[Histonet] HTs. Grossing Larger spcimens, Kidneys etc and the CAP regulations

[anthony <@t> histotechexchange.com]

Dear All:

I am trying to find out the requirements by CAP for a HT to gross larger
specimens, such as whole kidneys and livers etc. This person has years of
experience but has not sat the ASCP PA exam.

The state requires no special training other than the OK from a
Pathologist and to be under his/her supervision.

I have looked at the cap guidelines amendments for 2006 and they state:

Are all macroscopic tissue examinations performed by a pathologist or
pathology resident, or under the supervision of a qualified pathologist?

I am leaning toward them being able to gross lots of stuff, if the
pathologist is satisfied with there competency) except for the specimens
requiring staging of cancer severity. Even this if they have the
experience and the pathologist is satisfied that the competency and
experience is there.


Am I wrong?
NOTE:  Two levels of complexity of macroscopic tissue examination are
defined, as follows:

ANP.11600             Phase II

1) Processing is defined as a tissue examination limited to description,
inking and cutting of the specimen (if applicable), and submission of the
entire specimen to histology.  Tissue processing can be performed
according to standardized protocols.  Processing is generally limited to
small specimens (skin ellipses, small biopsies, curettings, etc.) and does
not require knowledge of anatomy.

2) Grossing (or gross examination) is defined as a tissue examination
requiring a greater exercise of judgment and a knowledge of anatomy. 
Dissection of the specimen and selection of tissue samples for submission
to histology are generally required.  The specimen description is not
necessarily standardized.

Specific requirements for supervision of non-pathologists who process
specimens, or assist in grossing specimens, are given below.

COMMENTARY:

N/A
What is the difference between the requirements for the second class of
specimen?

ANP.11605             Phase II

When individuals other than a pathologist or pathology resident process
specimens, or assist in gross examinations, is the extent of their
activities (including the types of specimens examined) defined in a
documented protocol?

NOTE:  This protocol must list the specific types of specimens that
non-pathologists are permitted to process, and for which non-pathologists
are permitted to assist in the gross examination.  The laboratory director
is responsible for this protocol.


ANP.12350             Phase II

For specimens from definitive cancer resections, and in specific biopsies
as outlined in the CAP Cancer Protocols, are all scientifically validated
data elements needed for standard systems of grading, staging and
prognostication included in the pathology report?

NOTE:  The pathology report must provide data that, within the confines of
information available to the pathologist, is sufficient to allow
appropriate grading and staging of neoplasms according to standard
classification schemes.  Lists of the scientifically validated data
elements may be found in the CAP Cancer Protocols and Checklists.  The use
of these checklists is encouraged, but not required, providing that the
required data elements are present in the report.  The use of synoptic
diagnostic reports is recommended, to ensure that all information relevant
to staging and grading is included, and to facilitate interpretation of
pathology reports by clinicians.

COMMENTARY:

N/A

REFERENCE: College of American Pathologists.  Practicing Pathology: 
Cancer Protocols. 
http://www.cap.org/cancerprotocols/protocols/intro.html.



Yours truly,

Anthony Williams HT (ASCP)
Histotech Exchange LLC
19 Whitmore Street
Lexington, VA 24450
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