New Journal Articles

Low-Grade Squamous Intraepithelial Lesion, Cannot Exclude High-Grade Squamous Intraepithelial Lesion" Is a Distinct Cytologic Category: Histologic Outcomes and HPV Prevalence. Am J Clin Pathol. 2007 Sep;128(3):398-403 Owens CL, etal.

The authors examine the validity of this category, comparing it to established diagnostic categories from the 2001 Bethesda classification. They define LSIL-H as cytology specimens definitely showing LSIL with occasional cells showing ASC-H. In their analysis which included a 2 year histopathologic follow-up, this category LSIL-H was significantly more frequently associated with CIN 1 than ASC-H. The risk if CIN 2 was intermediate between the diagnoses of LSIL and HSIL but not statistically different than the diagnosis of ASC-H.

The Henry Ford production system: measures of process defects and waste in surgical pathology as a basis for quality improvement initiatives. D'Angelo R, Zarbo RJ. Am J Clin Pathol 2007 Sep;128(3):423-9

In an innovative study, the researchers adopted a continuous quality improvement initiative to achieve a "zero-defect" performance. A defect was defined "as a flaw, an imperfection, or a deficiency in specimen processing requiring delaying or stopping work or returning work to the sender. These defects were noninterpretive, nondiagnostic defects critical to quality." The study established baselines for different defects all while achieving a defect rate per million sources of 4.3 to 4.8 sigma!

Submitted by Paul K. Shitabata, M.D.
Medical Director, Pathology Inc.