Major Organ Cellular Pathology including Cancer

Module details

Title

Major Organ Cellular Pathology including Cancer

Type

Specialist

Module code

SLS328

Credits

10

Requirement

Compulsory

Aim of this module

This module will provide the trainee with knowledge and understanding of the cellular structure and function of the major organs and the cellular pathological findings in a range of clinical disorders, including cancer. They will understand and apply a range of techniques to these clinical disorders and gain experience of interpreting results from patient investigations.

Competencies

#	Learning outcome	Competency	Action
# 1	Learning outcome 1	Competency From routine requests, identify the cellular pathology specimens required to confirm a diagnosis in each of the following major organ systems and perform the relevant techniques to process the sample: dermatopathology breast pathology hepatobiliary pathology gastrointestinal pathology genitourinary pathology respiratory pathology gynaecological pathology male reproductive pathology endocrine pathology ear, nose and throat pathology osteoarticular pathology.	Action View
# 2	Learning outcome 2	Competency Perform and record details of macroscopic examination of tissue received from named major organ disease and commonly occurring cancers, to include: dermatopathology breast pathology hepatobiliary pathology gastrointestinal pathology genitourinary pathology respiratory pathology gynaecological pathology male reproductive pathology endocrine pathology ear, nose and throat pathology osteoarticular pathology.	Action View
# 3	Learning outcome 2	Competency Perform to quality standards, basic and appropriate specialised cellular pathology techniques as part of the systematic investigation of tissue received from named major organ diseases and commonly occurring cancers, to include: dermatopathology breast pathology hepatobiliary pathology gastrointestinal pathology genitourinary pathology respiratory pathology gynaecological pathology male reproductive pathology endocrine pathology ear, nose and throat pathology osteoarticular pathology.	Action View
# 4	Learning outcome 3	Competency Perform a detailed evaluation of one new piece of equipment, method or procedure.	Action View
# 5	Learning outcome 1,2,3	Competency Perform to quality standards, cellular pathology tests of rejection from tissue grafts and/or organ transplantation.	Action View
# 6	Learning outcome 4	Competency In discussion with a pathologist, interpret in the correct clinical context the results of: macroscopic examination basic microscopic examination appropriate specialised techniques diagnostic algorithms from specimens received from a range of named major organ diseases and commonly occurring cancers, to include: dermatopathology breast pathology hepatobiliary pathology gastrointestinal pathology genitourinary pathology cardiac and vascular pathology respiratory pathology gynaecological pathology male reproductive pathology endocrine pathology ear, nose and throat pathology osteoarticular pathology.	Action View
# 7	Learning outcome 4,5	Competency In discussion with a pathologist, prepare and issue reports from the selected cases of named major organ disease and commonly occurring cancer in the context of other clinical information.	Action View

Assessments

You must complete:

• 2 case-based discussion(s)
• 2 of the following DOPS/ OCEs:

Perform interpretation of clinical details from 10 examples of major organ resections and prioritise samples according to clinical urgency.	DOPS
Perform interpretation of clinical details from 10 examples of major organ resections and plan the investigations to be performed and annotate the request accordingly.	DOPS
Perform specimen dissection of a range of major organ resection sample types requiring dissection with a knife	DOPS
Perform assessment and marking of relevant specimen excision margins.	DOPS
Perform dictated description of 10 specimens being dissected, detailing all required descriptors according to local protocols.	DOPS
Perform interpretation of clinical details from 10 examples of cancer organ resections and prioritise samples according to clinical urgency.	DOPS
Perform interpretation of clinical details from 10 examples of cancer resections and plan the investigations to be performed and annotate the request accordingly.	DOPS
Perform specimen dissection of a range of cancer resection sample types requiring dissection with a knife and select appropriate samples from those specimens to enable a diagnosis to be made.	DOPS
Perform assessment and marking of relevant specimen excision margins to enable correct orientation of the samples.	DOPS
Perform dictated description of 10 cancer resection specimens being dissected.	DOPS
Evaluate and perform a prognostic indicator assessment using the appropriate demonstration technique to a named cancer type.	DOPS
Perform microscopical interpretation of stained slides from 6 different major organ types	DOPS
From evidence gathered and discussions with relevant clinical colleagues, produce a clinical pathway document detailing the impact of the diagnostic process on the overall patient pathway for a named condition.	OCE
From evidence gathered and discussions with relevant clinical colleagues, produce a reflective account of the learning acquired	OCE
Perform microscopical interpretation of H and E stained slides from 6 different major organ types and demonstrate to a Consultant Histopathologist normal and abnormal morphology, relating their morphologic appearance to the clinical condition.	OCE
Perform microscopical interpretation of stained slides from 6 different major organ types and demonstrate to a Consultant Histopathologist the algorithmic processes used to determine a differential diagnosis.	OCE
In discussion with a Consultant Histopathologist, use information gathered from the algorithmic process to produce a preliminary diagnosis for 6 specimens from different major organ types.	OCE
From evidence gathered and discussions with relevant clinical colleagues, produce a clinical pathway document detailing the impact of the diagnostic process on the overall patient pathway for a named cancer type.	OCE
In discussion with a Consultant Histopathologist, use information gathered from the algorithmic process to produce a preliminary diagnosis for 6 specimens from different cancer types.	OCE

Learning outcomes

1. Identify and confirm the clinical presentation of a range of major organ diseases and commonly occurring forms of cancer.
2. Perform to quality standards a range of established cellular pathology techniques to named disorders of the major organs and commonly occurring forms of cancer.
3. Identify and evaluate new equipment, methods, or procedures to enhance the contribution of the cellular pathology laboratory to the diagnosis and management of major organ disease and commonly occurring forms of cancer.
4. Under supervision, prepare and interpret reports that involve cellular pathology findings as part of the investigation of major organ disease.
5. Work in partnership with other clinical specialisms as part of the diagnosis and review of named clinical diseases of major organs and commonly occurring forms of cancer.

Learning outcomes

1. Describe the structure and function of the major organ groups in the human body and their interaction with each other.
2. Discuss the pathophysiology and clinical presentation of common disorders of major organs and common cancers.
3. Explain the processes of tumour growth, angiogenesis, apoptosis and metastasis.
4. Describe and evaluate the application of established cellular pathology techniques to a range of named disorders of the major organs and cancers.
5. Discuss and justify the ethical and legislative processes associated with the investigation of major organ disease and cancer.
6. Discuss the role of the cellular pathology report as part of the decision- making process in guiding diagnosis, management and clinical outcomes in major organ disease and cancer.

Indicative content

• Aetiology, pathogenesis and main clinical features of common non- malignant and malignant diseases encountered in cellular pathology and their impact on patient management, including:
  • dermatopathology, e.g. non-malignant and malignant skin lesions
  • breast pathology, e.g. adenomas, fibrocystic change, cancer
  • hepatobilary pathology, e.g. cirrhosis, cholecystitis, cancer
  • gastrointestinal pathology, e.g. diverticulitis, polyposis, inflammatory bowel disease, cancer
  • genitourinary pathology, e.g. prostatic hyperplasia, cancer
  • cardiac and vascular pathology, e.g. ischaemic heart disease
  • respiratory pathology, e.g. chronic obstructive pulmonary disease (COPD), fibrosis, cancer
• Principles of the initiation and mechanisms of malignant growth and metastasis, including:
  • genetic deregulation and the role of proto-oncogenes and oncogenic viruses
  • the role of telomerase activation in tumourgenesis
  • cell proliferation
  • signalling pathways
  • apoptosis
  • the role of hormones
  • angiogensis
• Application of a wide range of histological, immunocytochemical and molecular techniques to the demonstration of the disease processes
• The role of prognostic and predictive markers (e.g. oestrogen receptor, human epidermal growth factor receptor 2 [HER-2]) in the grading of tumours and monitoring the spread of disease
• Ethical and regulatory issues
• New developments in equipment, methods and procedures used in the laboratory investigation of major organ disease and cancer
• The importance of the histopathology report in assisting diagnosis, management and clinical outcomes
• Multidisciplinary team meetings

Activities

• Prepare an example cellular pathology report for a resection specimen and demonstrate the ability to discuss the essential elements included.
• Produce a portfolio demonstrating knowledge and understanding of dissection practice and how it relates to the diagnostic process and subsequent patient care. Include details of investigations undertaken, with explanations, in the portfolio of cases prepared for learning outcome 1.
• Attend wards and clinics at which patients with named major organ diseases and commonly occurring cancers are being investigated and write a reflective account of what you have learned.
• Attend multidisciplinary meetings where patients with a major organ system disorder and a commonly occurring cancer are being discussed and write a reflective account of the experience.
• Visit a laboratory involved in supporting organ transplantation and describe the interaction with the clinical transplant team. Write a reflective account of your visit.
• Prepare a portfolio of illustrative cases with a minimum of three from the listed major organ pathologies and three from the listed commonly occurring cancers. Include the plan of laboratory investigation. To be developed further in learning outcomes 2 and 5.