Difference between revisions of "L4E rule 1-3 (2014)"

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| Surgical GI biopsies (neoplastic/pre-neoplastic)  
| Surgical GI biopsies (neoplastic/pre-neoplastic)  
| 1 L3/lesion (if submitted in one block) and low grade
| 1 L3/lesion (if submitted in one block) and low grade; lesion with high-grade dysplasia = 1 L4E
| >1 block use [[L4E rule 4 (2014)|L4E rule 4]], if high-grade dysplasia present L4E
| >1 block use [[L4E rule 4 (2014)|L4E rule 4]]
| 2 HP polyps in one block = 1 L4E, 1 tubular adenoma negative for HG dysplasia = 0.5 L4E
| 2 HP polyps in one block = 1 L4E, 1 tubular adenoma negative for HG dysplasia = 0.5 L4E
| Rule 1 <ref name=capacp2014/>  
| Rule 1 <ref name=capacp2014/>  

Revision as of 00:30, 25 October 2017

This article covers L4E rule 1-3 for the 2014 L4E workload system.

An overview of the L4E rules is found in the L4E rules of 2014.

Context

  • This rule deals with biopsies/curettages.

Details

Specimen type(s) Weight (L4E) Details Examples Rule
Complex skin biopsies/non-GI biopsies with countable fragments 1 L4E / 5 tissue fragments (frags), all fractions are rounded down 1-5 frags = 1 L4E, 6-10 frags = 2 L4E, 11-15 frags = 3 L4E, 16-20 frags = 4 L4E
"complex skin" includes inflammatory skin, malignancies except BCC and SCC, atypical melanocytic lesions, adnexal tumours, lymphoid infiltrates 		inflammatory skin biopsy 3 frags = 1 L4E, adnexal skin tumour 6 frags = 2 L4E Rule 1 [1]
Simple skin (non-complex skin) 1 L3/biopsy, 0.5 L4E/biopsy biopsies > 2 cm - use L4E rule 4 punch biopsy of BCC = 0.5 L4E, shave biopsy of seborrheic keratosis = 0.5 L4E Rule 1 [1]
Medical GI biopsies 1 L3/3 tissue fragments (frags), all fractions are rounded down; 1 L3 = 0.5 L4E 1-3 frags = 0.5 L4E, 4-6 frags = 1 L4E, 7-9 frags = 1.5 L4E, 10-12 frags = 2 L4E, 13-15 frags = 2.5 L4E 6 frags colorectal biopsies = 1 L4E Rule 1 [1]
Surgical GI biopsies (neoplastic/pre-neoplastic) 1 L3/lesion (if submitted in one block) and low grade; lesion with high-grade dysplasia = 1 L4E >1 block use L4E rule 4 2 HP polyps in one block = 1 L4E, 1 tubular adenoma negative for HG dysplasia = 0.5 L4E Rule 1 [1]
Breast core biopsies & prostate core biopsies 1 L3 per core (0.5 L4E/core) maximum of 20 cores; should use clinicians core count (if available), if clinicians' count not available use gross count 4 breast cores = 2 L4E
12 prostate cores = 6 L4E 		Rule 2 [1]
Core biopsies (not including prostate, breast) 1 L4E / 5 cores, all fractions are rounded down 1-5 cores = 1 L4E, 6-10 cores = 2 L4E, 11-15 cores = 3 L4E, 16-20 cores = 4 L4E 3 cores of lymph node = 1 L4E, 6 cores of mediastinal mass = 2 L4E Rule 2 [1]
Fragmented tissue/ curettage 1 L4E / 3 blocks, all fractions are rounded down 1-3 blocks = 1 L4E, 4-6 blocks = 2 L4E, 7-9 blocks = 3 L4E, 10-12 blocks = 4 L4E, 13-15 blocks = 4 L4E endometrial biopsy in 2 blocks = 1 L4E, TURP in 7 blocks = 3 L4E, bladder biopsy in 12 blocks = 4 L4E Rule 3 [1]

See also

References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 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.
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