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Launch Digital Edition

Webinars and Sponsored Roundtables — Register Now

Thursday, April 30, 2026, 11:00 AM–12:00 PM ET
Hear an expert discuss how Memorial Sloan Kettering Cancer Center (MSKCC) is utilizing
the oncoReveal® Nexus 21-gene panel to redefine turnaround time and actionable insights
in cancer care. Dr. Ewalt shares a perceptive look at the clinical need for rapid, front-line NGS sequencing, and how a unique, purpose built targeted NGS panel (Pillar Biosciences’ oncoReveal Nexus 21 gene Panel) was developed, validated and implemented clinically by Memorial Sloan Kettering Cancer Center (MSK-REACT) to complement their current comprehensive genomic profiling (CGP) approach.

Webinar presenter Mark Ewalt, MD, Associate Medical Director for Laboratory Operations for Diagnostic Molecular Pathology in the Molecular Diagnostics Service, Department of Pathology and Laboratory Medicine, MSKCC.

Moderated by: Bob McGonnagle, Publisher, CAP TODAY

CAP TODAY does not endorse any of the products or services named within. The webinar is made possible by a special educational grant from Pillar Biosciences.

Register Now

Thursday, May 28, 2026, 1:00–2:00 PM ET
This session is designed to improve understanding and application of recent updates to synoptic pathology reporting protocols such as the latest Reporting Template for Reporting Results of Biomarker Testing of Specimens from Patients with Carcinoma of the Breast. These changes reflect evolving clinical guidelines that directly influence diagnostic accuracy and treatment selection in breast cancer care.

Webinar presenters Thaer Khoury, MD, FCAP, Chair, Pathology and Laboratory Medicine, Roswell Park Comprehensive Cancer Cente, and Colin Murphy,  CEO of mTuitive.

Moderated by: Bob McGonnagle, Publisher, CAP TODAY

Register Now

Subspecialties

Interactive Product Guides

Q&A column

Q&A column

March 2026
Q. How should a blood bank respond when a non-irradiated blood product is inadvertently transfused to a patient who requires irradiated components, and what steps must be taken to ensure patient safety and regulatory compliance? Read answer.

Q. We are using direct smears for nongynecologic fine-needle aspirations and thinking about switching to liquid-based cytology (SurePath) preparation. There is nothing in the CAP accreditation checklist that pertains to a switch in slide preparation method… Read answer.

Q&A column

February 2026
Q. Why aren’t more medical students interested in applying for a pathology residency? Read answer.

Q. What is your opinion on employing qualitative rapid homogeneous immunoassay (enzyme-multiplied immunoassay technique, ELISA) urine screens for tricyclic antidepressant (TCA) testing in pregnant women and emergencies involving neonates, particularly at a low cutoff threshold of 300 ng/mL? Read answer.

Q&A column

January 2026
Q. What is the CAP’s stance on antibody identification software, which is available via subscription, middleware, or an open-source platform? Read answer.

Q. Can toxicology testing be performed on a person who has been deceased for two years? Read answer.

Q&A column

December 2025
Q. Now that the CMS allows direct observation for competency assessment to be performed virtually, does the CAP also allow it? If so, can you provide guidance? Read answer.

Q. We have implemented quality control at 10x in accordance with the Westgard rules. I use three levels of QC. If the results of two levels of QC are moving properly above and below the mean and only one level is showing a trend of a 10x rule violation, what corrective action should I take? Read answer.

Q&A column

November 2025
Q. Clinicians at my hospital doubt my prolactin results. They report patients with prominent pituitary adenomas who have normal prolactin results. There are other patients who have hyperprolactinemia but no adenoma or galactorrhea. In those patients, the prolactin concentrations remain elevated even after therapy. Can you clarify? Read answer.

Q. Is it necessary for a lab to report a corrected sodium level when the glucose level is really high? Studies show pseudohyponatremia can occur due to hyperglycemia. How common is this, and how do we decide which correction factor to use? Is it possible that this is easily overlooked by providers due to comorbidities in patients? Some references say there is a need to correct glucose for each 100 mg/dL increase above 400 mg/dL. Read answer.

Q&A column

October 2025
Q. Is telepathology used much in the United States for histology interpretation and diagnosis? For example, is it used to interpret digitally transmitted histology slides when working from home? Read answer.

Q. When a patient has a hematocrit level of ≥ 55 percent and a normal PT and APTT, do you still correct sodium citrate and ask for a redraw? Is it crucial to ask for a redraw when the emergency department orders a stat PT and APTT? Read answer.

Q&A column

September 2025
Q. Some of my laboratory staff are reluctant to reach out to the CAP with accreditation questions on checklist requirements because they fear that doing so will lead CAP inspectors to scrutinize those related items more closely during the next inspection. How does the College manage information from these phone calls? Read answer.

Q. An oncologist recently told me to perform a platelet count on a sodium citrate (blue top) tube even though the platelet results from the EDTA tube were valid—no platelet flags, a Q-flag value of zero, a normal platelet histogram, and no clumps seen on slide review. Based on this evidence, this patient is not an EDTA clumper and using the blue-top tube isn’t indicated or recommended, as far as I know. What is the science behind this request? There were platelet clumps in the blue-top tubes (platelet instrument flags and clumps seen on the slides from the citrate tubes), which further invalidated these results in my opinion as a licensed laboratory scientist. Read answer.

Q&A column

August 2025
Q. We manage multispecialty laboratories in multiple hospital locations. Most of the laboratories function on the traditional model of compartmentalized specialty-based testing units that offer routine and specialized services with their own dedicated space, equipment, and personnel. There is a future plan to establish an offsite centralized referral lab, but to improve operational efficiency and cost savings sooner, management is considering consolidating testing services at each location. What factors should be considered while planning the consolidation, keeping in mind the plan to establish a centralized reference lab? Should the testing services that will eventually be performed in the reference lab be excluded from the current consolidation plan? And how should we manage operations during the transition phase, i.e. once consolidation is completed but prior to the reference lab implementation? Read answer.

Q. We have been discussing supervisory review of test results that are manually entered into our laboratory information system (i.e. a test result not sent via interface from an analyzer or autoverified). Examples are a urine hCG performed on a kit cassette or a manual differential performed on a CBC, entered directly into the LIS by the performing technologist. Do manual test results require supervisory review, or is it only higher-complexity tests (like the differential) performed by a medical laboratory technologist that require such review? If review is required, who can review and what is the recommended time frame? Read answer.

Q&A column

July 2025
Q. What is the best way to check machine precision? Is it acceptable to run precision replicates in quality control mode? Read answer.

Q. Several molecular diagnostic vendors circulate across U.S. hospitals and clinics to provide collection kits to physicians and request that those physicians refer tests outside the institution for what is sometimes described as clinical trials or research. The vendors operate using a pharmaceutical company model of selling proprietary testing directly to physicians and patients and bypassing the laboratory. It is a problem because laboratories are often expected to collect and submit samples and then enter complex reports into the electronic health record.

These companies are farming health systems for business and bypassing the accreditation process. When the testing is used not for research but instead for “the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of the health of, human beings,” under U.S. law it is defined as laboratory testing (section 353 of the Public Health Service Act, 42 USC §263a), which is overseen by pathology laboratories and under pathology’s accreditation. Under this legal definition of laboratory testing, those outsourced tests are not research.

Can you comment on this practice from an accreditation perspective? Read answer.

Q&A column

June 2025
Q. Our institution performs rapid onsite evaluation (ROSE). In cases in which multiple passes are done, we frequently encounter unsatisfactory specimens (debris, neutrophils, bronchial cells, etc.). These cases are rescreened by a cytotechnologist and pathologist. If the case goes to a different pathologist, those unsatisfactory slides are unnecessarily screened three times. They’re also included in the daily slide workload of the cytotechnologist. Can the onsite pathologist dispose of unsatisfactory Diff-Quik slides and keep just the counter formalin-fixed slides? Since ROSE is provided for that episode, can you comment on billing? Read answer.

Q. Many times a platelet count on an automated hematology system indicates some degree of thrombocytopenia or the analyzer reports a high mean platelet volume or platelet large cell ratio, while a blood smear shows large platelets and/or giant platelets. Is it OK to include a comment in the report that the platelets are adequate or that the count could be due to large platelets, especially with values that indicate marked thrombocytopenia? Read answer.

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