An audit of histopathology reporting in Kausch-Whipple pancreaticoduodenectomy specimens

Introduction

Since histopathology reports of the resection specimens of malignant tumours should provide information of therapeutic and prognostic significance, national guidelines have been formulated on reporting common malignancies. However, no such guidelines are available locally for Kausch-Whipple pancreaticoduodenectomy (KWPD) specimens. The aim of this study was to audit the completeness of reporting of KWPD specimens against the minimum data sets formulated by the Royal College of Pathologists (RCP) UK.

 

Methodology

The histopathology reports of KWPD specimens of malignant tumours which were received at the Department of Pathology, Faculty of medicine, Ragama over a four year period were analyzed to determine whether the core data identified in the RCP minimum data set (BT-23, PT-24, DT-22 and AVT-22) was included. The percentage of items reported in each of the histopathology reports was calculated to ascertain the overall level of adequacy in each of the report.

 

Results

There were a total of 42 KWPD specimen reports including 18 tumours of the Ampulla of Vater (AVT), 11 pancreatic tumours (PT), 8 duodenal tumours (DT) and 5 biliary tumours (BT). The minimum number of core data items included was, BT-17/23, PT-17/24, DT-15/22 and AVT-14/22. Data that was poorly reported included the degree of differentiation, lengths of bile duct and lesser curvature and greater curvature of stomach, maximum tumour diameter (most poorly reported in AVT 16.67%, 3/18) and tumour involvement of margins in PT(0/11) and AVT(1/18, 5.56%).

 

Conclusion

Though overall reporting was found to be satisfactory in many of the reports, further improvements are required in reporting of certain data items. It is recommended that national guidelines and a proforma are introduced and followed.