Evaluation of suspected malignancies: Difference between revisions
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File:Histopathology of typical micropapillary urothelial carcinoma infiltrating the lamina propria - crop.jpg|If unsure whether a case is true lymphovascular invasion or a retraction artifact (imaged), use immunohistochemistry for D2-40 to highlight lymphatic vessels or CD-31 for blood vessels. | File:Histopathology of typical micropapillary urothelial carcinoma infiltrating the lamina propria - crop.jpg|If unsure whether a case is true lymphovascular invasion or a retraction artifact (imaged), use immunohistochemistry for D2-40 to highlight lymphatic vessels or CD-31 for blood vessels. | ||
</gallery> | </gallery> | ||
==Molecular workup== | ==Molecular workup== | ||
Ensure that any cancer undergoes reflex testing where applicable by local guidelines. Send samples according to requirements and guidelines for each test. For molecular proliferation tests (other than [[immunohistochemistry]]) such as Ki67, avoid samples with previous biopsy site or inflammation (as these will cause a false high proliferation | Ensure that any cancer undergoes reflex testing where applicable by local guidelines. Send samples according to requirements and guidelines for each test. Generally, choose the block with the greatest amount/area of the highest grade malignancy. For molecular proliferation tests (other than [[immunohistochemistry]]) such as Ki67, avoid samples with previous biopsy site or inflammation (as these will cause a false high proliferation rates). On the other hand, for next-generation sequencing, hemorrhage, necrosis and adipose tissue does not need to be minimized, as these contain only little genetic material. | ||
==Reporting== | ==Reporting== | ||
[[File:Histopathology of pancreatic adenocarcinoma with treatment effect.jpg|thumb|Also note "treatment effect", seen as fibroelastotic tissue, here with scattered remaining tumor cells.]] | |||
{{CAP}} If there is no CAP synoptic available for the cancer type at hand, attempt to find one in the latest AJCC Cancer Staging Manual (see the [[Secrets]] article), but make sure to use pathologic staging (with a p preceding the T, N or M) rather than clinical staging. | {{CAP}} If there is no CAP synoptic available for the cancer type at hand, attempt to find one in the latest AJCC Cancer Staging Manual (see the [[Secrets]] article), but make sure to use pathologic staging (with a p preceding the T, N or M) rather than clinical staging. | ||