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Introduction: The diagnosis of lymphoproliferative disorders (LPDs) is based on histological evaluation of representative tissue samples. Despite surgical excision biopsies (SEBs) are reference procedures for such diagnoses, lymph node core needle biopsies (LNCBs) are increasingly performed. The diagnostic yield of LNCB is, however, debated and few studies have compared the reproducibility of LNCB and SEB findings. Methods: To address the diagnostic value of LNCB and SEB, the present study considered a retrospective series of 43 paired LNCB/SEB samples. After histological revision, concordance rates between matched LNCB/SEB samples were evaluated, assuming SEB as gold standard procedure. The actionability of LNCB and SEB‐based diagnoses (i.e., relevance for planning further medical interventions) was also assessed. Results: Overall, LNCB provided actionable diagnoses in 39/43 (90.7%) cases, but a consistent subset of them (7/39 [17.9%]) turned out to be wrong at SEB. The cumulative diagnostic inaccuracy of LNCB (i.e., inadequate samples plus wrong diagnoses) was 25.6% and the mean diagnostic delay in such cases was 54.2 days. Conclusions: Although limited by selection biases due to its retrospective nature, this study highlights the intrinsic limitations of LNCB for the diagnosis of LPDs. SEB remains the gold standard procedure and should be performed in all suitable cases. [ABSTRACT FROM AUTHOR]

Since cardiac hypertrophy may be considered a cause of death at autopsy, its assessment requires a uniform approach. Common terminology and methodology to measure the heart weight, size, and thickness as well as a systematic use of cut off values for normality by age, gender, and body weight and height are needed. For these reasons, recommendations have been written on behalf of the Association for European Cardiovascular Pathology. The diagnostic work up implies the search for pressure and volume overload conditions, compensatory hypertrophy, storage and infiltrative disorders, and cardiomyopathies. Although some gross morphologic features can point to a specific diagnosis, systematic histologic analysis, followed by possible immunostaining and transmission electron microscopy, is essential for a final diagnosis. If the autopsy is carried out in a general or forensic pathology service without expertise in cardiovascular pathology, the entire heart (or pictures) together with mapped histologic slides should be sent for a second opinion to a pathologist with such an expertise. Indication for postmortem genetic testing should be integrated into the multidisciplinary management of sudden cardiac death. [ABSTRACT FROM AUTHOR]

Im Jahr 2004 gaben die Deutsche Gesellschaft für Pathologie (DGP) und der Bundesverband Deutscher Pathologen (BDP) den Startschuss zur Qualitätssicherungs-Initiative Pathologie (QuIP). Die QuIP bietet eine ganzheitliche Qualitätssicherung: Die beginnt mit Pilotverfahren und ausgewählten Instituten bei neuen Biomarkern und überführt diese in wiederkehrende Ringversuche für die tägliche Routinearbeit. Außerdem entwickelt die QuIP Infoportale zu Scores, Cut-offs und Therapieoptionen bei verschiedenen Markern. In der Vor- bzw. Nachbereitung der Ringversuche führt die QuIP Online- und Präsenzseminare durch – ein Zyklus, der immer wieder neu Schulungsbedarf identifiziert und dazu Qualifikationserwerb anbietet. Das Konzept des Qualitätssicherungs-Monitors wird derzeit für den Biomarker PD-L1 angeboten. PathologInnen wird der Abgleich der persönlichen Ergebnisse im Vergleich mit dem fachlichen Umfeld ermöglicht (Benchmarking). Damit liegt ein umfassendes Qualitätskonzept in Europa vor – QuIP steht somit für Quality in Pathology. [ABSTRACT FROM AUTHOR]

Since cardiac hypertrophy may be considered a cause of death at autopsy, its assessment requires a uniform approach. Common terminology and methodology to measure the heart weight, size, and thickness as well as a systematic use of cut off values for normality by age, gender, and body weight and height are needed. For these reasons, recommendations have been written on behalf of the Association for European Cardiovascular Pathology. The diagnostic work up implies the search for pressure and volume overload conditions, compensatory hypertrophy, storage and infiltrative disorders, and cardiomyopathies. Although some gross morphologic features can point to a specific diagnosis, systematic histologic analysis, followed by possible immunostaining and transmission electron microscopy, is essential for a final diagnosis. If the autopsy is carried out in a general or forensic pathology service without expertise in cardiovascular pathology, the entire heart (or pictures) together with mapped histologic slides should be sent for a second opinion to a pathologist with such an expertise. Indication for postmortem genetic testing should be integrated into the multidisciplinary management of sudden cardiac death., (© 2021. The Author(s).)