Critical values

Critical values is a concept which comes to anatomical pathology from clinical pathology.

In the context of surgical pathology, it is, perhaps more appropriately, called critical diagnosis.

The general consensus is that these findings require a phone call and/or discussion with the clinician to ensure the situation is managed appropriately in a timely manner.

List

Cytology

Critical diagnoses as per Pereira et al.:

• Unexpected malignancy - vast majority of cases.
• Microorganisms in non-gynecologic specimens and FNA specimens.

Surgical pathology

The following is primarily constructed from a list in Pereira et al.

General

• Large vessel in core biopsy specimen.
• Unexpected malignant diagnosis.
• Malignant diagnosis in the context of a medical emergency:
  • Neoplasm causing paralysis.
  • Malignancy causing superior vena cava syndrome.

Gynecologic

• No chorionic villi or trophoblasts on D&C in someone pregnant.
• Fat on endometrial biopsy.
• Fat on endocervical canal sampling.

Diagnostic of infection

• Fungal.
• Microbacterial.
• Bacterial.
• Viral.

Suggestive of infection

• Necrotic granulomas.

Cardiac

• Mesothelial cells in heart muscle biopsy.

Transplant related

• Transplant rejection.

Medical diseases

• Vasculitis.

Renal

• Crescents in kidney biopsy.

See also

• Basics.
• Quality.