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At least 19 recordsLinked to original sources
PubMed1991

The diagnosis of ovarian cancer by pathologists: how often do diagnoses by contributing pathologists agree with a panel of gynecologic pathologists?

The Cancer and Steroid Hormone Study, a multicenter, population-based, case-control study of ovarian, breast, and endometrial cancer in women 20 to 54 years of age, permitted the diagnoses of contributing pathologists to be compared with those of a panel of three gynecologic pathologists. A diagnosis of ovarian cancer was made by contributing pathologists on 477 subjects. Agreement between the two groups of pathologists was 97% for primary epithelial ovarian cancer and 89% for primary nonepithelial ovarian malignancies. Agreement on diagnosis of major cellular subtypes of ovarian malignancy ranged between 73% for endometrioid cancer and 100% for clear cell carcinomas. We conclude that the diagnosis of pathologic features of primary ovarian cancer is highly predictable. Nonetheless, diagnosis by histologic type varies sufficiently that a review process should be considered for clinical or investigative decisions involving specific histologic diagnoses of ovarian cancer.

Adult↗
PubMed2000

Comparative study of ovarian cancer histopathology by registry pathologists and referral pathologists: a study by the Gilda Radner Familial Ovarian Cancer Registry.

OBJECTIVE: The aim of this study was to evaluate whether there is a significant difference in the pathology diagnoses of women in the Gilda Radner Familial Ovarian Cancer Registry between the two expert Registry pathologists and the referral pathologist. Inaccuracies in verification that ovarian cancer did occur in family members could lead to unnecessary prophylactic surgery or genetic testing. METHODS: A retrospective review was performed of (1) site of malignancy; (2) histopathology of malignancy; (3) grade of malignancy; and (4) the presence or absence of malignancy between the Registry and referral pathologists. RESULTS: There was 95.3% complete agreement between the Registry and the referral pathologist on site of origin with a major difference in only 1.0% of the cases. In comparison of histopathology, there was a 61.7% complete agreement, and only 1.0% were considered major differences. There was 68.8% complete agreement in grade of the malignancy, whereas 2.3% were considered major differences. CONCLUSION: When constructing a family pedigree, it is important to obtain pathology reports to confirm the index case diagnosis of the presence or absence of ovarian cancer. However, because of the small percentage of major differences in diagnosis between the two Registry pathologists and the multiple referral pathologists, we believe genetic counselors and treating physicians can rely, in most instances, on the original histopathology report of verification of ovarian cancer without review of the original histopathology slides when recommending surveillance, genetic testing, and/or prophylactic surgery.

Female↗
PubMed1997

Continuing medical education for pathologists: an evaluation of the Royal College of Pathologists' Wessex pilot scheme.

AIM: To discover the attitudes to continuing medical education (CME) of the Wessex pathologists who participated in the Wessex CME pilot scheme and to identify their preferences and difficulties in pursuing CME activities. METHOD: The views of pathologists in the scheme were collected during a period of one year using workshops and discussions. A confidential, anonymous postal questionnaire based on these issues was sent to the 103 pathologists in Wessex who participated in the pilot scheme. RESULTS: A 64% response rate was obtained. The respondents identified lack of time and funded study leave as major barriers to CME and highlighted the gap between CME activity and its recognition and funding by employers. They wanted a wide variety of locally based CME activities to be recognised, and they valued local activities that linked theory with practice. They believed that the college scheme tended to favour academic activities over more practical and locally based ones. They found the paired peer review process time consuming but valuable for identifying their learning needs in some cases, but demonstrated that they have mixed preferences about the way they do their CME. CONCLUSIONS: The Wessex pathologists believe that CME is important and have positive attitudes to it. Their attitudes to CME echo the current literature about what makes CME effective. Unless individuals' preferences and difficulties are taken into account, CME programmes in which they participate are not likely to succeed.

Attitude↗
PubMed1995

Pathologist-gastroenterologist interaction. The changing role of the pathologist.

The importance of interaction between clinicians and pathologists is examined in the setting of gastroenterology and gastrointestinal disease, and the importance of communication is emphasized. The endoscopist must provide the pathologist with information about the patient, including results of the gross examination, biopsy location, relevant clinical history, bowel preparation, and current medications. The pathologist must provide a reproducible and useful report that answers the clinical questions posed by the endoscopist. This consultation between the gastroenterologist and pathologist provides the framework for proper patient care.

Gastroenterology↗
PubMed2005

The Internet for pathologists: a simple schema for evaluating pathology-related Web sites and a catalog of sites useful for practicing pathologists.

CONTEXT: With the increasing popularity of the Internet as a primary medical information source, it is critical for pathologists to be able to use and evaluate both general medical- and pathology-related Web sites. Several published models for evaluating Web sites prove cumbersome to use and often involve computer- or statistic-based algorithms. OBJECTIVES: To develop a simple group of scoring criteria to objectively evaluate medical Web sites and provide a list of the highest-scoring pathology-related sites that will be useful to the practicing pathologist. DESIGN: Using 11 commonly used Internet search engines, the top 50 "hits" retrieved from the search term websites for pathologists were scored using 5 criteria, including accuracy, ease of navigation, relevance, updates, and completeness. A possible 6 to 12 points per area were awarded, and the total score was summated. RESULTS: Scores obtained ranged from 12 to 21. Thirty-five Web sites, all scoring 15 or higher based on these criteria, were listed as most useful. CONCLUSION: A simple, easy-to-use, 5-category scoring system can prove useful in evaluating pathology- and medical-related Web sites.

Evaluation Studies as Topic↗
PubMed1991

Antimicrobial susceptibility testing trends and accuracy in the United States. A review of the College of American Pathologists Microbiology Surveys, 1972-1989. Microbiology Resource Committee of the College of American Pathologists.

The ability of the College of American Pathologists Microbiology Surveys subscriber laboratories to perform antimicrobial susceptibility testing accurately has improved slightly since 1984. Currently (1989 surveys), the accuracies for disk diffusion and minimum inhibitory concentration antimicrobial susceptibility testing were 98.2% and 96.1%, respectively. Disk diffusion testing has recently (since 1986) become more popular, along with rapid automated systems, such as the AMS-Vitek System (St Louis, Mo). Rapid tests for beta-lactamase and chloramphenicol acetyltransferase have performed well. Quality control procedures have switched to a cost-effective weekly frequency pattern for nearly 70% of laboratories. Some antimicrobial susceptibility testing problems still exist among anaerobic bacterial methods, procedures for fastidious organisms (Haemophilus, Streptococcus species, Moraxella, pneumococci, gonococci), tests for oxacillin-resistant staphylococci, and the methods for use against nonenteric gram-negative or gram-positive bacilli. Antimicrobial susceptibility testing users subscribing to the College of American Pathologists surveys should strictly follow the National Committee for Clinical Laboratory Standards interpretive and quality control criteria to assure the best performance with the Clinical Laboratory Improvement Act, 1988, compliant College of American Pathologists proficiency sample program.

Bacteria↗
PubMed2004

Vocal fold nodule vs. vocal fold polyp: answer from surgical pathologist and voice pathologist point of view.

Vocal fold polyps and nodules are caused by inflammation caused by stress or irritation. Our study involved looking retrospectively at 30 patients. A clinical diagnosis was established by an otolaryngologist and voice pathologist through videostroboscopic analysis. Histological sections after removal of the vocal fold lesion were available for microscopic examination. All of these cases have also been previously evaluated and photographed. A clinical diagnosis of either a polyp or a laryngeal nodule have been made and documented. Two pathologists made the histological evaluation separately initially unaware of the clinical diagnosis. Their impression was recorded. After the clinical diagnosis become available and comparison between the clinical and pathological diagnosis were made, a retrospective review of the tissue was attempted to reconcile the differences. In conclusion, after careful histological evaluation, no definitive histological distinction can be made between laryngeal nodules and polyps. Our data showed no distinction between the two entities when compared for the presence of edema, fibrin, inflammation, and amyloid-like material. A statistically significant difference was found in the size of the specimen and the presence of telangiectasias. Based on our data, a biopsy larger than 0.3 cm could be a polyp and a biopsy less than 0.3 cm could be a nodule.

Diagnosis, Differential↗
PubMedDate not supplied

The pathologist's examination of the "lumpectomy"--the pathologists' view of surgical margins.

Despite the widespread conservative management of breast cancer, the pathologists' examination of these specimens is far from uniform. Pathologists sample margins differently, and even disagree on what constitutes a positive margin. This variability in the pathologic examination of the lumpectomy creates tremendous problems in analyzing the existing literature on the importance of positive margins. Herein is a discussion of the available data on the significance of margin assessment. We furthermore suggest a practical approach to examining margins with an emphasis on a functional orientation of the specimen with respect to the nipple. Only by adopting a uniform system of margin assessment can we begin to critically evaluate the importance of positive margins in segmental resections of the breast.

Biopsy↗
PubMed1995

A pathologist is as a pathologist does. Changing roles in a changing time.

Managed care challenges pathologists to a paradoxical cultural transition requiring clinical participation in the community while refining competitive managerial skills to maintain a livelihood. This presentation explores several role changes that a pathologist may undertake to acquire perceived clinical and economic value in a managed care system.

Economic Competition↗
PubMed2006

What does the urologist expect from the pathologist (and what can the pathologists give) in reporting on adult kidney tumour specimens?

OBJECTIVE: To identify the parameters required by the urologist to determine the prognosis and the treatment of renal cancer in adults, and to establish the potential therapeutic targets of the new treatments that started to show clinical efficacy. METHODS: A literature search of the last 10 yr was done, paying specific attention to TNM 2002 (UICC staging) and Fuhrman's grading. Also, the main genetic characteristics of the different subtypes (according to the WHO 2004 classification) with potential therapeutic implications have been compiled. RESULTS: After the review of the literature, the opinion of the joint meeting including urologists and pathologists is that some aspects of the TNM 2002 classification must be refined. Criteria for nuclear grading should be different for the subtypes of renal cell carcinoma, and the WHO 2004 histological classification is clinically useful. CONCLUSIONS: In the workshop held in Palermo, common opinion was achieved on a number of points. The TNM 2002 classification is useful, but some adjustments should be made, particularly as referred to the tumour size cut-off, assessment of the invasion of the renal sinus fat tissue, and invasion of the ipsilateral adrenal gland. The Fuhrman's grading system is useful in clear cell renal cell carcinoma (RCC), and probably also in papillary RCC, but a redefinition for chromophobe RCC is needed. Finally, the determination of certain markers, such as VEGF and HIF, could constitute good target markers for the new therapies, but they remain under investigation.

Carcinoma, Renal Cell↗
PubMed1998

The preoperative bleeding time test lacks clinical benefit: College of American Pathologists' and American Society of Clinical Pathologists' position article.

The major conclusions of this position article are as follows: (1) In the absence of a history of a bleeding disorder, the bleeding time is not a useful predictor of the risk of hemorrhage associated with surgical procedures. (2) A normal bleeding time does not exclude the possibility of excessive hemorrhage associated with invasive procedures. (3) The bleeding time cannot be used to reliably identify patients who may have recently ingested aspirin or nonsteroidal anti-inflammatory agents or those who have a platelet defect attributable to these drugs. The best preoperative screen to predict bleeding continues to be a carefully conducted clinical history that includes family and previous dental, obstetric, surgical, traumatic injury, transfusion, and drug histories. A history suggesting a possible bleeding disorder may require further evaluation; such an evaluation may include performance of the bleeding time test, as well as a determination of the platelet count, the prothrombin time, and the activated partial thromboplastin time. In the absence of a history of excessive bleeding, the bleeding time fails as a screening test and is, therefore, not indicated as a routine preoperative test.

Anti-Inflammatory Agents, Non-Steroidal↗