CAPcast from the College of American Pathologists

By the end of 2019, the CDC had reported over 2,000 hospitalizations and over 60 confirmed deaths due to vaping associated lung injury. While research into the pathology of vaping-associated lung injury is in its early phases, Dr. Brandon Larsen and his pathology colleagues at the Mayo Clinic published research in the New England Journal of Medicine in early October (https://www.nejm.org/doi/full/...

Adding ultrasound fine needle aspiration or USFNA to your practice’s diagnostic menu can provide a more thorough sampling of a palpable nodule than when using manually-directed sampling. The CAP’s USFNA Advanced Practical Pathology program provides hands-on training to allow pathologists to add a new dimension to their practice, as Dr. Susan Rollins explains in this CAPcast. The course will be hel...

Pathologists have been at the forefront of efforts to understand why vaping causes severe lung illness in some individuals, and the nature of the injury that is caused by vaping. In this CAPcast interview, Dr. Timothy Allen, Chair of Pathology at the University of Mississippi Medical Center, discusses what pathologists currently know about the impact of vaping on lungs. The CAP strongly opposes va...

The Color Atlas of Mycology (https://capatholo.gy/2FrMobZ) is an up-to-date resource designed to assist pathologists and medical technologists in the laboratory identification of fungi using the most recent taxonomic classifications. In addition, because the book includes more than 15 years of proficiency testing data, it helps pathologists and laboratory professionals better identify medically-im...

Leading a laboratory involves both technical knowledge and softer skills: technical knowledge of testing and accreditation is needed along with the ability to manage people, perform risk assessment, and deal with finances and budgeting. Many pathologists leave training with the required technical knowledge but sometimes lack training and confidence in the “softer” skills. The CAP’s Laboratory Medi...

While many hospitals don’t frequently activate massive transfusion protocols (or MTPs), these events may be stressful and confusing for laboratory personnel. And because of the low frequency of MTP activation without designated trauma centers, there may be confusion as to the appropriate laboratory protocol, explains Dr. Alexis Peedin in this CAPcast. Dr. Peedin helped lead the development of a Cl...

The CAP Policy Roundtable conducts the Practice Characteristics Survey (https://capatholo.gy/2KTjqoK) every other year to gather data that pathologists can use to understand how their practice compares to others, and how pathologists are dealing with current health care trends and the changing business environment. The CAP also uses the data gathered to set advocacy priorities and understand marke...

The laboratory and pathologist play an essential role in the diagnosis of hemophagocytic lymphohistiocytosis or HLH. The pathologist’s morphologic diagnosis as well as direction to appropriate additional testing are truly essential for patient care, explains Dr. Megan Nakashima in this CAPcast. Dr. Nakashima also helped developed a course on this topic as part of the CAP’s Clinical Laboratory Impr...

In recent years, biobanking has become increasingly vital to furthering the promise of precision medicine. However, academic, government and commercial biobanking operations have also come under increased pressure to balance their budgets and plan for long-term sustainability in the face of budget shortfalls and increased competition for limited research funding. As one of the primary medical spec...

Protein electrophoresis is commonly ordered for patients with suspected or known plasma cell disorders. Pathologists may sometimes be unsure of the sequence in which tests should be ordered when evaluating for a plasma cell neoplasm, and it’s important to understand the utility and the limitations of each test, and its unique role in arriving at an accurate conclusion. In this CAPcast, Dr. Diana D...

Acute promyelocytic leukemia (APL) with PML-RARA is a true clinical emergency. Due to the rapid onset of this disease and rapid deterioration of the patient, it is important for pathologists to quickly and accurately identify APL, explains Dr. Juli-Anne Gardner in this CAPcast. Dr. Gardner developed a Clinicial Pathology Improvement Program or CPIP course on this topic (https://capatholo.gy/2Zw1tk...

MAHA is a nonimmune condition characterized by hemolytic anemia either due to abnormalities in the microvasculature or to intravascular devices that lead to fragmentation of the red blood cells. When MAHA is combined with thrombocytopenia, it is referred to as thrombotic microangiopathy (TMA). Pathologists may get requisitions for peripheral blood smear review that say “rule out MAHA”, explains he...

This year’s CAP annual meeting features 25 new courses and a diverse portfolio of programs that are central to daily practice. As chair of the CAP Curriculum Committee, Dr. Sarah Bean leads a multi-disciplinary group of pathologists through the rigorous process of reviewing and selecting the educational courses presented at the annual meeting. In this CAPcast, Dr. Bean discusses the key offerings...

Dr. Husain Sattar, a well-known pathology educator to medical students, provides insights as to what a pathologist does, his story on why he chose the specialty of pathology, and advice he would give to medical students interested in exploring pathology.

Statistical quality control or QC is a fundamental part of clinical laboratory practice; it assures that methods are performing at their usual level. Laboratories can make two main types of errors in selecting QC rules: too tight or too loose and both have ramifications, explains CAP inspector Dr. Robert Dufour in this CAPcast. If control limits are set too tight, time and money will be spent eval...

The CAP’s annual meeting, CAP19, is about knowledge, relationships and expertise. Held Sept. 21-25, CAP19 courses are designed to help you learn today and apply tomorrow when you return to your institution, particularly if you are a pathology resident, explains Dr. Adam Booth, Chair of the CAP Resident Forum Executive Committee. In this CAPcast, Dr. Booth outlines the key benefits at CAP19 for res...

Whether a pathologist has future aspirations or feels panic stricken with new responsibilities, those who are managing a practice will need to understand payment models, budgeting concepts, practice operations, and cost structures to maximize income, explains pathologist Dr. Andrea Volk, a graduate of the CAP's Practice Management Fundamentals Workshop, which will be taking place August 17-18 (htt...

Biorepositories are responsible for maintaining specimen integrity over long periods of time. Ensuring that specimens are stored at temperatures appropriate for their intended use is a critical component to ensuring their quality. While storage units are typically equipped with primary and secondary temperature monitoring probes, these probes often only provide a temperature sampling of one small...

Many parasites are considered “tropical diseases” so depending upon where you are in the world, you may not have a chance to diagnose parasitic infections with any degree of frequency. But maintaining ongoing competency in making an accurate diagnosis of a parasitic infection can therefore be challenging, explains UK Medicine pathologist Dr. Julie Ribes in this CAPcast. Dr. Ribes will be leading a...

Not only is Dr. Barbarajean Magnani a world-renowned pathologist specializing in toxicology, she is also a novelist. And just in time for the summer reading season, Dr. Magnani has released her second book featuring the brilliant—yet complex—physician Dr. Lily Robinson, who has an encyclopedic knowledge of all toxins and poisons, as well as a penchant for stilettos. In this new book, entitled The...

Pathologists could lose, or gain, $2.1 billion over seven years in Medicare’s new quality payment programs. This represents the difference between pathologists gaining the full possible Medicare payment bonuses or receiving the payment penalties. Pathologists need to understand Medicare’s merit-based incentive payment system (MIPS) program as it relates to reducing the burden of participating, und...

Highly sensitive next-generation sequencing-based assays have driven a rapid expansion of gene-disease associations for a diverse group of segmental overgrowth syndromes. In this CAPcast, Dr. Jonathan Heusel, a pathologist at the Washington University School of Medicine in St. Louis, discusses the medical director’s role in selecting both the appropriate assays and the reference laboratories to en...

Pathologists frequently evaluate peripheral blood smears for lymphocytosis or the presence of abnormal lymphoid cells. In this CAPcast, Dr. Kyle Bradley discusses benign and malignant lymphoproliferative disorders, which is the topic of a course he is teaching at CAP19, which will be held Sept. 21-25 in Orlando, Florida. Learn more and register for CAP19: www.capannualmeeting.org.

Pathologists can help improve patient care by staying up to date on the most recent recommendations on genomic testing for solid tumors, which can be a challenge since this information changes frequently. In this CAPcast, Drs. Leilani Valdes and Sophia Yohe discuss some of the key changes in genomic testing for oncology specimens, as well as how changing cancer treatment paradigms are changing the...

Practice Management skills such as budgeting, cost forecasting, and understanding payment models are not concepts taught in medical school. But pathologists need to develop and master these skills in order to advance their careers and manage a pathology department or practice, according to Dr. Robert L. Breckenridge, the Southwest Regional Medical Director for Quest Diagnostics. Dr. Breckenridge i...