Exploring Histopathology in Guernsey: My experience at the PEH

Allysa (photographed left) is currently a Clinical Fellow in the Emergency Department at the Royal Sussex County Hospital in Brighton, UK, and has a keen interest in pursuing a career in histopathology. In 2024 she undertook an attachment in the pathology department at Guernsey's local hospital under the supervision of now retired Consultant Hisopathologist, Dr Catherine Chinyama.

Hear from Allysa about her experience -

'To deepen my understanding of histopathology and explore whether it is the right specialty for me, I undertook a clinical attachment in the pathology department at Princess Elizabeth Hospital in Guernsey. Although Guernsey is not part of the NHS, its healthcare system follows UK best practices. This means the pathology service is impressively broad and self-sufficient, with occasional collaboration with UK labs for highly specialised tests.

During my time there, I rotated through microbiology, clinical chemistry, haematology, transfusion, and histopathology. Each department had its own rhythm and expertise, but what stood out was the seamless integration between them. Microbiology handled everything from FIT tests to biosafety level three pathogens, supporting infectious disease management and public health screening. Clinical chemistry ran a wide array of automated tests, including tumour markers like CEA and CA125, which fed directly into multidisciplinary team discussions. Haematology processed blood counts and bone marrow samples, often correlating findings with immunology results.

I was particularly intrigued by Guernsey’s blood donation programme. Entirely self-sustained, it sources whole blood and platelets from local donors. I observed both donation processes and learned about the rigorous screening protocols. Interestingly, only men donate platelets due to the complexity of screening female donors in this setting. The transfusion service processes and matches blood products in-house, ensuring safe and timely delivery.

In the mortuary, I witnessed the post-mortem process, which differs from UK practice. Pathologists in Guernsey complete death certificates and cremation forms themselves. I attended two autopsies: one of a mummified patient with dilated cardiomyopathy and fatty liver, and another of a man who died from a haemorrhagic stroke. These experiences highlighted the importance of correlating clinical history with histological findings.

The histopathology department was the core of my attachment. I followed prostate biopsy samples, both transrectal ultrasound (TRUS) and transperineal (TP), through every stage: logging, cut-up, fixation, processing, embedding, sectioning, staining, and reporting. I learned how TRUS samples are mapped and require immunohistochemistry, while TP samples are larger and often sufficient with H&E staining alone. I observed the use of microtomes, tissue processors, and staining machines, and gained insight into the challenges of slicing and embedding fragile tissue.

I also attended multidisciplinary meetings in urology, head and neck, gynaecology, and respiratory medicine. These sessions demonstrated how histopathological findings directly influence clinical decisions, from confirming malignancy to guiding treatment plans.

This attachment gave me a comprehensive view of histopathology’s role in patient care. I saw how each department contributes to diagnosis and how histology ties everything together. The Guernsey model—compact, collaborative, and clinically integrated—offered a unique learning environment. It reinforced my interest in histopathology and gave me a deeper appreciation for the precision and teamwork behind every diagnosis.

The experience provided me with valuable insights into the self-sufficiency of the blood bank, the rigour and thoroughness of laboratory analysis in supporting clinical diagnoses, and the unity of the pathology department in delivering high-quality care to the community of Guernsey.'