CAPcast from the College of American Pathologists

Supporting the platelet transfusion needs of refractory patients is very resource intensive. These patients present numerous challenges for all clinical providers, including pathologists, because they typically have multiple comorbidities, are receiving multiple medications, and given the low platelet count, are at risk for bleeding. Because of the suboptimal response to platelets, these patients...

Evolving regulatory guidance, changing reimbursement rules, staffing shortages and other concerns are creating more challenges for laboratory leaders. The latest edition of the Laboratory Administration for Pathologists (https://capatholo.gy/2F1uLzT) provides laboratory managers with practical knowledge to identify situations which could lead to sanctions as well as strategies to improve their lab...

Practicing pathologists continue to be vexed by issues that are related to payment for the services that they provide. However, better understanding the payment structure will enable pathologists to examine their own practices and adapt to reimbursement changes. In this CAPcast, Dr. Jonathan Myles, a member of the CAP Board of Governors and an expert on pathology reimbursement policies, discusses...

Since pathologists have oversight responsibility for testing, they should be involved in the pre-analytic and post-analytic phases of testing, as well as optimizing the analytic phase, to deliver the highest quality of care to our patients. In addition, pathologists are often leaders in the hospital and healthcare setting, where the cost of care delivery is scrutinized. Pathologists are in a uniqu...

Genitourinary (GU) neoplasia is a continuously evolving diagnostic area and GU cases are among some of the most common diagnoses in today’s practice. In this CAPcast, Dr. Donna Hansel will discuss recent guideline changes and advancements in this pathology specialty. Dr. Hansel will be one of the faculty members teaching a day-long course on GU pathology at CAP19 in Orlando, Florida. Her co-facult...

Pathology practices are entering a new value-based payment era and the ability to successfully demonstrate contributions to the quality of care provided will likely have a significant impact on their ability to positively impact their own reimbursement in the Merit-based Incentive Payment System, also known as MIPS. The Centers for Medicare & Medicaid Services (CMS) has finalized several changes t...

Thyroid nodules are a common source of diagnostic difficulties for practicing pathologists. The correct diagnosis of these nodules is often difficult given some of the controversies associated with their interpretation and evolving criteria for diagnosis. In this CAPcast, Dr. Saul Suster discusses controversial areas in thyroid nodule interpretation and recent changes in terminology for papillary...

Advances in minimally invasive thoracic sampling techniques allow pathologists and laboratories to perform multiple ancillary studies on small biopsy and cytology specimens. But with small specimens, ensuring optimum diagnostic yield and judicious triaging of these limited volume samples to perform an ever-growing list of ancillary studies is a challenge, according to Dr. Sinchita Roy-Chowdhuri. I...

Endometrial biopsy is amongst the most frequent specimens evaluated by pathologists. But difficulties in interpretation of findings and the presence of common morphologic mimics, including metaplastic and reactive changes, may lead to misdiagnosis, with important consequences for patient management. In this CAPcast, Dr. Ricardo Lastra discusses the common pitfalls in diagnosis as well as classific...

Colorectal carcinoma remains the most common gastrointestinal malignancy and a common cause of morbidity and mortality. Pathologists are seeing considerable change in the diagnosis, testing, and reporting of colorectal carcinoma. In this CAPcast, Dr. Raul S. Gonzalez will discuss three common areas of concern related to stains, deposits and buds as well as the recent publication of the Internation...

Colon biopsies, especially polyps, are the bread and butter of many pathologists and issues surrounding these specimens are not uncommon. In this CAPcast, Dr. Lysandra Voltaggio discusses issues and challenging diagnoses as it pertains to colon polyps. Dr. Voltaggio is teaching a course on this topic at CAP19; learn more and register at www.capannualmeeting.org.

Registration is now open for the CAP’s annual meeting, CAP19, which will be held Sept. 21-25 in Orlando, Florida. In this CAPcast interview, Dr. Jennifer Hunt, Chair of Pathology and Laboratory Medicine at the University of Arkansas for Medical Sciences, discusses the rich career and educational opportunities at this annual event. Learn more and register for #cap19ORL: https://www.capannualmeeting...

Immunotherapy targeting the PD-1/PD-L1 pathway represents a new therapeutic paradigm and a promising treatment option for advanced non-small-cell lung cancers, melanoma, and more recently, gastric and gastroesophageal carcinomas. As the role of PD-L1 IHC testing in the diagnostic work-up of solid tumors continues to expand, practicing pathologists are playing an increasingly larger role in test se...

Because pathologists confront informatics problems on a regular basis, it’s critical for them to effectively diagnose and treat common informatics problems in partnership with other clinical providers, hospital/client leadership, IT staff, and laboratory staff. In this CAPcast, Dr. John Sinard discusses common process and technology-based informatics issues and how pathologists can develop clinica...

Pathology systems such as digital microscopy, laboratory instruments, middleware, LIS, and EHR are starting to incorporate components based on machine learning and artificial intelligence. However, pathologists are poorly equipped to verify the quality of performance of the various digital pathology and other laboratory systems other than by using documents provided by the system vendors, accordin...

The paradigm for prostate cancer treatment is evolving. While there is an increasing desire to manage low-risk cancers without aggressive treatment, there is also a need to identify high-risk cancers and treat appropriately. In this CAPcast interview, Dr. Sean Williamson, a surgical pathologist from the Henry Ford Health System, discusses the diagnostic challenges of evaluating prostate biopsies,...

Soft tissue pathology—it can be a challenging area of specialty for many general pathologists. In this CAPcast, Dr. Jerad Gardner discusses the common pitfalls and benign mimics that pathologists are most likely to encounter, as well as how to navigate the many ancillary tests available for soft tissue lesions. Dr. Gardner will be teaching a course on this topic at CAP19, which will be held Sept....

Maximizing patient safety and reducing diagnostic errors is rooted in a quality management approach. The manual Quality Management in Anatomic Pathology (https://capatholo.gy/2UNJ9lk) provides pathologists and laboratory directors with the tools necessary to implement a comprehensive quality program, with an emphasis on regulatory compliance and cross-references to the CAP Laboratory Accreditation...

Clear, concise communication is required in all pathology practices with many constituencies, such as colleagues, clinicians, staff, nurses, administrators, and patients. But effective communication with all these audiences may be difficult. In addition, conventional modalities such as meetings, conference calls, written communications, and emails may have limited effect or may be used inappropria...

Injuries to patients or laboratory staff due to unsafe conditions can result in unwanted publicity, adverse accreditation decisions, and damage to the pathologist’s professional reputation. Pathologists who recognize and correct unsafe conditions are less likely to be involved in related court proceedings, according to Dr. Richard Scanlan, who will be teaching a course on this topic later this yea...

Throughout his pathology training, Dr. Richard Owings thought that finding a job would be the hardest part of transitioning from a trainee to new-in-practice pathologist. But after signing a contract with his current employer, he soon realized he had a lengthy punch list to complete before he started his new job. Dr. Owings outlines some of the challenges during this transition period in a recent...

According to Dr. Nicole Riddle’s recent article on CAP.org, whether you’re starting a new job or vying for a raise or promotion, you should always be negotiating. Research has shown that that only about 20% of people always negotiate their salaries while up to 40% never do. Dr. Riddle’s article on this topic, titled “Working Hard for the Money: The Importance of Salary Negotiation,” is now posted...

If you are a new-in-practice pathologist in your first job, it’s important to prove yourself early in your career, because a good impression sets you up for success down the road, according to Dr. Joshua Hanson, who recently wrote a blog on this topic, which is now posted on CAP.org: https://capatholo.gy/2B2wl2Q. In this CAPcast interview, Dr. Hanson, who is an attending surgical pathologist at th...

Morphologic examination by light microscopy remains an integral part of initial histopathologic assessment for hematolymphoid neoplasms; however, a variety of laboratory techniques are now being used to optimize diagnostic information in the appropriate clinical context. For diagnosing myeloid disorders and acute myeloid leukemia, one approach is to utilize an next gen sequencing panel and DNA-bas...

Because pathologists are integral to patient care, they can contribute significantly to preventing and reducing medical error. Understanding causes of patient safety errors is the first step in developing and implementing programs to reduce their occurrence, according to Dr. Deborah Sesok-Pizzini, editor of the book, Patient Safety in Anatomic & Clinical Pathology Laboratories (https://capatholo.g...