Lymphoma Pathology

Goals and Objectives

Specific Objectives

At the completion of training, the resident will have acquired the following competencies and will function effectively as:

Medical Expert/Clinical Decision-Maker

General Requirements

  • Demonstrate diagnostic skills for accurate diagnosis of lymphoproliferative disorders in a variety of organs.
  • Access and apply relevant information to clinical practice.
  • Demonstrate effective consultation services with respect to referral in consultation cases.

Specific Requirements

  • Demonstrate knowledge of normal anatomy, physiology and immunology of the lymphatic/immune system.
  • Demonstrate understanding of the general principles of embryologic development and the most common variations of normal lymph nodes, spleen, thymus and bone marrow.
  • Demonstrate a superior and detailed knowledge of the normal gross and light microscopic appearance of lymph nodes, spleen and other lymphoid tissues.
  • Understand the basic principles of cell biology, immunology and pathogenesis, and the changes that occur in specific lymphomas.
  • Be familiar with the CD classification of lymphocyte antigens and their application to immunophenotyping of lymphoproliferative disorders.
  • Understand the principles of immunohistochemical diagnosis in malignant and inflammatory conditions.
  • Understand the principles of tissue processing and the use of different fixatives in the laboratory.
  • Demonstrate an in-depth knowledge of the appropriate processing and sampling of biopsy specimens for suspected lymphoma.
  • Understand the principles of nucleic acid-based molecular biology techniques and be familiar with their application to diagnosis in lymphoma diagnosis, especially the role of PCR and Southern blotting in gene rearrangement, lineage and specific translocation studies.
  • Understand the overall approach to examining a lymphoid organ microscopically, formulating a differential diagnosis based on histologic features and proceeding with the selection of confirmatory immunophenotyping.
  • Be familiar with the WHO classification of lymphoproliferative disorders and their clinical significance.
  • Understand the diagnostic pitfalls in interpreting biopsy tissues, including sample size, fixation problems, etc.
  • Demonstrate ability to take satisfactory gross and microscopic photographs of lymphoid tissues, including digital presentations of individual cases for teaching purposes.

Communicator

General Requirements

  • Discuss cases with other members of the health care team in terms of diagnosis and prognosis.

Specific Requirements

  • Assist in the continuing education of physicians and other members of the hospital staff by participating in educational/clinical review forums such as lymphoma rounds.
  • Act as consultants to clinical colleagues on the interpretation and relevance of pathological findings, with particular regard to their significance in the management of the patient.
  • Understand the information a pathology report should provide in a given clinical situation and be able to communicate it effectively in an oral and written form.

Collaborator

General Requirements

  • Consult effectively with other physicians and health care professionals.
  • Contribute effectively to other interdisciplinary team activities.
  • Understand the role of the pathologist as “gate-keeper” in patients entering clinical trials

Specific Requirements

  • Utilize experience in clinical medicine and surgery to achieve a sound understanding of the effects of disease and the role of pathology in its management.
  • Demonstrate the ability to advise on the appropriateness of obtaining histologic and cytologic specimens and following examination of these, to advise on further appropriate investigations.

Manager

General Requirements

  • Utilize resources of the pathology laboratory effectively to achieve an accurate diagnosis.
  • Allocate finite health care resources wisely.
  • Work effectively and efficiently in a health care organization.
  • Utilize information technology to optimize patient care, life-long learning and other activities.

Specific Requirements

  • Demonstrate knowledge of the methods of quality control in the laboratory as it relates to flow cytometry and immunohistochemistry of lymphoproliferative disorders.

Health Advocate

General Requirements

  • Identify the important determinants of lymphoma pathogenesis and diagnosis.

Specific Requirements

  • As members of an interdisciplinary team of professionals responsible for individual and population health care, the anatomical pathologist will endeavour to help in informing the public about issues surrounding the diagnosis of lymphomas and risk factors for their development.

Scholar

General Requirements

  • Develop, implement and monitor a personal continuing education strategy with respect to continuing education in lymphoma pathology.
  • Critically appraise sources of medical information and recognize the current best sources for lymphoma research reporting.
  • Facilitate learning of patients, residents, students and other health professionals at rounds.
  • Contribute to development of new knowledge.

Specific Requirements

  • A small research project or case report should be discussed with the rotation supervisor at the beginning of the elective. This could be presented at any one of a number of forums ranging from lymphoma rounds to national meetings.

Professional

General Requirements

  • Deliver highest quality care with integrity, honesty and compassion.
  • Exhibit appropriate personal and interpersonal professional behaviours.
  • Practice medicine ethically consistent with obligations of a physician.
  • Demonstrate the knowledge, skills and attitudes relating to gender, culture, and ethnicity pertinent to anatomical pathology.

Specific Requirements

  • Act as an appropriate role model for students and others.
  • Demonstrate a professional attitude to colleagues, as well as to other laboratory staff.
  • Have an appreciation of the crucial role of the anatomical pathologist in providing quality patient care. This will include knowledge of individual professional limitations and the necessity of seeking appropriate second opinions.

 

 

Updated April, 2020

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