PIP-B

Performance Improvement Program in Surgical Pathology

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2012

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2012 PIP/PIPW-B

PARTICIPANT SUMMARY Program Update This report summarizes the diagnostic responses for set B of the 2012 Performance

Improvement Program in Surgical Pathology (PIP & PIPW).

A tabulation of the responses to the supplementary questions is not included since these are intended for educational purposes only.

SURGICAL PATHOLOGY COMMITTEE

Mary Beth Beasley, MD FCAP, Chair Philip A. Branton, MD FCAP, Vice Chair

Aleodor Alexandru Andea, MBA, MD FCAP Noel A. Brownlee, MD, PhD FCAP Brad B. Bryan, MD FCAP Liang Cheng, MD FCAP Simion Ion Chiosea, MD FCAP William V. Chopp, MD FCAP Byron E. Crawford, MD FCAP Rajan Dewar, MD, PhD FCAP H. Parry Dilworth, MD FCAP

Megan K. Dishop, MD FCAP Julie C. Fanburg-Smith, MD FCAP Alyssa M. Krasinskas, MD FCAP Tamera J. Lillemoe, MD FCAP Daniel J. Luthringer, MD FCAP Rochelle Simon, MD FCAP Nichole Lee Steidler, MD FCAP Saul Suster, MD FCAP Thomas S. Winokur, MD FCAP

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2012

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Diagnosis (2247) Neuroblastoma, poorly differentiated PIP Participants PIPW Participants Code Diagnosis No. % No. % 2439 Adrenocortical adenoma 0 0.0 0 0.0

0 0.0 2 2.9 2 2.9 0 0.0 0 0.0

12 17.6 23 34.0 19 27.9

10 14.7

2345 Adrenocortical carcinoma 1 0.1 1529 Ganglioneuroblastoma, intermixed 3 0.1 1568 Ganglioneuroblastoma, nodular 4 0.1 1227 Ganglioneuroma, maturing 2 0.1 2788 Ganglioneuroma, mature 1 0.1 1973 Neuroblastoma, differentiating 73 1.3 2247 Neuroblastoma, poorly-differentiated 5152 89.3 1259 Neuroblastoma, undifferentiated 497 8.6 2446 Pheochromocytoma 18 0.3

Technical Quality of Slide

PIP Participants Rating Glass Slide Evaluation No. % 001 Excellent 2196 40.8 002 1582 29.5 003 Satisfactory 1454 27.1 004 132 2.5 005 Unsatisfactory 7 0.1

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Diagnosis (1075) Intramuscular myxoma PIP Participants PIPW Participants Code Diagnosis No. % No. % 2600 Deep “aggressive” angiomyxoma 13 0.2 0 0.0 1075 Intramuscular myxoma 5540 96.4 44 66.8 2440 Low grade fibromyxoid sarcoma 66 1.2 9 13.6 1058 Myxofibrosarcoma 25 0.4 1 1.5 1700 Myxoid liposarcoma 36 0.6 4 6.0 1563 Myxoid neurofibroma 61 1.1 8 12.1 1960 Nodular fasciitis 6 0.1 0 0.0

Technical Quality of Slide

PIP Participants Rating Glass Slide Evaluation No. % 001 Excellent 2280 43.0 002 1482 27.9 003 Satisfactory 1401 26.4 004 129 2.4 005 Unsatisfactory 16 0.3

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2012

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Diagnosis (1240) Urothelial carcinoma PIP Participants PIPW Participants Code Diagnosis No. % No. % 2789 Adenocarcinoma of the urinary bladder 21 0.4 7 10.6 2167 Prostatic adenocarcinoma 7 0.1 3 4.5 1647 Sarcomatoid carcinoma 1 0.1 0 0.0 2314 Squamous cell carcinoma 79 1.4 9 13.6 2472 Small cell carcinoma 2 0.1 0 0.0 1240 Urothelial carcinoma 5639 97.9 47 71.3

Technical Quality of Slide

PIP Participants Rating Glass Slide Evaluation No. % 001 Excellent 2433 45.5 002 1458 27.2 003 Satisfactory 1339 25.0 004 118 2.2 005 Unsatisfactory 6 0.1

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2012

-14

Diagnosis (2805) Primary synovial chondromatosis PIP Participants PIPW Participants Code Diagnosis No. % No. % 2790

Hyaline cartilage chondrosarcoma involving joint

52 0.9 1 1.6

2791 Loose bodies (Secondary synovial chondromatosis)

365 6.4 16 25.4

2792 Osteoarthritis 1 0.1 0 0.0 2793 Periosteal chondroma or chondroma of

soft parts 57 1.0 3 4.8

2805 Primary synovial chondromatosis 5266 91.6 43 68.2

Technical Quality of Slide

PIP Participants Rating Glass Slide Evaluation No. % 001 Excellent 2403 45.0 002 1419 26.7 003 Satisfactory 1399 26.3 004 94 1.8 005 Unsatisfactory 9 0.2

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2012

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Diagnosis (2794) Cellular fibrothecoma PIP Participants PIPW Participants Code Diagnosis No. % No. % 2081 Adult granulosa cell tumor 36 0.6 12 20.0 2794 Cellular fibrothecoma 5030 87.5 30 50.0 2481 Cellular leiomyoma 38 0.7 0 0.0 1957 Endometrial stromal sarcoma 3 0.1 3 5.0 2028 Fibromatosis 14 0.2 0 0.0 1958 Fibrosarcoma 33 0.6 0 0.0 1100 Fibrothecoma 519 9.0 10 16.7 1901 Gastrointestinal stromal tumor 1 0.1 0 0.0 2205 Sclerosing stromal tumor 71 1.2 5 8.3

Technical Quality of Slide

PIP Participants Rating Glass Slide Evaluation No. % 001 Excellent 2280 42.9 002 1455 27.4 003 Satisfactory 1428 26.9 004 132 2.5 005 Unsatisfactory 14 0.3

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2012

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Diagnosis (2796) Intra-abdominal desmoplastic small round cell tumor PIP Participants PIPW Participants Code Diagnosis No. % No. % 2461 Dysgerminoma 55 1.0 3 5.0 1668 Epithelioid sarcoma 20 0.4 0 0.0 2795 Inflammatory myofibroblastic tumor 23 0.4 0 0.0 2796 Intra-abdominal desmoplastic small round

cell tumor 5633 98.1 57 95.0

2046 Metastatic renal clear cell carcinoma 7 0.1 0 0.0

Technical Quality of Slide

PIP Participants Rating Glass Slide Evaluation No. % 001 Excellent 2179 41.3 002 1449 27.5 003 Satisfactory 1442 27.4 004 178 3.4 005 Unsatisfactory 23 0.4

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2012

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Diagnosis (1649) Solitary fibrous tumor PIP Participants PIPW Participants Code Diagnosis No. % No. % 1645 Desmoid tumor 26 0.5 3 5.0 2797 Malignant mesothelioma, desmoplastic

type 17 0.3 0 0.0

1780 Schwannoma 37 0.6 0 0.0 1649 Solitary fibrous tumor 5626 97.9 52 86.7 2068 Synovial sarcoma 38 0.7 5 8.3

Technical Quality of Slide

PIP Participants Rating Glass Slide Evaluation No. % 001 Excellent 2600 48.9 002 1326 24.9 003 Satisfactory 1284 24.1 004 89 1.7 005 Unsatisfactory 19 0.4

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2012

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Diagnosis (2798) Hepatitis C with alpha-1-antitrypsin intracytoplasmic globules PIP Participants PIPW Participants Code Diagnosis No. % No. % 2798 Hepatitis C with alpha-1-antitrypsin

intracytoplasmic globules 5711 99.5 59 98.3

2799 Hepatitis C and ischemia 12 0.2 0 0.0 2800 Hepatitis C and primary biliary cirrhosis 14 0.2 1 1.7 2801 Hepatitis C and Wilson's disease 6 0.1 0 0.0

Technical Quality of Slide

PIP Participants Rating Glass Slide Evaluation No. % 001 Excellent 2429 46.0 002 1379 26.1 003 Satisfactory 1361 25.7 004 108 2.0 005 Unsatisfactory 12 0.2

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2012

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Diagnosis (2408) Hepatosplenic T-cell lymphoma PIP Participants PIPW Participants Code Diagnosis No. % No. % 2802 Aggressive NK-cell lymphoma/leukemia 101 1.8 1 1.7 2268 Classical Hodgkin lymphoma 4 0.1 2 3.4 1837 Gaucher disease 3 0.1 0 0.0 1630 Hairy cell leukemia 461 8.1 14 23.7 2408 Hepatosplenic T-cell lymphoma 4893 85.2 15 25.4 2803 Sickle cell crisis 187 3.3 22 37.3 1990 Splenic marginal zone lymphoma 78 1.4 5 8.5

Technical Quality of Slide

PIP Participants Rating Glass Slide Evaluation No. % 001 Excellent 1973 37.3 002 1513 28.6 003 Satisfactory 1612 30.5 004 171 3.2 005 Unsatisfactory 20 0.4

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2012

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Diagnosis (2484) Focal nodular hyperplasia PIP Participants PIPW Participants Code Diagnosis No. % No. % 2484 Focal nodular hyperplasia 5558 97.0 41 70.7 1909 Hepatic adenoma 52 0.9 12 20.7 2804 Large regenerative nodule 26 0.5 0 0.0 1520 Nodular regenerative hyperplasia 92 1.6 5 8.6

Technical Quality of Slide

PIP Participants Rating Glass Slide Evaluation No. % 001 Excellent 2356 44.7 002 1450 27.5 003 Satisfactory 1359 25.8 004 90 1.7 005 Unsatisfactory 13 0.3