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February 2016

Bladder cancer preps for its star turn

February 2016—A streak of sibling rivalry emerges when experts ponder progress in the field of bladder cancer. Whether it’s new markers or therapies, funding or advocacy, advances have come slowly, and the disease has long labored in the shadow of others. “Urologic malignancies in general lag behind, compared to breast cancer and other tumor types, like colon and lung, where we’ve been envious for a while,” says George Netto, MD, professor of pathology, urology, and oncology and director of surgical pathology molecular diagnostics, Johns Hopkins University School of Medicine.

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Community hospitals keep time on tissue handling

February 2016—The great promise of genomics and actionable cancer biomarkers relies on cancer tissues being handled in the right way so they are suitable for study. Reducing cold ischemia time and the total time that biospecimens spend in formalin is key to the process, say guidelines from the CAP and the American Society of Clinical Oncology on HER2 and on estrogen receptor and progesterone receptor testing in breast cancer specimens.

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Non-melanocytic lesions—preventing pitfalls in diagnosis

February 2016—Musician Lauryn Hill has been quoted as saying, “Reality is easy. It’s deception that’s the hard work.” That viewpoint just might resonate with pathologists who sometimes have to diagnose deceiving-looking skin lesions. In a talk at CAP ’15, Deborah L. Cook, MD, professor of pathology and director of dermatopathology at the University of Vermont, shared several case examples that illustrate that investigative effort. All of them involve non-melanocytic malignancies known to mimic benign entities and the converse—“the proverbial wolf in sheep’s clothing” and “sheep in wolf’s clothing,” as she puts it.

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Clinical Pathology Abstracts, 2/16

February 2016—Link between a liberal transfusion strategy and patient survival: Guidelines support using a restrictive strategy for blood transfusion management in various clinical settings. However, randomized controlled trials in cardiac surgery, oncology, and hip fracture surgery suggest that a more liberal transfusion strategy may benefit survival.

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Anatomic Pathology Abstracts, 2/16

February 2016—Subtype classification of lung adenocarcinoma in patients undergoing complete resection: The classification for invasive lung adenocarcinoma by the International Association for the Study of Lung Cancer, American Thoracic Society, European Respiratory Society, and World Health Organization is based on the predominant histologic pattern—lepidic, papillary, acinar, micropapillary, or solid—present in the tumor.

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Newsbytes, 2/16

February 2016—IT staffing considerations for the NGS laboratory: For the past five years, the University of Washington Department of Laboratory Medicine has been expanding its next-generation sequencing capabilities, adding the latest technologies and offering new tests in genetics, cancer, and infectious disease—and honing its information technology staffing skills along the way.

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Q&A column, 2/16

February 2016— I am a practicing board-certified pathologist and I have one cytotechnologist to screen Pap tests. She is moving to another city, and I must decide whether to send all Paps to a reference laboratory or to another lab just for screening and then returned to me for sign-out of normal and abnormal Paps.

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