The Association of Directors of Anatomic and Surgical Pathology (ADASP) has named several committees to develop recommendations regarding the content of the surgical pathology report for common malignant tumors. A committee of individuals with special interest and expertise write the recommendations, and they are reviewed and approved by the council of ADASP and subsequently by the entire membership. The recommendations have been divided into four major areas: (1) items that provide an informative gross description; (2) additional diagnostic features that are recommended to be included in every report if possible; (3) optional features that may be included in the final report; (4) A checklist (see Appendix). The purpose of these recommendations is to provide an informative report for the clinician. The recommendations are intended as suggestions and adherence to them is completely voluntary. In special clinical circumstances, the recommendations may not be applicable. The recommendations are intended as an educational resource rather than a mandate.

A new classification of lymphoid neoplasms, mostly based on existing terminology, is proposed by the International Lymphoma Study Group. The proposed classification was reached through a consensus of the members, despite their diverse backgrounds, and consists of a listing of currently recognized clinicopathological entities. These tumours are divided into three major categories: B-cell neoplasms, T-cell and postulated natural killer cell neoplasms, and Hodgkin's disease. The characterization of each entity is based on a synthesis of all available information. This concept departs from a purely morphological approach to lymphoma classification, which is considered to be inadequate, because many biologically distinctive lymphoma types can exhibit a broad and overlapping morphological spectrum. Some entities are provisional, pending further data to confirm that their recognition is reproducible. The salient clinicopathological features of each entity are summarized in this review.

We have reviewed our experience with four of the entities that are included under the generic term chronic myeloid leukaemia (CML), namely the classic Ph+ CGL, both BCR+ and BCR-, aCML and CMML. We have developed a statistical model that confirms that CGL, aCML and CMML can be distinguished from each other with reasonable success employing five quantitative parameters (WBC, percentage immature granulocytes, percentage monocytes, percentage basophils, percentage erythroid precursors in bone marrow) and one qualitative parameter (granulocytic dysplasia). It is hoped that these detailed recommendations will enable investigators to improve their diagnostic accuracy. This should permit more uniform comparisons of molecular biologic and clinical studies.

A workshop of the Histiocyte Society was recently held, in order to discuss the problems and confusion of malignant histiocytosis (MH) and large cell anaplastic (Ki-1) lymphoma (LCAL). The aims of this workshop were to clarify the terminology for malignant histiocytic disorders and LCAL and to produce reliable criteria for diagnosis of both MH and LCAL. This article summarises the conclusions reached.

The working group "BAL" was established to develop guidelines and recommendations for the practical application of BAL. The indications and complications of the technique are shown, followed by recommendations for the bronchoscopic procedure to collect the samples, for the laboratory processing of the specimen and for the evaluation of the cytological preparations. Guidelines for the interpretation of BAL findings are given. Some normal values from the literature are listed. Disease characteristic changes are presented.

In December of 1988, the National Cancer Institute in Bethesda, Maryland (USA), held a workshop that produced published guidelines for reporting the results of cervical and vaginal cytology. A second workshop was held in April 1991 to discuss the initial proposal and suggest modifications. The final recommendations are the following: the Papanicolaou classification for reporting consultation is not acceptable in the modern practice of diagnostic cytopathology (because it does not reflect current understanding of cervical/vaginal neoplasia--has no equivalent in diagnostic histopathologic terminology--does not provide diagnoses for non-cancerous entities and, as a result of numerous modifications, the specific Papanicolaou classes no longer reflect diagnostic interpretations uniformly). The cytologic report is a medical consultation in the same manner as is the histomorphologic report. Clinical information is absolutely essential for making the diagnosis. (A cytopathologic diagnosis should be an interpretation of morphologic findings, but this interpretation is best made in the context of the patient's clinical situation). The cytopathologist should determine whether the specimen is adequate for diagnostic evaluation. If unsatisfactory or satisfactory for evaluation but limited by ..., this should be noted in the report. The use of precise diagnostic terms to facilitate unambiguous communication between cytopathologist and clinician. The terminology for squamous epithelial lesions includes: 1) Atypical squamous cells of undetermined significance. 2) Squamous intraepithelial lesion (SIL), which encompass the spectrum of squamous cell carcinoma precursors, divided into low-grade SL (HPV-associated cellular changes, mild dysplasia and CIN1) and high-grade SIL (moderate dysplasia, severe dysplasia and carcinoma in situ and CIN2 and CIN3).(ABSTRACT TRUNCATED AT 250 WORDS)

As a result of rapidly evolving technology, advances in the understanding of the pathogenesis of cervical neoplasia, and the introduction of TBS terminology, we stand at a crossroads in the screening and management of this disease. This bulletin reflects management considered appropriate at this time. A number of key issues as indicated above must be addressed before more specific guidelines can be incorporated into routine clinical practice. Until data from clinical trials evaluating these new methods are available, the gynecologist is best advised to manage patients using the guidelines in this Technical Bulletin.