CNS Tumours - Structured Pathology Reporting database

Structured Reporting of CNS Tumours using a standard protocol re-constructed in a FileMaker database. The database CNS Protocol records data for 60 questions in 5 groups. Data is recorded for patient identification, observations about the clinical specimen, macroscopic and microscopic findings of the CNS specimen, and tumour grade. The completed data is reported as print or PDF output.

Patient Identification data

Family Name, Given Name, Gender, Date Of Birth, Patient Identifiers, Date of Request, Path Accession No., Requesting doctor name, Requesting doctor phone, Requesting doctor contacted, Ethnicity.

Clinical details data

Principal clinician, Surgeon's name, Presenting symptom, Clinical history, Imaging findings, Contrast enhancement, Current and previous treatment, Anatomical site, (Other specify), Laterality, Specimen type, (Other specify), Clinical or differential diagnosis.

Macroscopic findings data

Number of specimens, Specimen length, Specimen width, Specimen thickness, Specimen weight, Description, Recognisable anatomical structures, Amount of unprocessed tissue, Dist. to nearest dural resection margin, Specimen colour, Specimen consistency, Haemorrhage, Necrosis, Cystic change, Calcification, Other relevant comments.

Microscopic findings data

Microscopic findings, Distance between tumour and nearest dural resection margin (where dura is included), Is the specimen diagnostic?, Provide details, Any artifacts impacting specimen? eg crush, autolysis, cautery etc, Brain invasion (for meningiomas), Other relevant microscopic comments.

Ancillary Testss data

IHC Positive Abs, IHC Negative Abs, IHC Equivocal Abs, IHC Interpretation, IHC Clinical significance, Molecular testing.

Synthesis and Overview data

Histological tumour type, Diagnosis, Histological tumour grade, Specify why, Comment on tumour type and grade, Diagnostic summary, Overarching comments.