Major Organ Histopathology excluding Cancer

Module details

Title

Major Organ Histopathology excluding Cancer

Type

Specialist

Module code

SLS329

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 other than 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 histopathological specimens required to confirm a diagnosis in each major organ system and perform the relevant techniques to process the sample. Essential Dermatopathology Breast pathology Hepatobiliary pathology Gastrointestinal pathology Genitourinary pathology Respiratory pathology Gynaecological pathology Male reproductive pathology Endocrine pathology   Desirable Ear, nose and throat pathology Osteoarticular pathology Cardiac and vascular pathology Neuropathology.	Action View
# 2	Learning outcome 2	Competency Perform and record details of macroscopic examination of tissue received from named major organ disease. To include: Essential Dermatopathology Breast pathology Hepatobiliary pathology Gastrointestinal pathology Genitourinary pathology Respiratory pathology Gynaecological pathology Male reproductive pathology Endocrine   Desirable Ear, nose and throat pathology Osteoarticular pathology Cardiac and vascular pathology Neuropathology.	Action View
# 3	Learning outcome 2	Competency Perform to quality standards, basic and appropriate specialised histopathological techniques as part of the systematic investigation of tissue received from named major organ disease. To include: Essential Dermatopathology Breast pathology Hepatobiliary pathology Gastrointestinal pathology Genitourinary pathology Respiratory pathology Gynaecological pathology Male reproductive pathology Endocrine pathology  Desirable Ear, nose and throat pathology Osteoarticular pathology Cardiac and vascular pathology Neuropathology.	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 histopathological 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 algorithims from specimens received from a range of named major organ diseases, 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	Competency In discussion with a pathologist, prepare and issue reports from the selected cases of named major organ disease 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 microtomy on 10 different tissue types from different major organ resections and stain with H and E stain,	DOPS
Perform microscopical interpretation of stained slides and produce a quality assessment evaluation report	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.	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, discuss differential diagnosis at a relevant MDT meeting.	OCE

Learning outcomes

1. Identify and confirm clinical presentation of a range of major organ diseases.
2. Perform to quality standards a range of established histopathological techniques to named disorders of the major organs.
3. Identify and evaluate new equipment, methods, or procedures to enhance the contribution of the histopathology laboratory to the diagnosis and management of major organ disease.
4. Under supervision, prepare and interpret reports that involve histopathological 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.

Learning outcomes

1. Describe the structure and function of the major organ groups in the human body and their interactions with each other.
2. Explain the pathophysiology and clinical presentation of common disorders of major organs.
3. Describe systemic and local disease within major organ systems.
4. Describe the application of established histopathological techniques to a range of named disorders of the major organs.
5. Discuss the principles and practice of major organ transplantation, including immunosuppression.
6. Discuss and critically evaluate the ethical and legislative processes associated with the investigation of major organ disease.
7. Discuss the role of the histopathology report as part of the decision-making process in guiding diagnosis, management and clinical outcomes in major organ disease.

Indicative content

• Aetiology, pathogenesis and main clinical features of common diseases encountered in cellular pathology and their impact on patient management, including:
  • dermatopathology, e.g. non malignant skin lesions
  • breast pathology, e.g. adenomas, fibrocystic change
  • hepatobilary pathology, e.g. cirrhosis, cholecystitis
  • gastrointestinal pathology, e.g. diverticulitis, polyposis, inflammatory bowel disease
  • genitourinary pathology, e.g. prostatic hyperplasia, pyelonephritis, urothelial papillary lesions
  • cardiac and vascular pathology, e.g. ischaemic heart disease
  • respiratory pathology, e.g. chronic obstructive pulmonary disease (COPD), fibrosis
  • gynaecological pathology, e.g. endometriosis, fibrous diseases
  • male reproductive pathology, e.g. epididymal cysts
  • endocrine pathology, e.g. goitre
  • ear, nose and throat (ENT) pathology, e.g. nasal polyps, tonsillitis, cystic lesions
  • osteoarticular pathology, e.g. osteoarthritis and rheumatoid arthritis
• Application of a wide range of histological techniques to the demonstration of the disease processes, e.g. diagnostic algorithms
• Awareness of the multi-organ impact of disease and treatment
• Organ transplantation and the morphological presentation of rejection
• Multi-organ transplant
• Ethical and regulatory issues
• New developments in equipment, methods or procedures used in the laboratory investigation of major organ disease
• The importance of the histopathology report in assisting diagnosis, management and clinical outcomes

Activities

• Prepare an example histopathological 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 disease are being investigated, and write a reflective account of what you have learned.
• Attend a multidisciplinary team meeting where patients with a major organ system disorder 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 one from each listed major organ pathology. Include the plan of laboratory investigation. To be developed further in learning outcomes 2 and 5.