Journal of Histopathology and Cytopathology
Volume 2 N 1
Implementing Synoptic Reporting System in Bangladesh
Histopathology report is a medical document written by histopathologist. In all types of biopsy sample of tumours such as excisional, incisional, punch, curettage and needle biopsies, traditional histopathology reports of formalin fixed paraffin embedded tissue sections is followed by microscopic examination of haematoxylin and eosin stained slides is a gold standard for tumour diagnosis. Histopathologists have to write name of the organ from which the biopsy has been taken, gross description of the specimen, microscopic description of the lesion mentioning invasion, margin involvement, lymph node metastasis, grades, and diagnosis. It may also also contain an optional comment section that is used when diagnosis is inclusive or development of cancer is unclear. Histopathologist can mention inadequacy of sample and can recommend for other tests. With the exception of a few most of the practicing histopathologists in Bangladesh usually give histopathology reports in descriptive format. Most of the oncologists in this country manage cancer patients with these traditional descriptive histopathology reports.
Many developed countries are using synoptic (structured) histopathology reports along with traditional reports in the management of cancer patients.1 Synoptic report is applicable when entire or a part of an organ with malignant tumour is removed. This report lists the most important results in a structured format. It is a clinical documentation method that uses structured checklist to help clinicians to produce more complete, consistent and valuable medical reports.2 Synoptic reports are faster to produce and easier to interpret. It includes items or fields considered most important in determining patients’ treatment options and chance of recurrence. It is a clinical template that ensures that pathologists are always prompt to report on data that is critical for clinical decision making.
Some developed countries developed electronic synoptic report writing software to digitize their process, reducing reporting time and simplifying report distribution. Histopathologists can produce consistently complete reports, using configurable template under pinhead by interoperable code such as ICD-10. Because of their consistency and the ease of their distribution, electronic synoptic reports can be compiled and searched for quality assurance and clinical research.
In Bangladesh, those who use synaptic report is usually based on customized version of the college of American Pathologists (CAP) protocol. These reports therefore vary among themselves. Bangladesh Academy of Pathology (BAP) has already taken initiative to implement synoptic reporting in histopathology reporting of cancer patient when entire tissue is removed. BAP has recently arranged a workshop on synaptic report writing among the member of this organization. They decided that these types of workshops will be continued with participants including histopathologists and clinicians.
Adoption of standardized histopathology reporting formats that suits the best in the context of Bangladesh is the first step forward. We hope, synoptic reporting will be implemented soon in Bangladesh.
*Dr. Sadequel Islam Talukder, Assistant Professor, Department of Pathology, Shaheed Syed Nazrul Islam Medical College, Kishoreganj. Associate Editor, Journal of Histopathology and Cytopathology. email@example.com
- College of American Pathologists. Resources & Publications: Cancer Protocols www.cap.org/cancerprotocols.
- Simplifying cancer reporting with eForm. http://www.cap.org/web/home/lab/proficiency-testing/cap-eFRM?_afrLoop=987349351061638#!%40%40%3F_afrLoop%3D987349351061638%26_adf.ctrl-state%3Djimk1r9yv_30