[Histonet] Submission of tonsils to Pathology - #2

[Linda Margraf]

Richard;
Our children's Hospital (Children's Medical Center Dallas where I am the lab's Medical Director) made tonsils exempt from required pathologic examination 8 or so years ago following approval of the medical and surgical staff.  We now only receive tonsils the surgeons are concerned about (transplant patients, asymmetric lesions etc.).  Our surgical case accession numbers dropped by about 800 as a result of this but we do feel we are doing what's most cost effective yet beneficial to the patient.  We get one or two cases a week now. We have about 15 other items on our list of specimens that are exempt from pathologic review.  It is important to have the pathologists work with the clinicians to generate the list of tissue specimens that don't need to come to pathology.  
Linda M
Histonet administrator	

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Richard Cartun
Sent: Friday, June 03, 2011 11:41 AM
To: Histonet
Subject: [Histonet] Submission of tonsils to Pathology - #2

I apologize; I should have stated my question differently.  Our Children's Hospital wants to stop sending tonsils to Pathology unless the surgeon requests pathological examination.  An article published in Otolaryngology-Head and Neck Surgery (Nelson et al.) concluded that pathologic examination of tonsils is not a cost-effective use of limited health care resources.  "Zero cases of unsuspected pathology were identified on planned gross specimen evaluation (n=4186) and positive pathologic findings on microscopic analysis (n=1066) were only identified in post-transplant patients."

Have any of you exempted tonsils from submission to Pathology?  If not, maybe we should.

Richard

Richard W. Cartun, MS, PhD
Director, Histology & Immunopathology
Director, Biospecimen Collection Programs
Assistant Director, Anatomic Pathology
Hartford Hospital
80 Seymour Street
Hartford, CT  06102
(860) 545-1596 Office
(860) 545-2204 Fax



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