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Introduction

Our ability to solve a practical problem depends heavily upon finding the right information applicable to the problem. The intended primary function of this Web resource is to provide instructive information related to specific aspects of diagnostic surgical pathology, and to help the user quickly find information relevant to a specific problem. The information is organized, following routine work-flow in surgical pathology (i.e., tissue specimen handling, diagnosis formulation, and final pathology reports).

What should I do with a specimen? -- Specimen Exam (i.e. specimen gross examination)

Pathology diagnosis begins with specimen handling. Systematic examination and adequate sampling (i.e., "gross examination") are key determinants in correct and accurate diagnosis. Gross examination follows a set of rules and is a complex task. The "Specimen Exam" is a widely used grossing manual that contains practical guidelines and specific information for the task.

How to generate pertinent differential diagnoses? -- Quick diagnostic guide

Generating a concise list of tentative differential diagnoses is an early key step in pathology diagnosis. Many beginners are faced with this hurdle and feel helpless despite abundant information on the Internet and in textbooks. This section introduces a useful and practical strategy to circumvent this dilemma. It is based on the Pareto principle (also known as the law of vital few) that in a given organ or anatomic location, a small number of diseases (usually <10) accounts for over 80% of the commonly encountered diagnoses. This section lists, by each organ site, these essential diagnoses with their key diagnostic features. It will allow users to handle the great majority of cases and help them become a functional learner in daily practice.

How to correctly formulate my diagnosis? -- Dx. Wording and Tumor Reporting

A correct diagnosis inadequately or incorrectly conveyed can be as dangerous and harmful as a wrong diagnosis. The skill to formulate diagnoses seems largely neglected in scholarly publications and not adequately emphasized in our training. Although it is impossible and unwise to impose rigid formulas or styles for reporting diagnoses, some general guidelines should be followed. The goal of the "Diagnostic Wording" section is to introduce some of these guidelines and commonly-used diagnostic wording formats and styles.

On the other hand, structured tumor reporting has been included in the mandate by The American College of Surgeons Commission on Cancer [ACS-CoC] for its accreditation. Checklists and protocols posted by College of American Pathologists (CAP) and Association of Directors of Anatomic and Surgical Pathology (ADASP) list essential data elements to be included in pathology reports of malignant neoplasms. Our "Tumor Reporting" system is designed to facilitate the reporting process in compliance with the mandate by ACS-CoC .

Can I make diagnoses like an expert diagnostician? -- Diagnosis by Pattern Recognition

In almost all textbooks in medicine, information is organized by organ system and then by the type of disorder. To find relevant information about a specific disorder, one has to know the diagnosis first, using a “diagnosis-to-attributes” sequence. In problem-solving clinical practice, we follow an exact opposite sequence of process, starting with clinical information and morphological findings to reach the final diagnosis (i.e. an “attributes-to-diagnosis” sequence). The textbooks thus offer little help and require a lot of guesswork of possible diagnoses. Therefore, the clinical scenario calls for the development of a diagnostic tool that can assist diagnoses based on clinical and morphological findings. The computer-assisted diagnostic expert system (CADES) is designed to achieve this goal. A disease or diagnosis is characterized by a unique constellation of clinical (morphological) findings and biological behavior, forming a diagnostic pattern. The "Diagnosis by Pattern" on this web site represents a prototype of such CADES with a focus on neoplastic disorders.