Fine Needle Aspiration (FNA)

Highlands Pathology Consultants offers the most extensive cytology services in the region, including both inpatient and out-patient services for fine needle aspiration cytology (FNAs). With more than twenty years of experience with the fine needle aspiration procedure, the pathologists at Highlands have ample experience to ensure collection of an adequate specimen and to provide the most accurate interpretation possible. Immediate examination of FNA specimens during the procedure often eliminates the need to repeat aspirations, reducing patient discomfort and anxiety.

ThinPrep® Pap Test

Highlands was the first anatomic pathology laboratory in the area to offer the ThinPrep Pap® Test, which is a significantly more effective method for screening for uterine cervical cancer than the conventional Pap smear. The ThinPrep Pap Test represents an important improvement for women’s health care by increasing the detection of pre-malignant cervical lesions while reducing the need for unnecessary repeat tests. Our experience and numerous clinical studies show that the ThinPrep Pap Test provides considerably more accurate results than the conventional Pap smear.

Image Directed Cytology (IDC)

Highlands was also the first anatomic pathology laboratory in the area to offer Image Directed CytologyTM with the ThinPrep Pap Test. The imaging system is the first automated interactive image analysis for cervical cancer screening. It combines imaging technology with human interpretive expertise. Our experience and clinical studies show that IDC provides improved diagnostic performance. In the U.S. Clinical Trial, a 39% reduction in False Negative Fraction was reported for ASC-US+. In addition, IDC provided a more accurate diagnosis. 1, 2

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Out of Vial Testing

At the referring physician’s request, Highlands offers the Roche Cobas Human Papilloma Virus (HPV) test, providing a rapid, objective analysis for the presence of the virus associated with cervical dysplasia and cancer. The HPV test can be performed using residual cells in the ThinPrep sample.

In addition to the Pap test and HPV typing, the following tests may be ordered from the ThinPrep vial:

  • Chlamydia Trachomatis, Qualitative
  • Neisseria Gonorrhoeae, Qualitative
  • Herpes Simplex Virus, 1 and 2, Qualitative

Test Results

Our experienced staff of ASCP-registered cytotechnologists provides two-day turn-around on routine pap testing, with same day STAT service available on request. If a cervical biopsy is performed, the pathologist who examines the biopsy will also review the patient’s most recent Pap test. Drs. Kristin Pierce, Gregory Stancel, and Laura Stewart hold subspecialty board certification in cytopathology and serve as resources for the interpretation and performance of fine needle aspiration biopsies as well as the interpretation of challenging Pap tests and non-gynecologic cytology specimens.


Surgical Pathology:

Surgical pathology is a subspecialty of pathology practice dealing with microscopic examination of tissue and integration of these observations into a meaningful interpretation. Highlands utilizes state-of-the-art methods to provide the most timely and accurate diagnoses possible, including intra-operative frozen section interpretations. Our laboratory staff includes board-certified pathologist assistants and ASCP board-certified histologic technicians who strive to prepare microscopic slides of the highest quality for interpretation by the pathologist. Surgical pathology services are available from Highlands Pathology 7 days a week, 365 days a year and a pathologist is always on call for immediate consultation regarding all aspects of tissue diagnosis.



In recent years, the technique of immunohistochemical analysis of human tissue has revolutionized pathology practice by providing the pathologist with a unique ancillary tool to provide more accurate diagnostic and prognostic information than ever before. Our  laboratory has immunohistochemistry technology and provides comprehensive diagnostic services for a wide range of antigenic markers using automated staining methods. The laboratory strives to provide accurate, timely immunohistochemical analysis using a broad array of antibodies, including a wide range of hematolymphoid markers to assist in pathologic analysis of paraffin-embedded material.


Specialized Services Include:

Gastrointestinal Pathology:

Highlands Pathology Consultants offers expert gastrointestinal and liver pathology services. Dr. Ema Veras has subspecialty fellowship training in the area of Gastrointestinal Pathology and will lead this area for Highlands Pathology Consultants. HPC incorporates a comprehensive menu of immunohistochemistry markers and special stains to assist in diagnosing conditions such as H. pylori, Barrett’s esophagus, and other gastroenterologic diseases.


Highlands Pathology Consultants provides several pathologists with special interest and expertise in hematopathology. Drs. Christopher Heitz, Evan Kulbacki, Michael Rentz, and their associates are facile with performing and interpreting bone marrow examinations and evaluating abnormal blood smears. They have each successfully completed hematopathology fellowships. Dr. Kulbacki has a subspecialty board certification in hematopathology while Dr. Heitz and  Dr. Rentz are board-eligible. Drs. Heitz, Kulbacki, Rentz and colleagues are available for consultation in the areas of neoplastic and non-neoplastic hematology/hematopathology, including consultation regarding the evaluation of patients with possible hemorrhagic and/or thrombotic tendencies.

Blood Banking and Transfusion Medicine:

Highlands Pathology Consultants provides medical directorship for MarshRegionalBloodCenter and manages the full spectrum of blood bank services available through its high-level transfusion services. In addition, medical directorship is provided for transfusion services within each hospital of the Wellmont Health System. Highlands offers both limited and comprehensive clinical consults for the evaluation of patients with complex red cell antibodies, autoimmune processes, and diseases that may be treatable by therapeutic apheresis. Consultation is available regarding the evaluation of infants with neonatal jaundice, anemia, or thrombocytopenia. Additionally, consultation is provided for establishing patient care standards and for transfusion reaction investigation.

Medical Directorship and Clinical Pathology Consulting:

Highlands Pathology Consultants has extensive experience in providing Medical Directorship of clinical laboratories for hospitals and physician offices requiring such services to meet accreditation and licensing requirements. All of the Highlands’ pathologists qualify to serve as laboratory medical directors under any and all applicable statutes, rules and regulations. Clinical laboratory directorship services traditionally include periodic on-site visits, observation of clinical performance of laboratory personnel; evaluation of laboratory equipment and supplies; review and recommendation of indicators of quality of care; approval of criteria to be used in specific laboratory related quality assurance; and attendance at regularly scheduled meetings of the medical staff. Services can be customized to fit the needs of the client. Additionally, clinical pathology consulting services are available 7 days per week, 24 hours per day.

1. Based on a statistically significant improvement in sensitivity for ASC-US+ and a statistically significant improvement in specificity for HSIL+ from the ThinPrep Imaging System clinical trial. Reference: ThinPrep Imaging System Operation Summary and Clinical Information. 2. A more accurate diagnosis is based on sensitivity of ASC-US+, and specificity is based on HSIL+. Reference: ThinPrep Imaging System Operation.