Fellowship in Tumour Pathology

Course Objectives

i) Emphasise the need to gross big surgical specimens according to guidelines so that synoptic reports(like CAP or RCPath) can be generated ,providing accurate pathological staging (pTN) and adequate prognostic information.
ii) Improve diagnostic skills, emphasizing descriptive report writing. Emphasise the need to keep a differential diagnosis list based on morphology.
Iii) Immunohistochemistry-based panels to be used to refine diagnoses. The value of appropriate panels, additional markers, use of positive and negative controls, quality control measures will be emphasized. Prognostic & predictive markers in different sites e.g. breast will be highlighted.
iv) Companion diagnostics like PD-L1immunostaining and complementary diagnostics like Mismatch Repair IHC.
v) Training in frozen section reporting for primary diagnosis, margins etc. and other aspects of intraoperative consultation such as squash preparations, scrape smears and intraoperative FNAs.
vi) Haematology- To ensure quality control of the automated haematology analyser and verify flagged results by smear
vii) Interpretation of peripheral smears, bone marrow aspiration and bone marrow biopsy including IHC when indicated
viii) Flow cytometry in the diagnosis of acute and chronic leukemia/lymphoma involving marrow
ix) Familiarity with Molecular tests in the diagnosis of haematological malignancies
x) Fine needle aspiration cytology: routine and ultrasound/ CT-guided- practice and interpretation. The use of cell blocks for IHC /FISH will be highlighted as well as the guidelines for reporting in different sites.
xi) Fluid & gynaec cytology reporting
xii) Expose and familiarise Fellows to newer techniques such as FISH, NGS, RT-PCR, clonality assays that are adjuncts to morphology and diagnosis.
xiii) Foster interest in research, write-up of small projects, publish interesting case reports

Course Duration

At the end of the course, the student is expected to know the following:
i) Histopathology-optimal grossing of surgical specimens independently; independent reporting of frozen sections; finalizing histopathology reports; deciding panels of IHC markers in individual cases; making final diagnoses after IHC; deciding which molecular markers to ask for in any individual case. Ensure that reports are dispatched within the TAT of the lab.
ii) Haematology- Interpretation of peripheral smears, bone marrow aspiration and bone marrow biopsy including IHC when indicated ;Flow cytometry in the diagnosis of acute and chronic leukemia/lymphoma involving marrow;familiarity with Molecular tests in the diagnosis of haematological malignancies.
iii) Cytology- Be able to interpret fine needle aspiration cytology: routine and ultrasound/ CT-guided; IHC on cell blocks & the guidelines for reporting cytopathology in different sites; Fluid & gynaec cytology reporting.
iv) Molecular pathology- which molecular tests are useful in tumours in different sites, prognostic and predictive marker testing, use of gene panels.
v) Report on any oncology specimen confidently and assertively discuss relevant points of individual cases with clinical and radiology colleagues. Realise that certain cases may warrant a second opinion, which may be obtained from senior colleagues/mentors/external subspecialty experts.