L4E rule 4 (2014)
From Libre Pathology
The definitive reference for the rule is found on the CAP-ACP website.
You can test your knowledge in the L4E rule 4 quiz.
- This rule applies to most benign resections.
- It applies to some small biopsies that are submitted in several blocks, e.g. an endoscopically resected large tubular adenoma of the colon without high-grade dysplasia submitted in 3 blocks.
|Specimen type(s)||Weight (L4E)||Details||Examples|
|Most non-malignant resections (see below)||1 L2/block, 0.33 L4E/block, minimum 1 L3 (0.5 L4E)||1 block = 0.5 L4E, 2 blocks = 0.66 L4E, 3 blocks = 1 L4E, 4 blocks = 1.33 L4E, 5 blocks = 1.66 L4E||benign hysterectomy in 12 blocks = 4 L4E, hemithyroid with nodular hyperplasia in 15 blocks = 5 L4E|
- Rule 5 may apply to cases requiring a synoptic report as per the CAP.
Specimens this rule applies to
Benign disease in:
- Simple Nephrectomy.
- Breast lumpectomy.
- Small bowel resection.
- Large bowel resection.
- Sleeve gastrectomy.
Malignant disease - non-radical resections:
- Partial nephrectomy.
- Hemithyroidectomy with cancer.
- Workload and Workforce Committee of the CAP-ACP. Workload Measurement Guidelines. Canadian Association of Pathologists (CAP-ACP). 2014. URL: https://www.cap-acp.org/cmsUploads/CAP/File/CAP-ACP%202014%20Workload%20FINAL.pdf. Accessed on: 17 October 2017.