Specimen Dissection Back to basics
|
|
- Allan Lane
- 5 years ago
- Views:
Transcription
1 Carol Turnbull FIBMS PGDipHSSM BSc. What is Northern Ireland is famous for? Specimen Dissection Back to basics A few famous faces from Northern Ireland recognise anyone? And apparently we are not too bad at golf either!! 1
2 The Plan Why BMS cut?, the benefits and current attitudes. Governance and Risk (patient focused) and getting it wrong!! Good Practice Clinical history and block selection How to write a good gross description What is normal and abnormal? A few practical tips History and Culture In 2010, BCH delivered 26,000 cases but 90-95% were cut by BMS staff Needs driven due to increased demands on Consultant Path. Pioneered in the Belfast City Hospital but now rolled out across the UK Held in very high regard by our national accreditation body (CPA) Disapproved of by many Frowned on by many Consultant pathologists who thought this can t be safe, BMS can t be competent Dubious CPA inspectors st CPA visit. BCH identified as a pilot site 2000 IBMS and RCPath set exams at post masters level in tissue dissection Decades later, system gradually accepted with appropriate safeguards The benefits Consistently high standard BMS job satisfaction and career progression Effects on staff retention Work with existing resources. Major savings. Releases medical staff for reporting and other clinical duties therefore better use of consultant time. 2
3 Online survey of UK Consultant Pathologists (take home messages) Vast majority of UK Consultant Histopathologists taking part in the survey support BMS cut-up Utilisation limited at present due to staffing, funding and concerns over quality Training, examinations and audit of practice will provide assurance of quality Pathology managers need to be provided with more evidence of the fiscal benefits. To err is human J Clin Pathol 2011; 64: Risk We can never eliminate risk, however we can put measures in place to minimise risk. How does clinical governance relate to specimen dissection? Clinical Governance is how we handle the specimen from receipt in the lab to the final report, ensuring optimal handling and without risk of an incorrect report or diagnosis. 3
4 Ensuring continuity, where do errors occur? Specimen receipt and booking in In the cut up room In the main lab In the pathologist s office Final reporting and authorising F*** ups seen in all areas Minimising the risks to the patient Check PID against labels on pots 3 TICKS name, lab number and/or DOB and specimen number, required for audit. (preferably unique identifier) Check part numbers correspond to the labels on the specimen pots e.g.. X2 X3 Log / record any/all discrepancies, check against theatre lists. Getting it wrong! Mixing specimens can have dire consequences Inappropriate treatment can be given. (surgery, chemo, DXT) Treatment can be delayed or omitted. Psychological trauma Costly damages against the trust. 4
5 Clean, tidy, orderly workstation Good Practice!! The principles of Good Practice Tidy, clean and orderly workstation Work in pairs to cross check data Clean paper towel for each specimen and/or part Wash and wipe forceps and blades before, during and after dissection of each specimen (preferably under a running tap) Now on to the messy stuff!!! The surgical cut up 5
6 We need to Read and Understand the clinical history /comments Biopsy or excision (really only 2 types). This tells you the purpose, diagnostic, reexcision, therapeutic If required, helps you to decide how to open the organ to allow maximum fixation of the lesion Orientation markers should not be removed until after photography and protocols for inking have been carried out. Gross measurements usually taken before dissection Ask yourself these questions! 1. What structures are present? 2. Is there a tumour present? 3. What type of tumour is it? 4. Is it benign or malignant? 5. Is it completely excised? 6. How far has it spread (stage) 7. What is the likelihood of it returning and or metastasising to other locations? The importance of the gross description!! Important skill for diagnosis and prognosis Provides a permanent record Used for staging, eg tumour size, location, distance to margins, multiple tumours etc. (TNM) Correlation between micro and macro Accuracy of block selection (good block key) Example of block key for a right hemi-colectomy A = limit node B and C = tumour and serosa x2 D and E = tumour and mesentery x2 F = appendix G = polyp distal to main tumour mass H J K L = nodes 6
7 How do we write a gross description? 1. Identify the structures present, weights and measurements 2. Main findings of lesion and its relationship to normal structures and distance to margins 3. Secondary pathology not yet described, e.g. other lesions, polyps, cysts and contents Qualities of a good gross description Be succinct and precise Good organisation (the information should flow) Adequate dissection (thoroughly examine as measurements may change) Use? (If unsure of involvement) Standardization (use of proformas) Use photos and diagrams as an aid to description Good block key How do we describe lesions? LOSSCCC Location..where the lesion is Outline..what does the border look like Size..the exact measurements Shape..encapsulated, nodular Colour..tan, white, yellow Consistency..keratotic,mucinous,firm Cut surface..homogenous, heterogenous that s all well and good!!! but how can we recognise tumours? 7
8 What do these tumours look like? Benign versus Malignant Benign Circumscribed (thin membrane) Encapsulated No necrosis Rubbery fibrous tissue Malignant Irregular infiltrative edges May have necrosis and haemorrhage Very hard How do tumours spread and metastasise? 1. Local invasion most common, direct growth into adjacent tissues 2. Lymphatic spread forms secondary tumours in lymph nodes 3. Blood borne spread eg bronchus, breast, thyroid, kidney and prostate 4. Transcoelomic spread in pleural, pericardial and peritoneal cavities How do we select the right blocks? Blocks of tumour in relation to other structures (select viable tissue) Blocks of tumour with the nearest excision margin Blocks showing the deepest point of invasion. Block all lesions / abnormalities mentioned in the description (and tissue between) Shave margins if necessary. Lymph nodes and vessels Block of normal tissue as a comparison of what is normal for each individual 8
9 How do we select the correct type of margin? Shave margin.. e.g. oes, vaginal cuff, prostate, bronchus, ureter Perpendicular margin..used particularly where a small rim of uninvolved tissue would be considered a negative margin eg. Intestine, skin, thyroid nodule If inking margins, care not to transfer ink onto non-marginal tissue. Shave Advantages are greater surface area and view entire structure with lumen Disadvantages are the exact distance cannot be measured Margins (2 types) Perpendicular Advantages are exact distance can be measured. Disadvantages are there is a small sample of the tissue margin. A few good tips!! If blocks contain fatty tissue, remember to keep them thin (<3mm) to aid processing. Float out fatty and fresh tissue! One patient at a time please!! After each case is finished put the blocks away in fixative ready for processing. Do not leave partially dissected specimens on the bench without appropriate labelling No distractions A few more!! No open containers on the bench Rinse larger specimens with running water to reduce formalin exposure Check the lids for tissue!! Care not to transfer cells on paintbrushes, e.g. lletz bx of cervix Final check of labelled cassettes and number of cassettes taken 9
10 In conclusion!! Biomedical scientist involvement in specimen dissection provides a quality safe and cost effective service. Helps to address the shortage of Consultants Require Consultant support 1 st do no harm!! ( its ok to ask for preview) Learn to recognise normal from abnormal tissue, life long learning!! And finally, this is a great way of working within your existing resources. Remember that You are the most valuable resource. Thank you. Any questions? 10
Handling & Grossing of Colo-rectal Specimens for Tumours. for Medical Officers in Pathology
Handling & Grossing of Colo-rectal Specimens for Tumours for Medical Officers in Pathology Dr Gayana Mahendra Department of Pathology Faculty of Medicine University of Kelaniya Your Role in handling colorectal
More informationQA Processes. Philip DaCosta BSCP QA Lead, Yorkshire & the Humber September 2013
QA Processes Philip DaCosta BSCP QA Lead, Yorkshire & the Humber September 2013 Standards QA visits Dashboards BCSP standards Standards for Organisation Service delivery Reporting Data quality Audit and
More informationANATOMICAL PATHOLOGY TARIFF
ANATOMICAL PATHOLOGY TARIFF A GUIDE TO UTILISATION. The following guidelines have been agreed by consensus of Anatomical Pathologists who are members of the Anatomical Pathologist s Group, or the National
More informationAddendum report coding for the National Quality Improvement Programme in Histopathology: a multi-institutional audit
Addendum report coding for the National Quality Improvement Programme in Histopathology: a multi-institutional audit S. Mahon 1,3, D. Catargiu 2, S. Phelan 2, S. Crowther 3, N. Swan 1. St. Vincent s University
More informationCONSULTATION DURING SURGERY / NOT A FINAL DIAGNOSIS. FROZEN SECTION DIAGNOSIS: - A. High grade sarcoma. Wait for paraffin sections results.
Pathology Report Date: 3/5/02 A, B. Biopsy right distal femur- high grade spindle cell sarcoma Immunohistochemistry studies are pending to further classify the nature of the tumor. CONSULTATION DURING
More informationUrology An introduction to cut up DR J R GOEPEL
Urology An introduction to cut up DR J R GOEPEL Overview Principles Individual organs Small pieces Partial resections Whole organs Data recording and data sets Principles You are working for the patient
More informationHISTOPATHOLOGY DEPARTMENT
HISTOPATHOLOGY DEPARTMENT TITLE: Cytology and andrology user guide INDEX ORGANISATIONAL UNIT AREA OF APPLICATION DOCUMENT TYPE AUTHOR(S) AUTHORISED BY AUTHORISATION DATE DATE PRINTED COPY NUMBER LOCATION
More informationCatholic University of Louvain, St - Luc University Hospital Head and Neck Oncology Programme. Anatomopathology. Pathology 1 Sept.
Anatomopathology Pathology 1 Anatomopathology Biopsies Frozen section Surgical specimen Peculiarities for various tumor site References Pathology 2 Biopsies Minimum data, which should be given by the pathologist
More informationCELL AND TISSUE INJURY COURSE-II PATHOLOGY LABORATORY. PATHOLOGY of MASS LESIONS and TISSUE DEFECTS -MACROSCOPY Assoc. Professor Rengin Ahıskalı
CELL AND TISSUE INJURY COURSE-II PATHOLOGY LABORATORY PATHOLOGY of MASS LESIONS and TISSUE DEFECTS -MACROSCOPY Assoc. Professor Rengin Ahıskalı M1 - RENAL TUBERCULOSIS cavitary areas caseous necrosis fibrous
More informationKidney Case 1 SURGICAL PATHOLOGY REPORT
Kidney Case 1 Surgical Pathology Report February 9, 2007 Clinical History: This 45 year old woman was found to have a left renal mass. CT urography with reconstruction revealed a 2 cm medial mass which
More informationPATHOLOGY GROUP GUIDELINES FOR THE EXAMINATION AND REPORTING OF COLORECTAL CANCER SPECIMENS
PATHOLOGY GROUP GUIDELINES FOR THE EXAMINATION AND REPORTING OF COLORECTAL CANCER SPECIMENS Produced by: Address: Yorkshire Cancer Network Pathology Group Arthington House, Cookridge Hospital, Hospital
More informationPROTOCOL SENTINEL NODE BIOPSY (NON OPERATIVE) BREAST CANCER - PATHOLOGY ASSESSMENT
PROTOCOL SENTINEL NODE BIOPSY (NON OPERATIVE) BREAST CANCER - PATHOLOGY ASSESSMENT Author: Dr Sally Ann Hales On behalf of the Breast and pathology CNGs Written: March 2005 Reviewed by CNG: June 2009 &
More informationNeoplasia part I. Dr. Mohsen Dashti. Clinical Medicine & Pathology nd Lecture
Neoplasia part I By Dr. Mohsen Dashti Clinical Medicine & Pathology 316 2 nd Lecture Lecture outline Review of structure & function. Basic definitions. Classification of neoplasms. Morphologic features.
More informationBladder Case 1 SURGICAL PATHOLOGY REPORT. Procedure: Cystoscopy, transurethral resection of bladder tumor (TURBT)
Bladder Case 1 February 17, 2007 Specimen (s) received: Bladder Tumor Pre-operative Diagnosis: Bladder Cancer Post operative Diagnosis: Bladder Cancer Procedure: Cystoscopy, transurethral resection of
More information6/5/2010. Renal vein invasion & Capsule Penetration (T3a) Adrenal Gland involvement (T4 vs. M1) Beyond Gerota s Fascia? (?T4).
GU Cancer Staging: Updates and Challenging Areas 13 th Current Issues in Surgical Pathology San Francisco, CA June 5, 2010 Jeffry P. Simko, PhD, MD Associate Professor Departments of Urology and Anatomic
More informationPathology Report Patient Companion Guide
Pathology Report Patient Companion Guide Breast Cancer - Understanding Your Pathology Report Pathology Reports can be overwhelming. They contain scientific terms that are unfamiliar and might be a bit
More informationDefinition of Synoptic Reporting
Definition of Synoptic Reporting The CAP has developed this list of specific features that define synoptic reporting formatting: 1. All required cancer data from an applicable cancer protocol that are
More informationCELLULAR PATHOLOGY TURNAROUND TIMES
CELLULAR PATHOLOGY TURNAROUND TIMES These are average figures for some key specimens in days for the month of August 2018. The times include weekends & bank holidays when the laboratory is closed. The
More informationGYNAECOLOGICAL CYTOLOGY
The laboratory runs a tour of the department for Practice Nurses on request, as part of their training, explaining the procedures and requirements for Gynae LBC. RECOMMENDED PROTOCOL FOR SMEAR TAKERS Only
More informationHISTOPATHOLOGY. Introduction
HISTOPATHOLOGY Introduction Contacts Services offered Pathology tissue request Laboratory hours Special instructions Histopathology reports List of specimens Introduction The Histopathology section of
More informationStaging Challenges in Lower GI Cancers. Disclosure of Relevant Financial Relationships. AJCC 8 th edition and CAP protocol updates
Staging Challenges in Lower GI Cancers Sanjay Kakar, MD University of California, San Francisco March 05, 2017 Disclosure of Relevant Financial Relationships USCAP requires that all planners (Education
More informationHistotechnological problems in dermatopathology and their possible consequences
Histotechnological problems in dermatopathology and their possible consequences Zsolt B. Argenyi, M.D. Professor of Pathology & Dermatology Director of Dermatopathology University of Washington, Seattle,
More informationFrog Dissection SNC2P Grade 10 Science Applied Biology Tissues, Organs and Systems of Living Things
Frog Dissection SNC2P Grade 10 Science Applied Biology Tissues, Organs and Systems of Living Things Purpose To identify and examine the external and internal structures of the frog and compare them with
More informationLN04 - Lymphoma Tissue Microarray
Reveal Biosciences offers Histochemical Staining, Immunohistochemistry (IHC), In Situ Hybridization (ISH), Whole Slide Imaging, and Quantitative Image Analysis on any TMA LN04 - Lymphoma Tissue Microarray
More informationMelanoma Case Scenario 1
Melanoma Case Scenario 1 History and physical 11/5/16 Patient is a single, 48-year-old male in good health who presented to his primary physician for a yearly physical exam during which a 3.4 x 2.8 x 1.5
More informationRectal Cancer Cookbook Update. A. JOURET-MOURIN with the collaboration of A Hoorens,P Demetter, G De Hertogh,C Cuvelier and C Sempoux
Rectal Cancer Cookbook Update A. JOURET-MOURIN with the collaboration of A Hoorens,P Demetter, G De Hertogh,C Cuvelier and C Sempoux Prof Dr A Jouret-Mourin, Department of Pathology, UCL, St Luc, Brussels
More informationTake Home Quiz 1 Please complete the quiz below prior to the session. Use the Multiple Primary and Histology Rules
Take Home Quiz 1 Please complete the quiz below prior to the session. Use the Multiple Primary and Histology Rules Case 1 72 year old white female presents with a nodular thyroid. This was biopsied in
More informationCYTOLOGY: What every general practitioner should know ( and every future specialist)
CYTOLOGY: What every general practitioner should know ( and every future specialist) 16 April 2014 Dr C Crause Pathologist and Senior Lecturer Department of Anatomical Pathology University of Pretoria/NHLS
More informationHandout for Dr Allison s Lectures on Grossing Breast Specimens:
Handout for Dr Allison s Lectures on Grossing Breast Specimens: Dr. Kimberly H. Allison Director of Breast Pathology and Breast Pathology Fellowship Director of Residency Training in Pathology Stanford
More informationPathology Specimen Handling Requirements
CONWAY REGIONAL HEALTH SYSTEM CLINICAL LABORATORY Pathology Specimen Handling Requirements POLICY: Tissue or body fluids, etc. removed or collected during any procedure for purposes of Pathologist examination
More informationRetroperineal Lymph Node Dissection (RPLND)
Acute Services Division Information for patients about Retroperineal Lymph Node Dissection (RPLND) Introduction This booklet gives you information about surgery to remove the residual lymph nodes at the
More informationMPH Quiz. 1. How many primaries are present based on this pathology report? 2. What rule is this based on?
MPH Quiz Case 1 Surgical Pathology from hysterectomy performed July 11, 2007 Final Diagnosis: Uterus, resection: Endometrioid adenocarcinoma, Grade 1 involving most of endometrium, myometrial invasion
More informationMelanoma Case Scenario 1
Melanoma Case Scenario 1 History and physical 11/5/16 Patient is a single, 48-year-old male in good health who presented to his primary physician for a yearly physical exam during which a 3.4 x 2.8 x 1.5
More information1. Guidelines for Reporting Carcinoma of the Breast
1 2 1. Guidelines for Reporting Carcinoma of the Breast Compilation and editing of this volume: Prof. Dilani Lokuhetty (Consultant Histopathologist) List of contributors Consultant Histopathologists Dr.
More informationNorthumbria Healthcare NHS Foundation Trust. Breast Sentinel Lymph Node Biopsy. Issued by the Breast Team
Northumbria Healthcare NHS Foundation Trust Breast Sentinel Lymph Node Biopsy Issued by the Breast Team Why do my Lymph Nodes require investigation? The lymphatic system is a pathway of lymph vessels and
More informationPollen Slide Mounting Protocol
Pollen Slide Mounting Protocol Materials: Syn-Matrix mounting medium Microcentrifuge Microscope slides Slide coverslips (18mm x 18mm) Coverslip podium (see Figure 1) Capillary tubes Dissecting microscope
More informationACOS Inquiry and Response Selected Inquires CS Tumor Size/Extension Evaluation, CS Lymph Nodes Evaluation, CS Metastasis at Diagnosis Evaluation *
ACOS Inquiry and Response Selected Inquires CS Tumor Size/Extension Evaluation, CS Lymph Nodes Evaluation, CS Metastasis at Diagnosis Evaluation * CS Tumor Size/Extension Evaluation 24842 12/11/2007: Q:
More informationSkin Scrape. Year Group: BVSc4 + Document number: CSL_D16
Year Group: BVSc4 + Document number: CSL_D16 Equipment for this station: Considerations for this station: Equipment list: Kiwi fruit #10 scalpel blade Liquid paraffin Glass microscope slides Wax marker
More informationSurgical Therapy: Sentinel Node Biopsy and Breast Conservation
Surgical Therapy: Sentinel Node Biopsy and Breast Conservation Stephen B. Edge, MD Professor of Surgery and Oncology Roswell Park Cancer Institute University at Buffalo Dr. Roswell Park: Tradition in Cancer
More informationTable of contents. Page 2 of 40
Page 1 of 40 Table of contents Introduction... 4 1. Background Information... 6 1a: Referral source for the New Zealand episodes... 6 1b. Invasive and DCIS episodes by referral source... 7 1d. Age of the
More informationAB MR Interpretation Overview
AB MR Interpretation Overview Goal of AB MR interpretation is to maintain high sensitivity and specificity In order to minimize false positives and short term follow ups, it is fundamental to focus only
More informationImage guided core biopsies:
Recommendations on the Surgical, Radiologic and Pathologic Approaches to Breast Disease: Using best practices based on multidisciplinary methodologies developed through the Allina Breast Committee. Image
More informationCase Scenario 1: This case has been slightly modified from the case presented during the live session to add clarity.
Case Scenario 1: This case has been slightly modified from the case presented during the live session to add clarity. Background: 46 year old married premenopausal female with dense breasts has noticed
More informationFetal Pig Dissection Day 2 Circulatory and Respiratory Systems
Name: Date: Period: Fetal Pig Dissection Day 2 Circulatory and Respiratory Systems Dissection Roles (choose a different role from Day 1): Recorder reads directions out loud to group and records answers
More informationSpecialist Referral Service Willows Information Sheets. Cancer in cats and dogs: Assessment of the patient
Specialist Referral Service Willows Information Sheets Cancer in cats and dogs: Assessment of the patient Cancer in cats and dogs: Assessment of the patient Cancer is common in human and veterinary medicine.
More informationBREAST PATHOLOGY GROSSING GUIDELINES
THINGS TO CONSIDER: A. Please review ALL imaging and previous biopsies PRIOR to grossing any breast case. a. It may be helpful to draw out your own guide to assist when grossing B. Faxitron your breast
More information05/07/2018. Organisation. The English screening programme what is happening? Organisation. Bowel cancer screening in the UK is:
Organisation The English screening programme what is happening? Phil Quirke Lead Pathologist Bowel Cancer Screening PHE England Bowel Cancer Screening Pathology Committee Started 2006 with roll out 4 devolved
More informationUSGFNA of thyroid nodules
US Guided FNA (USGFNA) of neck masses INTERVENTIONAL HEAD & NECK ULTRASOUND Brendan C. Stack, Jr., MD., FACS, FACE Professor Otolaryngology-Head and Neck Surgery Indications Technique Interpretation Results
More informationEssentials of Clinical MR, 2 nd edition. 73. Urinary Bladder and Male Pelvis
73. Urinary Bladder and Male Pelvis Urinary bladder carcinoma is best locally staged with MRI. It is important however to note that a thickened wall (> 5 mm) is a non-specific finding seen in an underfilled
More informationGreater Manchester & Cheshire Guidelines for Pathology Reporting for Oesophageal and Gastric Malignancy
Greater Manchester & Cheshire Guidelines for Pathology Reporting for Oesophageal and Gastric Malignancy Authors: Dr Gordon Armstrong, Dr Sue Pritchard 1. General Comments 1.1 Cancer reporting: Biopsies
More informationYour Guide to the Breast Cancer Pathology. Report. Key Questions. Here are important questions to be sure you understand, with your doctor s help:
Your Guide to the Breast Cancer Pathology Report Key Questions Here are important questions to be sure you understand, with your doctor s help: Your Guide to the Breast Cancer Pathology Report 1. Is this
More informationComprehensive cancer cover
Retirement Investments Insurance Health Comprehensive cancer cover Life Insurance+ with critical illness and Critical Illness+ Cancer is one of the biggest fears for the British public This is why our
More informationSmall diagnostic biopsies Handling and reporting issues. Dr Varsha Shah Consultant Histopathologist Royal Gwent Hospital Newport
Small diagnostic biopsies Handling and reporting issues Dr Varsha Shah Consultant Histopathologist Royal Gwent Hospital Newport RCPath 2017 Biopsy vs. resection specimens Smaller Tissues: Larger Issues
More informationObjectives. Intraoperative Consultation of the Whipple Resection Specimen. Pancreas Anatomy. Pancreatic ductal carcinoma 11/10/2014
Intraoperative Consultation of the Whipple Resection Specimen Pathology Update Faculty of Medicine, University of Toronto November 15, 2014 John W. Wong, MD, FRCPC Department of Anatomical Pathology Sunnybrook
More informationCPC 4 Breast Cancer. Rochelle Harwood, a 35 year old sales assistant, presents to her GP because she has noticed a painless lump in her left breast.
CPC 4 Breast Cancer Rochelle Harwood, a 35 year old sales assistant, presents to her GP because she has noticed a painless lump in her left breast. 1. What are the most likely diagnoses of this lump? Fibroadenoma
More informationL impatto dell imaging sulla definizione della strategia terapeutica
GISCoR L impatto dell imaging sulla definizione della strategia terapeutica M. Galeandro U.C. Radioterapia Oncologica ASMN-IRCCS Reggio Emilia 14 Novembre 2014 Rectal Cancer TNM AJCC-7 th edition 2010
More informationBreast Imaging: Multidisciplinary Approach. Madelene Lewis, MD Assistant Professor Associate Program Director Medical University of South Carolina
Breast Imaging: Multidisciplinary Approach Madelene Lewis, MD Assistant Professor Associate Program Director Medical University of South Carolina No Disclosures Objectives Discuss a multidisciplinary breast
More informationLarge blocks in prostate and bladder pathology
Large blocks in prostate and bladder pathology Farkas Sükösd Department of Pathology, University of Szeged The history of the large block technique in radical prostatectomy and cystectomy The first large
More informationTESTING TIMES TO COME? AN EVALUATION OF PATHOLOGY CAPACITY IN NORTHERN IRELAND NOVEMBER 2016
TESTING TIMES TO COME? AN EVALUATION OF PATHOLOGY CAPACITY IN NORTHERN IRELAND NOVEMBER 2016 EXECUTIVE SUMMARY Whilst cancer survival is at its highest ever level, our health services are under considerable
More informationSurgical Management of Neuroendocrine Tumors of the Gut. Richard Hodin MD Professor of Surgery Massachusetts General Hospital Harvard Medical School
Surgical Management of Neuroendocrine Tumors of the Gut Richard Hodin MD Professor of Surgery Massachusetts General Hospital Harvard Medical School Sites of GI Carcinoid Tumors Small intestine 44% Rectum
More informationCLINICAL EFFECTIVENESS
Re-audit of gastrointestinal tract specimens with respect to compliance with RCPath guidelines Dr Manisha Ram Dr Moina Kadri Background epidemiology and aetiology Over the past 20 years there has been
More informationMy Journey into the World of Salivary Gland Sebaceous Neoplasms
My Journey into the World of Salivary Gland Sebaceous Neoplasms Douglas R. Gnepp Warren Alpert Medical School at Brown University Rhode Island Hospital Pathology Department Providence RI Asked to present
More informationReferences. GI Biopsies. What Should Pathologists Assistants Know About Gastrointestinal Histopathology? James M Crawford, MD, PhD
What Should Pathologists Assistants Know About Gastrointestinal Histopathology? James M Crawford, MD, PhD jcrawford1@nshs.edu Executive Director and Senior Vice President for Laboratory Services North
More informationGynaecological Pathology Reporting Cervical Pathology Dr Raji Ganesan Birmingham
Gynaecological Pathology Reporting Cervical Pathology Dr Raji Ganesan Birmingham Format Introduction Cervical biopsy Difficulties in diagnosis of CIN p16 Cervical loop Squamous carcinoma diagnosing and
More informationObtaining the diagnosis:
CANCER SURGERY Obtaining the diagnosis: Most cancers are first biopsied in order to determine tumor type. Incisional biopsies extract small portions of tumor for microscopic examination. Excisional biopsies
More informationAACE/ACE Advanced Endocrine Neck Ultrasound Training Course 2016
AACE/ACE Advanced Endocrine Neck Ultrasound Training Course 2016 This 9mm left inferior nodule should remind us all why we re here! There is no absolute number of images required for documentation
More informationCase Scenario 1: This case has been slightly modified from the case presented during the live session to add clarity.
Case Scenario 1: This case has been slightly modified from the case presented during the live session to add clarity. Background: 46 year old married premenopausal female with dense breasts has noticed
More informationWhat in the world is Histotechnology? Karen Stiffler, MA, HTL Program Director for Histotechnology
What in the world is Histotechnology? Karen Stiffler, MA, HTL Program Director for Histotechnology The Basics of Histology Histology: the study of body tissues "histo" is from the Greek "histos" meaning
More informationComprehensive cancer cover
Retirement Investments Insurance Health Comprehensive cancer cover Life Insurance+ with critical illness and Critical Illness+ Cancer is one of the biggest fears for the British public This is why our
More informationPatient/Carer instructions for the administration of Subcutaneous Cytarabine
Patient/Carer instructions for the administration of Subcutaneous Cytarabine This document covers the following information: What cytarabine is What subcutaneous means What happens if you decide to inject
More informationUpdate on Thyroid FNA The Bethesda System. Shikha Bose M.D. Associate Professor Cedars Sinai Medical Center
Update on Thyroid FNA The Bethesda System Shikha Bose M.D. Associate Professor Cedars Sinai Medical Center Thyroid Nodules Frequent occurrence Palpable: 4-7% of adults Ultrasound: 10-31% Majority benign
More informationImaging in breast cancer. Mammography and Ultrasound Donya Farrokh.MD Radiologist Mashhad University of Medical Since
Imaging in breast cancer Mammography and Ultrasound Donya Farrokh.MD Radiologist Mashhad University of Medical Since A mammogram report is a key component of the breast cancer diagnostic process. A mammogram
More informationDirectorate of Laboratory Medicine. Manchester Cytology Centre Non gynaecological cytology service User Manual January 2011
Directorate of Laboratory Medicine Manchester Cytology Centre Non gynaecological cytology service User Manual January 2011 Table of contents About us 2 Services available at the Manchester Cytology Centre
More informationPrince of Wales Hospital
Prince of Wales Hospital Department of Surgery 123 Surgical Safety 123 Correct Site Marking : Policy Nov 2008 1 Content : 1. Purpose of this Policy 2. Principles 3. Standards to be followed 4. Failure
More informationReporting of Breast Cancer Do s and Don ts
Reporting of Breast Cancer Do s and Don ts 7 th SGH Annual Breast Pathology Course Professor Michael Bilous Conjoint Professor Western Sydney University Consultant Pathologist, Australian Clinical Labs,
More information8. The polyp in the illustration can be described as (circle all that apply) a. Exophytic b. Pedunculated c. Sessile d. Frank
Quiz 1 Overview 1. Beginning with the cecum, which is the correct sequence of colon subsites? a. Cecum, ascending, splenic flexure, transverse, hepatic flexure, descending, sigmoid. b. Cecum, ascending,
More informationBreast Cancer Diagnosis, Treatment and Follow-up
Breast Cancer Diagnosis, Treatment and Follow-up What is breast cancer? Each of the body s organs, including the breast, is made up of many types of cells. Normally, healthy cells grow and divide to produce
More informationData Science Reduces Anatomic Pathology Reporting Errors
Data Science Reduces Anatomic Pathology Reporting Errors Session # 270, February 14, 2019 Jay J. Ye, MD, PhD, Pathologist Dahl-Chase Pathology Associates 1 Conflict of Interest Jay J. Ye, MD, PhD Has no
More informationBenign vs. Cancer. Oculofacial Biopsy. Evolution of skin cancer. Richard E. Castillo, OD, DO
Oculofacial Biopsy Richard E. Castillo, OD, DO Benign vs. Cancer Evolution of skin cancer Metaplasia Dysplasia Carcinoma-in-situ Invasive carcinoma Intravasation Overview Preoperative Planning Choosing
More informationCOLORECTAL CANCER STAGING in 2010
COLORECTAL CANCER STAGING in 2010 Robert A. Halvorsen, MD, FACR MCV Hospitals / VCU Medical Center Richmond, Virginia I do not have any relevant financial relationships with any commercial interests COLON
More informationGreater Manchester and Cheshire HPB Unit Guidelines for the Assessment & Management of Hepatobiliary and Pancreatic Disease Chapter 14
Greater Manchester and Cheshire HPB Unit Guidelines for the Assessment & Management of Hepatobiliary and Pancreatic Disease Chapter 14 Contents 14. Neuroendocrine Tumours 161 14.1. Diagnostic algorithm
More informationCELLULAR PATHOLOGY TURNAROUND TIMES
Title: - Summary CELLULAR PATHOLOGY TURNAROUND TIMES These are average figures for some key specimens in days for the month of November 2016. The times include weekends when the laboratory is closed. The
More informationHow to decipher a pathology report for alopecia
How to decipher a pathology report for alopecia DISCLOSURE OF RELATIONSHIPS WITH INDUSTRY Lynne J. Goldberg, MD S063-Hair Disorders Made Easier DISCLOSURES I do not have any relationships with industry
More informationNon-Gynecologic Cytology Specimen Handling & Collection Instructions
Page 1 of 6 Non-Gynecologic Cytology Specimen Handling & Collection Instructions Labelling and Requisition Requirements Specimen Container Patients full name ( printed in same format as patients health
More informationLearning Objectives. 1. Identify which patients meet criteria for annual lung cancer screening
Disclosure I, Taylor Rowlett, DO NOT have a financial interest /arrangement or affiliation with one or more organizations that could be perceived as a real or apparent conflict of interest in the context
More informationRECTAL CARCINOMA: A DISTANCE APPROACH. Stephanie Nougaret
RECTAL CARCINOMA: A DISTANCE APPROACH Stephanie Nougaret stephanienougaret@free.fr Despite the major improvements that have been made due to total mesorectal excision (TME) management of rectal cancer
More informationFrog Dissection-Skin Vista Murrieta High School-- Biomedical Science. Mr. Diaz
Frog Dissection-Skin Vista Murrieta High School-- Biomedical Science Mr. Diaz Background: Please read entire lab As members of the class Amphibia, frogs may live some of their adult lives on land, but
More informationNICE diagnostics guidance on intraoperative tests (RD 100i OSNA system and Metasin test) for detecting sentinel lymph node metastases in breast cancer
NICE diagnostics guidance on intraoperative tests (RD 100i OSNA system and Metasin test) for detecting sentinel lymph node metastases in breast cancer NICE provided the content for this booklet which is
More informationCancer , The Patient Education Institute, Inc. ocf80101 Last reviewed: 06/08/2016 1
Cancer Introduction Cancer begins in your cells, which are the building blocks of your body. Extra cells can form a mass called a tumor. Some tumors aren t cancerous, while other ones are. Cells from cancerous
More informationEvaluation of Breast Specimens Removed by Needle Localization Technique
Evaluation of Breast Specimens Removed by Needle Localization Technique Specimen Handling: The breast specimen when received should be measured and grossly inspected for any orientation designated by the
More informationBowel cancer. In this fact sheet: Page 1 of 13 Macmillan fact sheet 2017: Bowel cancer. Bowel Cancer: English
Bowel Cancer: English Bowel cancer This information is about bowel cancer and treatments for bowel cancer. Any words that are underlined are explained in the word list at the end. If you have any questions,
More informationCase Scenario 1: Thyroid
Case Scenario 1: Thyroid History and Physical Patient is an otherwise healthy 80 year old female with the complaint of a neck mass first noticed two weeks ago. The mass has increased in size and is palpable.
More informationSkin Cut Up D R R O K I A H A L I C O N S U L T A N T D E R M A T O P A T H O L O G I S T S T H
Skin Cut Up D R R O K I A H A L I C O N S U L T A N T D E R M A T O P A T H O L O G I S T S T H General Instructions 5.1.1 The type of biopsy is documented. 5.1.2 Orientated or not (suture indicating what
More informationSPECIALIST REGISTRAR PAEDIATRIC HISTOPATHOLOGY JOB DESCRIPTION. Page 1 of 10
SPECIALIST REGISTRAR IN PAEDIATRIC HISTOPATHOLOGY JOB DESCRIPTION SEPTEMBER 2011 Page 1 of 10 THE CENTRAL MANCHESTER UNIVERSITY NHS FOUNDATION TRUST - ROYAL MANCHESTER CHILDREN S HOSPITAL DEPARTMENT OF
More informationBreast Cancer. What is breast cancer?
Scan for mobile link. Breast Cancer Breast cancer is a malignant tumor in or around breast tissue. It usually begins as a lump or calcium deposit that develops from abnormal cell growth. Most breast lumps
More informationColon and Rectum. Protocol revision date: January 2005 Based on AJCC/UICC TNM, 6th edition
Colon and Rectum Protocol applies to all invasive carcinomas of the colon and rectum. Carcinoid tumors, lymphomas, sarcomas, and tumors of the vermiform appendix are excluded. Protocol revision date: January
More informationProstate cancer ~ diagnosis and impact of pathology on prognosis ESMO 2017
Prostate cancer ~ diagnosis and impact of pathology on prognosis ESMO 2017 Dr Puay Hoon Tan Division of Pathology Singapore General Hospital Prostate cancer (acinar adenocarcinoma) Invasive carcinoma composed
More informationGuidelines for Specimen Submission to Pathology Laboratory
به نام خدا Guidelines for Specimen Submission to Pathology Laboratory Pre-analytic phase 1. Specimen identification 2. Adequacy of clinical history 3. Specimen fixation 4. Specimen delivery 5. Accessioning
More informationApproval for research carried out on human extracted teeth from Birmingham School of Dentistry Tooth Bank under ethical approval no: 14/EM/2811
Approval for research carried out on human extracted teeth from Birmingham School of Dentistry Tooth Bank under ethical approval no: 14/EM/2811 Generic ethical approval has been obtained for research to
More informationCAP Companion Meeting at USCAP Quality and Patient Safety in Anatomic Pathology: Practical Solutions. Surgical Pathology
CAP Companion Meeting at USCAP 2010 Quality and Patient Safety in Anatomic Pathology: Practical Solutions Directed Peer Review in Surgical Pathology Stephen S. Raab, MD University of Colorado Denver 2010
More information