General guidelines for microscopic evaluation and for making pathology diagnoses:

The purpose of the microscopic evaluation is to provide a diagnosis, as well as an evaluation of the severity and
extent of the disease process.

Microscopic examination of the tissues requires great attention and focus, not too different from an air-flight
controller. There should no extraneous sounds or distractions. The pathologist should be well rested and seated
comfortably for viewing the slides.

Great caution should be exercised to ensure that the slides being evaluated belong the patient for whom the
diagnosis is being read, and that the diagnoses are entered under the correct patient record.

Patient's clinical information and gross findings should be reviewed prior to the review of slides. Any prior data that
may be in the pathology information system should also be looked at. In difficult cases, a call to the clinician may
reveal clinical history that may not be provided with the submitted specimen, such as a prior diagnosis of a
malignancy.

Each slide should be reviewed at 1x, ie with the naked eye, before putting it under the microscope. There are cases
where the most important information is in fragments at the edge of a slide.

It is important that the pathologist be aware of the criteria used for arriving at various diagnoses and of the
differential diagnostic considerations. Books and journal publications should be consulted in difficult cases, and if
warranted, an expert in the particular field may be consulted.

The pathologist should be aware of the possibility of more than one diagnosis in some cases, and the possibility of
the presence of unexpected findings, such as a focal carcinoma on the ovarian surface form a patient with uterine
leiomyomata.

Special stains, immuno-stains, and other techniques should be used as necessary to support or arrive at the
diagnoses.

At times it may be necessary to go back to the specimen to obtain additional sections, either to evaluate a difficult
case, or if the initial sections are inadequate for other reasons. At other times, deeper levels in the prepared blocks
may reveal hidden information.

Those diagnoses where the patient needs immediate attention of her physician should be called-in to the physician.
Unusual diagnoses should be discussed with the clinicians to avoid misunderstanding.

Home.


Copyright 2005-9 Interactive eDiagnosis LLC All rights reserved
EZ Final Diagnosis