Pathology – Services
Expertise in Pathology
With our diagnostic services and through our clinical laboratories, our pathologists and pathology staff play an integral role in patient care.
For more information about pathology services, call
Top-notch laboratory services
As an academic medical center, we are held to a higher standard of care and service.
Our progressive laboratory services deliver a comprehensive test menu, state of the art diagnostic methods, rapid turnaround, and expert consultative services not generally offered by commercial laboratories.
Delivering these services locally ensures continuity of care to the patients we serve. In addition, these services are available to the medical community at large through our outreach services.
Anatomic Pathology laboratories and services
Our Division of Anatomic Pathology provides a full spectrum of surgical pathology and cytopathology services. Special histochemical, immunofluorescent, and immunoperoxidase staining (e.g., staining for estrogen and progesterone receptors and Her/2 neu on breast biopsies; panels of antibodies for evaluation of tumors of unknown origin; lymphoma panels) and electron microscopy are available.
Cases are welcome for expert consultation or second opinion in the areas of hematopathology, dermatopathology, neuropathology, pediatric, pulmonary, renal, gynecologic, head and neck, bone, breast, and gastrointestinal pathology.
Anatomic Pathology - Main Office
Transcription of PSHMC surgical pathology and autopsy reports. Provides information about status of reports in progress. Coordinates release of slides and reports to outside hospitals and second review of specimens from other hospitals for PSHMC patients.
Provides processing, screening, and interpretation for all types of diagnostic cytology specimens for PSHMC (GYN, FNA and non-GYN). Performance of fine needle aspiration of superficial lesions and immediate assessment for adequacy of radiologically guided FNA.
Our surgical pathology service performs gross and microscopic interpretation of all diagnostic biopsies and surgical resections including intraoperative consultation, neuropathology, molecular diagnostics, research project support, and ancillary testing such as electron microscopy, immunoperoxidase staining, and histochemical staining.
The dermatopathology service provides routine specimen processing and interpreting, consult services, immunohistochemistry studies, in situ hybridization, and direct immunofluorescence studies to participating dermatologists. Klaus F. Helm, MD, the Director of Dermatopathology; Michael D. Ioffreda, MD;. and Loren E. Clarke, MD, are board-certified dermatopathologists who interpret all cases.
The dermatopathology service offers the following advantages: easily accessible dermatopathologists and staff, clinical-pathologic correlation with submitted pictures, and special expertise in immunodermatology, alopecias, and lymphomas. Rapid turnaround is available for most specimens. Sample transportation can be arranged with courier pickup for local physicians or Federal Express transport for physicians outside of the courier's range. Canisters and formalin bottles will be supplied for shipping. Patient billing is done and most insurance carriers are accepted. Biopsy results can be faxed, mailed, or phoned.
Provides second opinion consultations for surgical pathology on non-Hershey Medical Center patients and primary interpretation of renal, nerve, and muscle biopsies from regional referrals.
Decedent Care Services - Autopsy Services
Administrative support and record keeping for all PSHMC deaths (750 deaths/yr) and postmortem examinations for PSHMC patients and regional hospitals.
For further information, see Decedent Care Services - Autopsy Services (third tab on this page)
The Division of Clinical Pathology has eight faculty members, each responsible for one of the service areas of the Medical Laboratory.
Blood Bank, Apheresis, and Transfusion Medicine
Medical Director: Melissa R. George, DO
Co-Medical Director: Ronald E. Domen, MD
- Irradiation of blood products
- Antibody IDs and titers
- Prenatal testing
- Donor testing
- RHIG preventive therapy (dispensed, not administered)
- Leukoreduction by filtration
- Therapeutic apheresis [Requires consultation]
- Therapeutic phlebotomy [Requires consultation]
- Direct Antiglobulin Testing (DAT or Coombs' Test)
- Transfusion Medicine consultation/expertise
Medical Director: Michael H. Creer, MD
- Routine chemistry profiles and panels
- Therapeutic drug monitoring
- Blood gas analysis; cooximetry; and whole blood testing for glucose, lactate and ionized calcium
- Thyroid and fertility testing
- Diabetes testing including hemoglobin A1C and microalbumin
- Cyclosporine and FK506 testing
- Sweat tests for cystic fibrosis screening, performed on outpatients twice a week by appointment and as needed on inpatients
- Infectious disease testing including hepatitis, HCV and HIV markers
- Wide variety of specialty tests, including intra-operative PTH and fetal fibronectin
- Tumor markers including PSA, CA-125, and AFP
- Cardiac markers - Troponin I, Myoglobin, CKMB and homocysteine
- Inflammatory and nutritional markers
- Serum/urine protein and immunofixation electrophoresis, hemoglobin electrophoresis, and associated tests including serum immunoglobulins, hemoglobin A2 and hemoglobin F quantitation.
- Toxicology screening for drugs of abuse
Hematology, Thrombosis, and Hemostasis
Medical Director of Hematology and Thrombosis and
Medical Director of Hemostasis: M. Elaine Eyster, MD
- Automated CBC, platelet, and 5 part differential
- Reflex manual differentials performed by staff experienced in abnormal cell morphology
- Reflex or orderable review by pathologist
- Examination for blood parasites
- Reticulocyte analysis by flow cytometry
- Automated coagulation testing: aPTT, PT, fibrinogen and quantitative D-dimer
- Specialized assays for the diagnosis and treatment of disorders of thrombosis, with physician interpretation: Protein S, Protein C, Antithrombin III, Activated Protein C Resistance, Lupus Anticoagulant Testing, and Mixing Studies
- Specialized assays for the diagnosis and treatment of disorders of hemostasis: Factor Analysis, Factor Screens, Factor Inhibitors, Heparin (Xa) Assay, Fletcher Factor Screen, Russell Venom Viper Time
- Urine and serum pregnancy screen (same day service)
- Spinal, serous, synovial, dialysate fluid cell counts and differentials
- Synovial crystal examination
- Kleihauer Betke fetal cell stain
- Occult blood screen (stool and gastric)
- Urinalysis with reflex microscopic examination
- Routine urinalysis with routine microscopic examination
- Osmolality on serum and urine
The Special Hematology laboratory offers the following clinical tests to outreach customers. A courier is available for same day delivery of specimens within a 40-mile radius of our laboratory. Our facility provides the following services:
- Comprehensive evaluation of blood and bone marrow specimens for benign and malignant diseases
- Flow cytometry testing
- Leukemia phenotyping
- Lymphoma phenotyping
- Myeloma diagnosis and MRD
- Sezary syndrome
- PNH testing
- Lymphocyte subset analysis and immune panel
- Qualitative and quantitative testing for Hepatitis C – RNA
- Quantitative testing for HIV – RNA (Viral load)
- Hepatitis C gentotyping
- HIV genotyping for drug resistance
- Platelet aggregation studies
Physician interpretation/impression is available for the above tests.
Medical Director: David W. Craft, PhD, D(ABMM)
- Bacteriology including culture and automated rapid detection platforms for identification and antimicrobial susceptibility testing (AST)
- Continuous monitoring system for blood cultures with reflex to multiplex rapid identification platform
- Matrix Assisted Laser Desorption Ionization-Time of Flight (MALDI-TOF) for rapid identification of bacteria and yeast
- Specific protocols for cystic fibrosis, anaerobic identification and AST, and highly infectious pathogens
- Mycobacteriology including smear, culture, and DNA probe for identification of Mycobacterium tuberculosis and M. avium-intracellulare complex
- Continuous monitoring system for mycobacterial broth cultures
- Mycology including smear and culture identification of yeasts and molds, and yeast AST
- Partners in antimicrobial stewardship program, infection control, pharmacy and therapy, and emergency preparedness
- Teaching mission to College of Medicine, undergraduate clinical lab scientists, post-doctoral microbiologists, pathology residents, and infectious disease fellows
- Public health and infectious disease research in Peruvian Amazon Basin
Medical Director: Hiroko Shike, MD, D(ABHI)
- The lab performs histocompatibility testing, such as HLA typing, HLA antibody screening/identification, and lymphocyte crossmatch
- The lab provides essential testing for donor selection, evaluation of immunological risk, and diagnosis of rejection in various types of transplantation (e.g., kidney, pancreas, heart, liver, and stem cell/bone marrow)
- HLA typing is useful in predicting certain drug reactions (e.g., HLA–B*57:01 in abacavir hypersensitivity) or susceptibility to certain diseases (e.g., HLA-B27 in ankylosing spondylitis)
- The lab performs testing for platelet transfusion support
- The lab provides HLA typing for research/clinical laboratories
Accredited by American Society of Histocompatibility and Immunogenetics (ASHI).
Medical Director: Wallace H. Greene, PhD, D(ABMM)
- The clinical virology laboratory offers a comprehensive service for viral isolation, rapid direct detection with viral diagnostic assays and viral serologies.
- The lab offers technical and scientific expertise and support by working closely with the health care provider to determine the most appropriate and cost effective course of action. The laboratory is in operation Monday through Friday, 8:00 a.m. to 4:30 p.m., Saturday 8:00 a.m. to noon and Sunday 1:00 p.m. to 4:00 p.m.
- All positive results are telephoned to the requesting physician. Special instructions in collection techniques are provided by the virology staff. In addition, all viral collection supplies provided at no cost.
- We offer isolation and identification for the following viruses: adenovirus, cytomegalovirus, enterovirus, herpes simplex virus, influenza virus, parainfluenza virus, mumps, measles, rotavirus, respiratory syncytial virus, and varicella-zoster virus.
- Molecular diagnostic assays for chlamydia and Neisseria gonorrhea are available.
- Because our virology lab is within the medical center we achieve optimal sensitivity with viral cultures due to decreased transport times. We are also readily available for on-site or phone consultations.
Pathology Core Reference Lab
Medical Director: Michael H. Creer, MD
Our core endocrine laboratory provides comprehensive specialty hormone analysis such as insulin (total and free), pro-insulin, PTH (intact), androstenedione, aldosterone, 17 OH Progesterone, DHEA-S, ACTH, HGH, IGF-1, IGF-BP3, free testosterone and other analytes such as estriol, N-telopeptide, bone specific alkaline phosphatase and renin activity.
The Medical Laboratory performs more than 1.5 million tests each year reflecting the diverse make-up of patients seen at this academic care center and the extensive outpatient population.
The laboratory includes units for blood bank/apheresis, microbiology, virology, hematology, chemistry, HLA/immunology, laboratory information systems, phlebotomy/specimen collection, and central processing.
Molecular Diagnostics Laboratory
Medical Director: Michael H. Creer, MD
T cell and B cell clonality by PCR
PCR detection of leukemia/lymphoma mutations: t(9;22), t(15;17), t(14;18), and JAK2 (V617F)
Quantitative real-time PCR for minimal residual disease: t(9;22) and t(15;17)
Hypercoagulability by Invader: Factor V Leiden and Prothrombin G20210A
Decedent Care Services (DCS) is devoted to handling a decedent's affairs in a sensitive, confidential, and efficient manner.
The Decedent Care team is dedicated to providing support and assistance during the most difficult time for families and staff. Founded in 1970, the PSHMC DCS was modeled after programs at the University of Iowa and Case Western Reserve. DCS has provided support for the Department of Pathology and the hospital at large for more than 40 years. Through DCS, services that might be performed by as many as six other hospital units are combined into one central service, providing control and efficiency over the death care process.
We strive to provide guidance and support for family members and hospital staff, ensuring that all actions in the continuum of care are administered with confidentiality and respect. We provide technical and logistical support so that all parties have positive outcomes within an efficient time frame.
The team consists of a medical director, administrative manager, supervisor, and two full-time and four part-time decedent care associates (DCAs). Our 24 hours a day, 365 days a year operation provides quality services around the clock.
The DCAs are trained professionals who provide a calm and supportive presence during an emotional and potentially stressful time. Each DCA has mortuary- or science-related backgrounds and degrees.
The DCS team works collaboratively with multiple departments and organizations to communicate information that’s essential to the process that takes place after a death.
Prior to family contact, a DCA reviews the patient's medical record and demographic data to become familiar with information such as who is the legal next of kin. If necessary, the DCA will contact the County Coroner to determine and assist with jurisdiction.
The DCA meets with the clinician to discuss death certification and case options, which may include autopsy consent.
An autopsy is a dignified and detailed surgical examination of the body after death that provides diagnostic information to the family and treating physicians. Autopsy findings usually validate major clinical diagnoses and may refine or clarify clinical data. Occasionally, an autopsy reveals important unexpected information about a patient's disease or condition. Autopsy information is a vital component of education and continuous quality improvement.
Autopsies are performed without charge to family members of a deceased in-patient. An autopsy may be performed without charge on an established Hershey Medical Center patient who passed away at home or in a care facility. All autopsies are performed by pathologists, physicians with specialized training in laboratory medicine. A typical autopsy requires three to six hours and should not delay or restrict funeral arrangements.
If an autopsy is requested, the DCA will assist the next of kin in completing an informed consent and discussing any limitations they wish to impose on the autopsy. Autopsies are also performed for contracted hospitals.
Other services we provide include assistance with:
- Organ/tissue donation: In accordance with PA Act 102, DCAs report the death to an organ/tissue donor agency and assist in the initial screening to determine donor suitability and maintain a record of the event. If donation consent is obtained, the DCA often assists the agency and the next of kin in the completion of the consent and then coordinates transfer of the patient for the procedure.
- Family agent interaction: The DCA will meet with the next of kin to obtain contact information and identify who the family's agent for disposition will be: funeral home, cremation or body donation service. They will assist with initial contact and coordinate timely release of the patient's remains.
- Research support service: DCS provides technical support for research programs within and outside of the medical center and is a regional neural tissue harvest center.
- Liaison service: DCS provides referral, communication and assistance with various organizations including but not limited to: Coroner, Police Department, State Department or Foreign Embassy, Pennsylvania Department of Health, Bureau of Vital Statistics, Military Commanding Officer, Red Cross, Center for Medicare and Medicaid Services. In house communication includes but not limited to: Medical Records, Infection Control, Bed Management, Risk Management and Quality Services.
- Education: The Decedent Care Center staff and pathologists are dedicated to enhancing knowledge of families, physicians, nurses, health care students, chaplains and other allied health personnel.
Penn State Health Milton S. Hershey Medical Center Clinical Services
- Penn State Cancer Institute
- Penn State Special Hematology Laboratory
- Penn State Women's Health
- Penn State Surgery
- Penn State Heart and Vascular Institute
- American Society of Clinical Pathologists (ASCP)
- College of American Pathologists (CAP)
- Pennsylvania Association of Pathologists (PAP)
- Lab Tests Online