On the cutting edge and a slice above the rest – Who is a Histotechnologist?

Every March 10th, we celebrate Histotechnology Professionals Day to help raise awareness about the laboratory field of Histotechnology. Despite never meeting patients, histotechnologists play a vital healthcare role in helping patients receive the right diagnosis and care. These laboratory professionals are helping save lives one slide at a time.

But what does a histotechnologist do? To understand the profession, you must first understand Histology.

What is Histology?

Histology is the study of the microanatomy of cells, tissues, and organs as seen through a microscope.

A histotechnologist has advanced training in how and why specimens are collected and processed for testing. This expertise qualifies the histotechnologist to manage even unexpected situations in the laboratory, such as solving technical or instrument problems, understanding the underlying health and disease causes of unusual test results, and evaluating new laboratory techniques and procedures. Histotechnicians and histotechnologists must work quickly, as they are frequently under pressure to deliver results while the patient is in surgery. They are commonly referred to as “histotechs”.

What does a histotech do?

When the pathology lab receives the patient’s tissue sample, it is first examined and dissected by a pathologists’ assistant who will submit tissue samples in a fixative (usually formalin) to the Histology Lab for processing.  Some histotechs are also able to gross small specimen biopsies for processing.  This process includes a dictation of their “naked” eye description of the tissue which appears in the patient’s final report.

Histotechs work around the clock and play a large role in saving lives, but do it in an orderly fashion. The first step in tissue processing is to run the tissue sample through a series of alcohols to remove any water, clear the tissue in xylene and infiltrate the tissue sample in paraffin (wax material).  The Histotech will then embed the tissue in melted paraffin, creating a “paraffin block”, which hardens to room temperature.

The next step is for the paraffin blocks to be cut/sliced on a microtome, also known as microtomy, at paper-thin or less slices (measured in microns).  This process will create a ribbon of tissue sections which is floated on a temperature-controlled, heated waterbath.  The histotech will then pick up the tissue sections, placing them on a glass slide and routinely stained with special dyes that make the cell details visible under the microscope.  The pathologist can now microscopically examine the tissue on the slide and determine if disease is present, or if it has spread, and help the clinician decide the best course of treatment for the patient.

Cryotomy, a frozen section procedure to perform a rapid microscopic analysis/diagnosis of a fresh tissue sample, is also performed by a histotech.  These samples are sent from the surgeon in the operating room, while the patient is still under anesthesia, allowing the pathologist to provide an immediate analysis/diagnosis to aid the surgeon on how to proceed with the surgery.

Histotechs can also perform more complex techniques such as enzyme histochemistry, immunohistochemistry, and electron microscopy. A histotechnologist can also teach and be a supervisor in a laboratory.

Histotechs will tell you that their work is an art form.  They value precision and work with knives, chemicals and glass slides, as well as fragile, delicate instruments that require careful monitoring.

While patients do not see or speak with the lab team helping behind the scenes, the connection is still very meaningful for the histotechs.  They care about the production side of their work and the quality of the slides.  All histotechs will tell you they treat every specimen as if it belongs to one of their own family members waiting for their test results.

Thank you to all of Northwell’s histotechnologists!