Lung carcinoma surgical pathology report adequacy: a College of American Pathologists Q-Probes study of over 8300 cases from 464 institutions

Abstract

Objective: To assess the adequacy of reporting gross and microscopic pathologic findings of resected lung carcinoma.

Design: Q-Probes study following the College of American Pathologists format.

Setting: Pathology laboratories, 1991.

Participants: Four hundred sixty-four institutions.

Main outcome measures: Rate of reporting gross and microscopic features.

Results: Information provided in over 8300 surgical pathology reports of resected primary lung carcinomas from 464 institutions was reviewed. Descriptors included gross and microscopic findings. The rate of reporting the descriptors from the aggregate sample is listed as follows (the corrected rate for those descriptors in which evaluation was not applicable are listed in parentheses for each descriptor where appropriate): general findings, standard report or checklist used 20.8%, type of procedure stated 89.6%, and lobe or lung of origin stated 99.1% (99.5%); gross findings, distance of neoplasm from nearest visceral pleura 61.1%, involvement or lack of involvement of bronchus 68.7%, presence or absence of involvement of veins 18.3%, parenchyma not involved by neoplasm described 80.1% (81.4%), visceral pleural surface described 83.0%, tumor size stated 97.2%, and description of regional lymph nodes attached to specimen 74.7% (82.7%); and microscopic findings, microscopic description 77.6%, histologic type of tumor stated 99.3%, grade of carcinoma stated 80.9% (88.7%), presence or absence of lymphatic vascular invasion 24.3%, status of lymph nodes stated 89.0% (95.9%), presence or absence of venous invasion 22.6%, presence or absence of neoplasm at bronchial margin 90.8%, presence or absence of neoplasm at vascular margin 30.9%, presence or absence of carcinoma in the visceral pleura 64.6% (66.9%), and presence or absence of abnormality in nonneoplastic parenchyma 72.8% (74.1%).

Conclusion: The rate of reporting gross and microscopic features varies; recommendations for reporting are made and include the use of a standard report form or checklist.