Cellular Pathology Audit Template: (To Be Inserted When Completed) (To Be Inserted)

Cellular pathology audit template
Date of (To be inserted when completed)

completion
Name of lead (To be inserted)

author/
participants
Specialty Cellular pathology/paediatric pathology
Title An audit of peripheral neuroblastic tumours reporting standards

Background Datasets published by the Royal College of Pathologists define the core data
items that are to be included in the histology reports of different cancers to ensure
all necessary data is provided.
In May 2019, the Dataset for histopathological reporting of peripheral neuroblastic

tumours (2nd edition) was published, which states the core data items to be
included when reporting peripheral neuroblastic tumours.
Aim & 1. To determine whether the data items defined in the Dataset for
objectives histopathological reporting of peripheral neuroblastic tumours are being
included in histopathology reports for diagnostic biopsies/pre-treatment
tumour resections.
2. To determine whether the data items defined in the Dataset for
histopathological reporting of peripheral neuroblastic tumours are being
included in histopathology reports for post-treatment tumour resections.
3. To determine whether the data items defined in the Dataset for
histopathological reporting of peripheral neuroblastic tumours are being
included in histopathology reports for trephine biopsies.
Standards & Criteria range: 100% or, if not achieved, there is documentation in the case
criteria notes that explains the variance.
The agreed standards: each core data item stated in the dataset should be
included in the histopathology report.
Method Please note the audit covers three specimen types:
1. diagnostic biopsy/pre-treatment tumour resection
2. post-treatment tumour resection
3. trephine bone biopsies.
Sample selection:
 Retrospective selection of all cases for a specified time period.
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 Review of the histopathology reports of peripheral neuroblastic tumours on
laboratory information system.
 Record whether the data items outlined below are/are not included in each
report.
Data to be collected on proforma (see below).

Results (To be completed by the author)
The results of this audit show the following compliance with the standards:
Core data items % compliance

Clinical
Site of specimen stated (1, 2, 3)
Pre- or post-treatment recorded (1, 2, 3)
Site(s) of separate lymph nodes recorded (1, 2)
Macroscopic
Type and size of specimen stated (1, 2, 3)
Fresh tissue for genetic studies taken – yes or no
(1)
Number of nodules present and nodular variant
subtype stated (1, 2)
Lymph nodes attached stated – yes or no (1, 2)
Adequate bone marrow trephine biopsy stated –
yes or no (3)
Microscopic
International Neuroblastoma Pathology
Classification (INPC) tumour category stated
(diagnostic biopsy/pre-treatment resection only) (1)
Neuroblastoma grade of differentiation stated (1)
Immunohistochemistry profile stated positivity for
one or more of the commonly used neural markers
(PHOX2B, synaptophysin, NSE, PGP9.5) if
morphology on H&E is equivocal (1, 2).
In unequivocal cases state N/A.
Necrosis stated (if present) – yes or no (1, 2)
Calcification stated (if present) – yes or no (1, 2)
Lymph node metastases stated – yes or no (1, 2)
Site(s) of positive node(s) stated – yes or no (1, 2)
Site(s) of negative node(s) stated – yes or no (1, 2)
Trephine biopsy: at least six sections examined
Immunohistochemistry utilised two neuroblastoma
antibodies
Trephine bone biopsy: presence or absence of
bone marrow infiltration recorded, including

percentage involvement (left and right)
Trephine bone biopsy: neuroblastoma
differentiation recorded
SNOMED CT codes or SNOMED T and M codes
recorded
Commentary:
It is recommended to include results of all the molecular genetics findings on the

tumour that are available to the reporting pathologist.
Conclusion (To be completed by the author)
Recommend- Present the result with recommendations, actions and responsibilities for action,
ations for and a timescale for implementation. Assign a person(s) responsible to do the
improvement work within a timeframe.
Some suggestions:
 highlight areas of practice that are different
 present findings.
Action plan (To be completed by the author – see attached action plan proforma)
Re-audit date (To be completed by the author)
Reference Cullinane C, Shukla R, Stahlschmidt J. Dataset for histopathological reporting of

peripheral neuroblastic tumours (2nd edition). London, UK: The Royal College of
Pathologists, 2019.
www.rcpath.org/profession/guidelines/cancer-datasets-and-tissue-pathways.html

Data collection proforma for core items in peripheral neuroblastic tumour reports
Audit review practice
Patient name:
Hospital number:
Date of birth:
Consultant:
Specimen type:
Diagnostic biopsy (1) Resection pre-treatment (1) Resection post-treatment (2)
Trephine bone biopsy, right (3, right) Trephine bone biopsy, left (3, left)
Lab Number: Specimen date:
1 2 3 If no, was there 4 Compliant with

Yes No documentation to guideline based on
explain the Yes from column 1 or
variance? an appropriate
Yes/No plus free- explanation from
text comment column 3. Yes/No
Site of specimen stated
Pre- or post-treatment stated
Site(s) of separate lymph
nodes recorded
Type and size of specimen –
biopsy (needle or
open/surgical) or resection
stated
Fresh tissue for genetic
studies taken
Resection: number of
nodule(s) present and nodular
variant subtype stated
Resection: lymph nodes
attached
Resection: lymph node
metastasis
metastasis positive site(s)
metastasis negative site(s)
Adequate bone marrow trephine
biopsy stated
Tumour category according to
INPC stated (diagnostic
biopsy/pre-treatment resection)

Neuroblastoma grade of
differentiation stated
Presence or absence of necrosis
stated
Presence or absence of
calcification stated
Immunohistochemistry profile
stated
Trephine biopsy: at least six
sections examined
Immunohistochemistry utilised two
neuroblastoma antibodies
Comment on specimen adequacy
Comment on bone marrow
infiltration, including percentage
involvement
Comment on neuroblastoma
differentiation
SNOMED CT codes or SNOMED
T and M codes recorded

Audit action plan
An audit of peripheral neuroblastic tumours reporting standards
Audit Objective Action Timescale Barriers Outcome Monitoring

recommendation and
constraints

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Cellular pathology audit template

Date of (To be inserted when completed)

Name of lead (To be inserted)

Specialty Cellular pathology/paediatric pathology

Title An audit of peripheral neuroblastic tumours reporting standards

In May 2019, the Dataset for histopathological reporting of peripheral neuroblastic

CEff 040719 1 V1 Final

Data to be collected on proforma (see below).

Core data items % compliance

CEff 040719 2 V1 Final

It is recommended to include results of all the molecular genetics findings on the

Conclusion (To be completed by the author)

Re-audit date (To be completed by the author)

Reference Cullinane C, Shukla R, Stahlschmidt J. Dataset for histopathological reporting of

CEff 040719 3 V1 Final

Audit review practice

Lab Number: Specimen date:

1 2 3 If no, was there 4 Compliant with

CEff 040719 4 V1 Final

CEff 040719 5 V1 Final

Audit Objective Action Timescale Barriers Outcome Monitoring

CEff 040719 6 V1 Final

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