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To the Editor.--We read with interest the latest publication from the College of American Pathologists (CAP) on their Electronic Cancer Checklists (eCC) 'Exploring the College of American Pathologists Electronic Cancer [...]

To the Editor.--Question GEN 20375 of the College of American Pathologists (CAP) Laboratory Accreditation Checklist requires that all laboratories have a document control policy in place 'to manage policies, procedures, [...]

To the Editor.--We read with interest Dr Schnadig's (1) article on overdiagnosis of thyroid carcinoma. Pathologists have recognized this problem for at least a decade, (2) and have actively worked [...]

To the Editor.--It has previously been shown that the use of a checklist such as the one used in synoptic reporting can lead to a more complete surgical pathology report, [...]

To the Editor.--Amendments are a well-known measure of error in surgical pathology. Previous studies have documented many content and design choices that are associated with greater report accuracy for tumor [...]

To the Editor.--In the report 'Do Synoptic Reports Add Value in Prostate Needle Biopsies?' Drs Renshaw and Gould (1) described a software parsing method to extract diagnostic data from the [...]

To the Editor.--Synoptic reports serve many purposes for pathologists, clinicians, and researchers (1-3) and have been shown to improve the completeness of surgical pathology reports for excision specimens. (4,5) The [...]

To the Editor.--Synoptic reporting is required by the College of American Pathologists (CAP) and employs checklists to improve reporting in surgical pathology. The CAP provides these checklists as written documents [...]

Context.--The College of American Pathologists requires synoptic reports for specific types of pathology reports. Objective.--To compare the accuracy and speed of information retrieval in synoptic reports of different formats. Design.--We assessed the performance of 28 nonpathologists from 4 different types of users (cancer registrars, MDs, medical non-MDs, and nonmedical) at identifying specific information in various formatted synoptic reports, using a computerized quiz that measured both accuracy and speed. Results.--There was no significant difference in the accuracy of data identification for any user group or in any format. While there were significant differences in raw time between users, these were eliminated when normalized times were used. Compared with the standard format of a required data element (RDE) and response on 1 line, both a list of responses without an RDE (21%, P < .001) and a paired response with more concise text (33%, P < .001) were significantly faster. In contrast, both the 2-line format (RDE header on one line, response indented on the second line) (12%, P < .001) and a report with the RDE response pairs in a random order were significantly slower (16%, P < .001). Conclusions.--There are significant differences in ease of use by nonpathologists between different synoptic report formats. Such information may be useful in deciding between different format options. (Arch Pathol Lab Med. 2017;141:418-422; doi: 10.5858/arpa.2016-0216-OA), Synoptic reporting of all tumor excisions is required by the College of American Pathologists (CAP). The CAP specifically requires that each element in a synoptic report be reported in a [...]

To the Editor.--The creation of a 'synoptic' report is required by the College of American Pathologists (CAP) Laboratory Accreditation Process for surgical pathology reports of resection specimens with malignancy (ANP [...]

To the Editor.--Like many pathologists, we find the use of intraoperative smears in conjunction with frozen sections invaluable in assessing specimens at the time of surgery. While touch preparations work [...]

Context.--Additional reviews of diagnostic surgical and cytology cases have been shown to detect diagnostic discrepancies. Objective.--To develop, through a systematic review of the literature, recommendations for the review of pathology cases to detect or prevent interpretive diagnostic errors. Design.--The College of American Pathologists Pathology and Laboratory Quality Center in association with the Association of Directors of Anatomic and Surgical Pathology convened an expert panel to develop an evidence-based guideline to help define the role of case reviews in surgical pathology and cytology. A literature search was conducted to gather data on the review of cases in surgical pathology and cytology. Results.--The panel drafted 5 recommendations, with strong agreement from open comment period participants ranging from 87% to 93%. The recommendations are: (1) anatomic pathologists should develop procedures for the review of selected pathology cases to detect disagreements and potential interpretive errors; (2) anatomic pathologists should perform case reviews in a timely manner to avoid having a negative impact on patient care; (3) anatomic pathologists should have documented case review procedures that are relevant to their practice setting; (4) anatomic pathologists should continuously monitor and document the results of case reviews; and (5) if pathology case reviews show poor agreement within a defined case type, anatomic pathologists should take steps to improve agreement. Conclusions.--Evidence exists that case reviews detect errors; therefore, the expert panel recommends that anatomic pathologists develop procedures for the review of pathology cases to detect disagreements and potential interpretive errors, in order to improve the quality of patient care. (Arch Pathol Lab Med. 2016; 140:29-40; doi: 10.5858/arpa.2014-0511-SA), The test cycle in surgical pathology and cytology is similar to the test cycle of other laboratory tests. (1-4) It is composed of the preanalytic, analytic, and postanalytic phases. The [...]

BACKGROUND. The chromophobe variant of renal cell carcinoma is a recently described and frequently unrecognized tumor. Because the prognosis of the chromophobe variant appears to be intermediate between that of oncocytoma and the clear cell variant of renal cell carcinoma, accurate diagnosis may be important for appropriate clinical management. METHODS. A retrospective analysis of fine-needle aspirations of four primary and two metastatic chromophobe renal cell carcinomas (five typical and one eosinophilic variant) with histologically confirmed primary tumors was performed. Hale's colloidal iron stain was strongly positive in a diffuse cytoplasmic pattern in all resected primary tumors. RESULTS. All fine-need e aspirations were characterized by cellular smears comprised of single cells and small groups of cells. The cytoplasm varied from granular to flocculent. A characteristic feature was the presence of occasional marked y enlarged, bizarre, often multinucleated cells, within a background of moderately atypical cells. Nuclear enlargement, hyperchromasia, pleomorphism, and outline irregularity were noted in all cases. These features imparted a koilocyte-like appearance to many of the cells. Intranuclear pseudoinclusions were present in four cases and were numerous in two. CONCLUSIONS. Both primary and metastatic chromophobe renal cell carcinomas have unique cytologic features that allow for their distinction from oncocytoma and other variants of renal cell carcinoma. Cancer (Cancer Cytopathol) 1997;81:122-8. [C] 1997 American Cancer Society.

BACKGROUND. Fine-needle aspiration (FNA) of the adult kidney is an excellent diagnostic tool in the appropriate clinical setting. The indications, cytologic criteria, and therapeutic implications of renal FNA may be changing. METHODS. A review of the English language literature concerning the indications, utility, and criteria for renal FNA was performed. RESULTS. The indications for renal FNA are changing as radiologic imaging allows better assessment of cystic lesions and incidentally identifies an increasing percentage of renal lesions. Cytologic criteria and pitfalls for the diagnosis of a wide variety of benign and malignant lesions have been delineated and refined. The increasing use of partial rather than radical nephrectomy for some renal lesions suggests that accurate distinction between these lesions may have important therapeutic implications. CONCLUSIONS. Renal FNA provides important information that can affect the management of patients with renal masses. Gancer (Cancer pytopathol) 1997;81:71-88. [C] 1997 American Cancer Society.