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Women's Health

Quality

  • 13 experienced board certified Pathologists, including 4 board certified in Cytopathology
  • 4 experienced Cytotechnologists
  • 2 experienced Clinical Genetic Molecular Biology Scientists 

Full Panel of GYN Testing

  • Fully certified in ThinPrep, SurePath and Convential pap testing.
  • Chlamydia trachomatis (CT) and Neisseria gonorrohoeae (NG) testing using Aptima Combo 2 Assay from liquid-based paps, swabs and urine.
  • High Risk HPV testing using the COBAS platform from liquid-based paps.
  • BD Affirm VPIII testing testing for Candida species, Gardnerella vaginitis and Trichomonas vaginalis.
  • Correlation of biopsies to pap smears.
  • Certified in SpiraBrush Biopsy technique for a virtually painless biopsy.

Breast Health

  • Onsite ER/PR and Her2 testing.
  • Close association with the nationally recognized Radin Breast Center.
  • Quick turn-around on Breast FNA's and biopsies.

Fast Results

  • Two day turn-around time on almost 95% of all paps (including ancillary testing).
  • Two day turn-around time for most biopsies.
  • 24 hour turn-around time on breast FNA's.

Exceptional Service

  • Pathologists and cytotechnologists available by phone for any and all questions.
  • Work closely with Radin Breast Center.
  • Local service means ease of adding additional testing to already received material. 
  • In house IT to work with EMR integration.
  • Negative pap smear results available by phone using the LabCalls service.  

Molecular Diagnostics

Our Molecular diagnostic laboratory currently provides the following diagnostic testing:

Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) by Aptima Combo 2 Assay

Summary:
We use the Aptima Combo 2 assay which utilizes a target capture and transcription mediated amplification technology for the detection and differentiation of ribosomal RNA (rRNA) from Chlamydia trachomatis (CT) and/or Neisseria gonorrhoeae (GC) from various specimen types listed below. This assay has been FDA approved*.

Specimen Type:

  • Liquid Based (ThinPrep, SurePath) – 1 mL
  • Female Endocervical / Male Urethral Swab
  • Urine (Caution: Urine in original collection container must be transferred to Aptima Collection tube within 24 hours)

Methodology:
Qualitative transcription-mediated amplification

Turn-around:
1-3 business days.


Human Papillomavirus (HPV) by COBAS® HPV Assay

Summary:
We use the Roche cobas® HPV test, which is a real time PCR assay that provides specific genotyping information for HPV Types 16 and 18, while concurrently detecting the other 12 high-risk HPV types in a pooled result. ß-globin from cellular input is used as an internal control to assess specimen quality and identify specimens containing factors that inhibit the amplification process. This FDA approved assay is automated on the cobas® 4800 System*. 

Specimen Type: 
Liquid Based (ThinPrep, SurePath) - 1 mL.

Methodology: 
Automated nucleic acid extraction and real time PCR amplification. 

Turn-around: 
2-5 business days.


Vaginitis Panel by BD Affirm VPIII Assay

Summary:
We use BD Affirm VPIII assay which is a direct DNA probe hybridization test in use the detection and identification of Candida species, Gardnerella vaginitis and Trichomonas vaginalis nucleic acid in vaginal fluid specimens from patients with symptoms of vaginitis/vaginosis. This assay has been FDA approved.

Specimen Type: 
BD Affirm swab. (Caution: Only 72 hour test window from swab collection time)

Methodology: 
Direct DNA probe hybridization. 

Turn-around: 
1-3 business days.


*  ThinPrep sample medium is FDA approved for pre/post aliquot HPV, and GC/CT testing.Currently performance characteristics of  HPV and GC/CT testing using SurePath sample medium were determined by SPL in a validation study. The FDA has not approved the SurePath sample medium for HPV and GC/CT testing. 

Gastrointestinal / Liver Pathology

  • Our Gastrointestinal/Liver Pathology Group provides specialty expertise and personalized consultative service for biopsy interpretation.
  • Dr. David Barrett (Mayo Clinic, Rochester MN) and Dr. Daniel Phillips (University of California, San Francisco CA) are fellowship-trained in Gastrointestinal/Liver Pathology at major centers of academic expertise in the field.
  • Our team is dedicated to providing a high level of care for patients here in the valley and quality service for our clients.  Our laboratory is able to process and report endoscopic biopsies on the same day they are received if requested.
  • Our physicians are always readily available and responsive to your concerns.  Our integrated reports include microscopic images of biopsy specimens and the direct contact information of the case pathologist.
  • Pathology Associates incorporates current advances in ancillary diagnostic techniques, and our laboratory has a large menu of available additional studies such as immunohistochemistry and in-situ hybridization for complete evaluation of complex cases.
  • Click on the "More Resources" button to the left for example reports and other useful resources.

Dermatopathology

Quality Personalized Service.

  • All dermatologist cases and any skin specimen (upon request) are reviewed by our local board-certified dermatopathologists who are readily available for consults on any dermatopathology case.
  • Dr. Jennings-Dover and Dr. Knezevich both have quality academic training and experience and are able to deliver academic-caliber interpretation with expertise in benign and malignant skin neoplasms, inflammatory skin conditions, infectious disease, hair and nail disorders, oral pathology, vulvar pathology, and soft tissue pathology.
  • We offer a vast in house menu of special stains and immunohistochemical stains for a thorough work up of dermatopathology diagnoses.
  • All direct immunofluorescence and electron microscopy cases get special attention from our board-certified dermatopathologists, and are promptly sent for analysis and interpretation at Stanford University with a quick turn-around.
  • We offer the option of complete specimen preparation with review by our board-certified dermatopathologists or a technical option of performing gross examination and slide preparation for dermatologists who wish to review their own biopsies.

Hematopathology

  • The Hematopathology service provides comprehensive diagnostic and consultative services for hematopoietic disorders involving peripheral blood, bone marrow, lymph nodes and solid organs.
  • Majority of cases are reviewed by our specialized hematopathology member, board-certified hematopathologist, Dr. Calvin Chen who has quality academic training and experiences and can provide high standard and academic-caliber interpretation and consultation.
  • Areas of expertise include acute leukemia, chronic myeloproliferative neoplasm, plasma cell neoplasm, myelodysplastic syndrome, Hodgkin lymphoma and non-Hodgkin lymphoma.
  • We incorporate advanced ancillary testings including flow cytometric analysis immunophenotyping, cytogenetic analysis and molecular studies, such as PCR and FISH analysis from high quality laboratory reference laboratory and include the findings into an integrated summary report.
  • Peripheral blood smear consultation is readily available provided by specialized hematopathology group members in aiding diagnosis of hematologic disorder, including thrombotic thrombocytopenic purpura, idiopathic thrombocytopenic purpura, acute leukemia and lymphoproliferative process.
  • We offer a vast in house menu of special stains, paraffin section in-situ hybridization and immunohistochemical studies for a thorough work up for diagnosis as well as prognostic factors for hematopathology cases.
  • Our pathologists also perform inpatient and outpatient bone marrow aspiration and biopsy procedure at our affiliated hospitals.

Surgical Pathology

Our gross dissection department is built on the “Lean Sigma” model which is a “one piece work flow,” that always flows in one direction. Each specimen is handled individually from beginning to end. There is no batching of specimens. Our bar-coding system assigns to each patient a unique 2-D barcode which is affixed to every aspect of that patient's case (e.g. requisition, cassettes, slides etc.), which follows them from beginning to end. Each department scans these barcodes for processing and patient verification.

To compliment this process we’ve taken automation to the cutting edge. Each grossing station is equipped as follows:

  • Automated laser-etching cassette labelers remove the human element of hand written cassettes.
  • Dual computer monitors provide a completely paperless environment and comprehensive visualization of the patients’ information.
  • Wireless voice recognition system provides hands-free, real-time confirmation and dictation editing.
  • Digital Video Recording (DVR) system captures every movement and specimen during the grossing process.

All of these tools working together synergistically provide Sierra Pathology Laboratory, Inc with a uniquely superior process, providing efficiency and accuracy. 

Over 80% of outpatient surgical pathology cases are processed and a final report completed within 24 hours of receiving the sample in our laboratory. Nearly 95% are completed within 48 hours. For clients who wish to make use of the AutoFax feature of our reporting system, these final reports will be faxed directly to the clients’ office within minutes of being signed out. For many of our clients up and down the Valley, the norm is to receive most reports the day following the surgical procedure.

Genitourinary Pathology

Most of the Pathologists have Surgical Pathology fellowship training which includes exposure to genitourinary pathology and some also have Cytopathology fellowship and Cytopathology board certification which includes exposure to urinary tract cytology. We have many years of experience with prostate pathology and offer in our laboratory immunostains important for prostate carcinoma diagnosis in small biopsies. On requests, photomicrographs can be placed on prostate biopsy reports.

Clinical Lab

Currently we operate draw stations located at Family Medical in downtown Fresno and Sang Medical Group. We are still looking for facilities to partner with, if you need a draw station at you site and would like to discuss this opportunity please use the contact form on our contact us page.