2026-08-17 - Anatomic Pathology CRG Meeting

Scott Campbell

https://snomed.zoom.us/my/pathologycrg

Scott Campbell

The meeting focused on reviewing immunohistochemistry modeling strategies and discussing cancer taxonomy concepts, particularly around metastatic neoplasms. Scott presented a proposed structure for modeling immunohistochemistry techniques, suggesting they be modeled as single techniques with specific antibody and clone information, including chromogen colors in the naming. The group discussed whether to maintain separate "metastatic neoplasm" concepts as morphologic abnormalities, with participants generally agreeing these concepts should likely be eliminated since they don't make logical sense as distinct morphologies and could cause confusion. The team also touched on how to properly model primary versus secondary tumors and metastatic spread, though this discussion was left incomplete for further consideration.

• Take initiative to schedule the genomics meeting, since it has stalled without a clear owner driving it forward.

• Send updated meeting invites to all participants who were missing from the recurring meeting (including Jieun/June, Brian, and others who did not receive the new invite).

• Compile a comprehensive list of immunohistochemistry standards (antibodies, clones, chromogens/colors) to review at the next meeting.

• Review the full list of issues raised by the Odyssey/OMOP team regarding cancer concepts and prepare recommendations for group consultation, starting with the metastatic neoplasm morphology hierarchy.

• Ensure histology quality project progress is reported at a high level once per month in the group meeting going forward.

• Address outstanding adenocarcinoma classification issues (noted by Elaine as still unresolved) in upcoming sessions.

• Follow up with David Clooney regarding the immunohistochemistry modeling strategy (no response received yet).

• Scott & Elaine: Cancel/scratch tomorrow morning's meeting since Suzanne is out and Elaine needs to complete pending work.

• Scott (with Jim and Elaine): Draft a proposed editorial/modeling structure for immunohistochemistry staining techniques (to be used as a guide before authoring content), to be shared before the next meeting.

• Jim & Elaine: Support development of a formal proposal regarding the metastatic neoplasm morphology hierarchy (whether to retire it), to be put out for broader consultation.

The team discussed scheduling changes, with Elaine confirming she would need to reschedule tomorrow's meeting due to urgent work. Scott reviewed Christian's materials and identified areas that could be improved, including potential fixes through histology quality improvements and addressing College of American Pathologists findings for synoptic reports. The team welcomed Hung as the new pathologist member, replacing Raj who has rotated off, with Hung having previous experience with myeloid neoplasm work. There was some confusion about meeting invites, with Jieun noting she was excluded from the current meeting series, though Scott confirmed new invites had been sent out.

The team discussed their agenda for the next six months, which includes reviewing immunohistochemistry staining techniques, histology quality improvement, and cancer-related items. Scott mentioned the need for monthly updates on the histology quality project to maintain visibility and avoid surprises. Elaine noted they still need to address adenocarcinomas. Stefan raised a question about editorial rules regarding classifying conditions as disorders versus observables, expressing concern about potentially doing duplicate work.

The team discussed the distinction between clinical findings and disorders in SNOMED terminology, with Jim explaining that observable entities represent what is observed while disorders represent disease states. Scott presented a proposed immunohistochemistry strategy where concepts would be modeled as single techniques with specific antibody and clone combinations, including chromogen information in the naming structure. The team reviewed examples of PD-L1 immunohistochemistry techniques and discussed how to handle polyclonal stains, with the proposal to include chromogen color and clone information in the naming structure to help algorithms identify the correct markers.

The group discussed modeling immunohistochemistry techniques in SNOMED, focusing on how to represent staining methods and combinations in DICOM and HL7 messages. They debated whether to maintain the "metastatic neoplasm" taxonomy as a morphologic abnormality, with consensus emerging that it might be more appropriate to model metastasis as a characteristic of a primary neoplasm rather than a separate morphologic category. The team agreed that any significant changes to these concepts would require broader consultation due to their long-standing presence in SNOMED.