Q&A Column, 3/14
March 2014—Q. What are the actionable mutations in melanoma that warrant routine molecular testing? Who should be tested, and what specimen should be tested? Is there a role for stat BRAF testing and for next-generation sequencing?
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Moderated by: Bob McGonnagle, Publisher, CAP TODAY
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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.
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.
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Q&A
Q & A Column, 2/14
February 2014—We are thinking about using a reference laboratory for HER2 FISH testing of breast carcinomas with an arrangement in which that lab performs the technical component and we perform the interpretation. A “frequently asked question” from 2011 on the CAP Web site seems to say that we must perform bright-field ISH proficiency testing to be in compliance, since we are not performing the hybridization and cannot refer PT to another laboratory. Can you clarify the PT requirement, if any, for this situation? The vendor we are dealing with has offered to establish its own FISH PT program.
Q & A Column , 1/14
January 2014—I read a question and answer in the April 2001 CAP TODAY about platelet clumping on EDTA and whether vortexing is an acceptable procedure. A common solution suggested was to redraw the specimen into sodium citrate or acid citrate dextrose (ACD). How do you calculate the correction factor for blood drawn in an ACD tube? Our lab has an old procedure for ACD correction, and it is to divide the RBC of the EDTA tube by the RBC count of the ACD tube. I don’t have any reference for this and would appreciate information.
Q&A Column, 12/13
December 2013—Our hematology standardization committee has asked us for input on performing cell counts on tubes No. 1 and No. 4 for cerebrospinal fluid. Each site in our system has a different protocol set up with its emergency department with regard to when a count is performed on tube No. 1 after counting tube No. 4. Some sites use RBC greater than five to automatically count tube No. 1 with or without an order to not delay patient care, whereas other sites use greater than 50 or greater than 200. Is there an established guideline recommendation for the number of RBCs seen on CSF tube No. 4 before doing an additional count on tube No. 1?
Q&A Column, 11/13
November 2013—Can you explain the logic behind doing a full workup for identification and sensitivity on multiple positive blood culture bottles on the same patient, drawn on the same day?
Q & A, 10/13
October 2013—We are standardizing procedures across our system. In thrombocytopenic patients with low platelet counts, some sites perform manual platelet counts using the Unopette system; others perform slide estimates to confirm an automated count. The need for improved turnaround times and greater accuracy and precision is clear. Are there studies that have evaluated the true accuracy of a low platelet count via a manual dilution technique versus the many automated techniques, and is there a true value in performing the time-consuming manual platelet count?
Q & A, 9/13
September 2013—Our clinicians are asking about testing for IgG4-related disease. What role does IgG4 immunohistochemical staining play? IgG4-related disease is a recently recognized fibroinflammatory condition that may affect a wide variety of organ systems, producing mass lesions and generally responding to immunosuppressive therapy. The pancreas, salivary/lacrimal glands, and kidney are frequently affected, but almost any tissue may be involved, including aorta, pleura, retroperitoneum, and lymph nodes.
Q & A, 08/13
August 2013—What are considered best practices for tracking re-sult trending in the lab? We use hemoglobin running mean in our hematology department because it is built into the analyzer software. The chemistry department will have a difficult time applying moving averages without purchasing middleware.
Q & A, 7/13
July 2013—Can you clarify the difference between the terms “optimization,” “validation,” and “verification” as used in immunohistochemistry? These three terms relate to the processes that the laboratory must undertake before new diagnostic, prognostic, or predictive immunohistochemistry markers are used for clinical and/or pathologic decisionmaking.
Q & A, 6/13
June 2013—Say an individual is stuck with an HIV-contaminated needle or occult infected with HIV by bodily fluid transmission and is started on preventive antiretroviral treatment to prevent permanent infection. (Treatment protocol is one-month intensive treatment.) Is there any known laboratory procedure by which a specimen could be isolated to determine by culture if the patient was indeed infected (assuming the patient is seronegative six months plus after treatment was initiated)?