become a standard procedure in the diagnosis and treatment of breast cancer and melanoma. Together with radiologists, we are also developing minimally invasive breast diagnostics, one of the first of its kind in Croatia. We also perform neuropathological diagnostics and uropathological diagnostics on surgical, needle and biopsy samples. Together with the Department of Cardiac and Transplant Surgery, we participate in the preparation and follow-up of heart transplant patients.

Thousands of endoscopic biopsies of the gastrointestinal tract and lungs, needle biopsies of the liver, transthoracic biopsies of the pleura and lungs, as well as biopsies of bone marrow and lymph nodes are processed in out Department every year. Parallel to the development of subspecialty diagnostics, immunohistochemical, immunocytochemical and molecular diagnostics are constantly being developed as an integral part of modern pathohistological diagnostics in accordance with global diagnostic standards.

The Division of Nephropathology and Electron Microscopy is the leading center in Croatia and the region where kidney biopsies and samples for electron microscopy are processed not only for the needs of Dubrava University Hospital, but also for cooperating institutions from Croatia and Bosnia and Herzegovina. The division also provides diagnostic support as part of the kidney transplant program.

The Division of Cytology is one of the few cytology divisions in Croatia that performs cytological diagnostics of all organ systems, including gynecological cytology (PAPA test), cytology of fluid samples (urine, effusions in body cavities, cerebrospinal fluid, joint fluid), bone marrow puncture and lymph nodes, pulmonological cytology, thyroid gland puncture, salivary glands puncture, other formations in the head and neck area, and aspiration cytology of all available formations. Thanks to developed endoscopy as well as radiological diagnostics, the specialties of cytologic diagnostics, apart from breast cytology, are punctures of deep organs – cytology of the pancreatobiliary, gastrointestinal system and liver, other abdominal formations as well as the mediastinum and lungs (endoscopic ultrasound – EUS, EBUS, CT-guided lung punctures, etc.), with urgent microscopic analysis on site, so-called ROSE (rapid on site evaluation). In the field of pancreatobiliary cytopathology, we are the leading center not only in Croatia, but also in this part of Europe. The division also has flow cytometry. The staff is part of the Reference Center for Diseases of the Biliary Canalicular system of the Ministry of Health of the Republic of Croatia.

Considering the developed subspecialist pathohistological and cytological diagnostics, we have been involved for the past 10 years in the development of a multidisciplinary approach in the diagnosis and treatment of particularly malignant diseases, and our doctors are involved in the work of numerous multidisciplinary teams.

The Department of Pathology and Cytology currently has 56 employees. In 2023, biopsy from 19 720 patients (133 600 paraffin blocks), 18 500 immunohistochemical examinations and 15 637 cytological examinations,  500 molecular examinations (PCR analysis – EGFR, ALK, ROS, MSI, KRAS, NRAS, BRAF, PIK3CA) and intraoperative analyses were processed.

Under the conditions of the COVID-19 pandemic, when Dubrava University Hospital became a national COVID hospital, the employees of the Department of Pathology and Cytology, in addition to autopsy and treatment of those who died of COVID-19, also performed post-mortem, pathohistological and cytological diagnostics of patients with COVID-19, as well as routine diagnostics. We have carried out diagnostics for patients with COVID-19 for cooperating institutions. For cooperating institutions, we performed diagnostics for post-COVID patients. Junior medical specialists of the Department participated in the work of the Respiratory Center, and engineers and technicians also participated in the collection of microbiological samples for the molecular diagnosis of the COVID-19 infection.