L4E rule 5 (2018)
From Libre Pathology
The definitive reference for the rule is found on the CAP-ACP website.
- This rule applies to specimens that require a synoptic report as per the College of American Pathologists (CAP) or are required by provincial health authorities.
|Specimen type(s)||Weight (L4E)||Details||Examples|
|all non-radical resections with cancer for which a synoptic report has to be filled-out as per CAP guidelines||3 L4E per synoptic report, at least 5 L4E for a given case||if the case is <5 L4E = 5 L4E for whole case; if the case is >5 L4E, 3 L4E/synoptic filled out||malignant colorectal polyp in 2 blocks = 5 L4E, breast lumpectomy with carcinoma in 16 blocks = 4 L4E (rule 4) + 3 L4E (for synoptic report), hemithyroidectomy with PTC in 20 blocks = 5 L4E (rule 4) + 3 L4E (for synoptic report)|
- Radical resections are covered by L4E rule 9.
|Specimen||Rule 5 applies?||L4E||Explanation|
|Invasive malignant melanoma - 1 punch biopsy||Yes||5 L4E||synoptic has to be done, would otherwise by 1 L4E as per rule 1|
|Melanoma in situ - 1 punch biopsy||No||1 L4E||no synoptic has to be done, rule 1 applies|
|Partial nephrectomy in 10 blocks with clear cell RCC||Yes||2.5 L4E + 3 L4E (synoptic)||synoptic has to be done, rule 4 and rule 5 apply|
|Lumpectomy in 24 blocks with DCIS||Yes||6 L4E + 3 L4E (synoptic)||synoptic has to be done, rule 4 and rule 5 apply|
|Cytoprostatectomy in 32 blocks with prostate cancer and bladder cancer||Yes||8 L4E + 3 L4E (synoptic for prostate cancer) + 3 L4E (synoptic for bladder cancer)||synoptic has to be done, rule 4 and rule 5 apply|
- Workload and Workforce Committee of the CAP-ACP. Workload Measurement Guidelines. Canadian Association of Pathologists (CAP-ACP). 2018. URL: https://www.cap-acp.org/cmsUploads/CAP/File/CAP-ACP_Workload_Model_2018_Final_2020180907(1).pdf. Accessed on: 19 May 2019.