ECP 2023 Abstracts

S337 Virchows Archiv (2023) 483 (Suppl 1):S1–S391 13 E-PS-20-003 A case series of patients with NTRK fusion from the Federation of Bosnia and Herzegovina N. Bilalovic*, F. Erkan Akay, L. Pilav *Department of Clinical Pathology & Cytology, Clinical Center, Uni- versity of Sarajevo, Bosnia and Herzegovina Background & objectives: Multiple novel drugs developed for precision medicine have demonstrated outstanding efficacy in neoplastic patients with unique molecular targets. Detecting patients with a neutrophilic tropomyosin receptor kinase (NTRK) fusion has become clinically sig- nificant, especially with the discovery of TRK inhibitor treatment. Methods: In this case series, during the years 2021 and 2022, 60 patients were tested for NTRK fusion, with three displaying moderate expression and two expressing strong cytoplasmic positivity. This study aimed to determine the nationwide landscape of NTRK/TRK testing in the Federation BH and the usage of pan-TRK immunohistochemistry (IHC) as a preselection tool to detect NTRK fusions. Results: A total of 2 fusions involving NTRK were identified in tumours. One of the two patients was a 44-year-old male patient diag- nosed with an infantile fibrosarcoma (IFS)-like tumour with an ETV6- NTRK fusion who presented with a painful and palpable mass in the proximal adductor region of the right hip. The other patient was a 15-year-old male with juvenile NTRK-rearranged SPN who presented with a mass on his right knee underwent surgery at first. But after 4 months, the mass recurred in the inguinal region, hence he was put on lacrotrectinib treatment for 8 cycles, displayed an outstanding response, and has been in remission since. Conclusion: Our goal is to raise awareness, especially in developing countries, of NTRK fusion testing, which may lead to the expansion of actionable target treatments and the advancement of precision medicine and testing modalities E-PS-20-004 Mirror mirror on the wall, who is the fairest of us all; lessons learned from audits of histopathology laboratories; an auditor’s perspective from Lahore, Pakistan F. Rehman*, A. Iqbal, M.U. Farooq, Z. Zafar, S. Yar, A. Hamid *Associate professor Pathology department, Ameerudin medical col- lege/postgraduate medical institute, Lahore, Pakistan Background & objectives: In order to comply with international standards and ensure quality assurance, participation in external audits plays an essential role. Laboratories in Pakistan seek accreditation from Pakistan national accreditation council (PNAC, a local accreditation body) or College of American Pathologists (CAP). Methods: Audits were conducted in terms of different phases of rou- tine testing including pre-analytical, analytical and post-analytical phases. Histopathology laboratories from both governmental and non-governmental institutions were included in the study. A structured checklist was used as per ISO 15189 requirements for medical labora- tory accreditation. Auditor then inspected compliance with various parameters of the checklist. Results: Some of the non-governmental histopathology laboratories have been accredited by College of American pathologists. Only 6.25% of laboratories from governmental institutions applied for accreditation and future surveillance. Histopathology laboratories were participating in both diagnostic and technical modules of proficiency testing programs offered by international accreditation bodies including CAP & RCPATH Australasia. Challenges faced by governmental institution’s laborato- ries were mainly inappropriate fund allocation for quality assurance & accreditation, lack of human resources and delay in routine purchase of reagents & consumables. Maximum errors were observed in preanalyti- cal phase of testing due to non-compliance with specimen submission guidelines and lack of relevant information on requisition forms. Conclusion: Quality assurance and improving customer satisfaction is the main goal of any histopathology laboratory. Medical laborato- ries should be encouraged to comply with regular scheduled audits. Timely reporting, participation in proficiency testing, adherence to international guidelines and reporting protocols, effective monitoring of turnaround time and collaboration with physicians and paramed- ics will help in continuous improvement in histopathology laboratory services. The organizations play a crucial role by provision of techni- cal support and allocating appropriate funding and human resources especially in governmental institutes. E-PS-20-005 Role of multidisciplinary team meetings in reshaping histopathol- ogy laboratory image: physician’s perspective F. Rehman*, Z. Rashid, M.U. Farooq, F.N. Alam, A. Hamid *Associate professor Pathology department, Ameerudin medical col- lege/postgraduate medical institute, Lahore, Pakistan Background & objectives: Multidisciplinary team meetings involve healthcare professionals from different disciplines; working together to evaluate and manage patients with complex medical diseases. The pivotal role of a histopathologist in MDT’s is of providing important diagnostic clues essential in deciding patient’s management. Methods: A cross-sectional study involving 323 physicians was con- ducted at a tertiary care hospital in Lahore, Pakistan. A self-designed structured questionnaire covering various aspects of histopathologist role in MDTs was prepared after extensive literature search. The physi- cians from different departments of hospital were questioned regarding various aspects of histopathologist’s participation in MDTs. Data was entered and analysed using SPSS version 21. Results: Physicians from various disciplines mainly surgery and allied departments (including plastic surgery, otolaryngology, neurosurgery, orthopaedics, paediatric surgery) and medicine and allied departments participated in the survey. The main advantages of MDTs was coor- dination between physicians and diagnosticians in making an appro- priate decision regarding patient therapeutic management, prognosis and follow up. The main hurdles in these collaborative meetings were lack of coordination, delayed access to complete clinical information, abrupt changes in duty rosters of both residents and practicing physi- cians, insufficient histopathology reports due to additional testing or rework and lack of adherence to management guidelines and reporting protocols and checklist. Conclusion: Histopathologists play a critical role in MDTs by providing expert opinions on patient’s laboratory results, essential in provision of an accurate diagnosis and effective management decisions. they also serve in bridging the gap between physician’s perception of laboratory services and the efforts put by histopathologist in justifying their results. E-PS-20-006 Acquisition of histotechnical knowledge in surgical pathology training programs, a necessity or a need? A cross sectional multi- institutional study from Pakistan F. Rehman*, H. Salahuddin, R. Basharat, S. Anwar, A. Hamid, M.U. Farooq *Associate professor Pathology department, Ameerudin medical col- lege/postgraduate medical institute, Lahore, Pakistan Background & objectives: Acquiring the histotechnical knowledge regarding general and advanced histotechniques is an integral part of surgical pathology training programs in Pakistan. This is important for optimal performance of professional duties and management of troubleshooting in daily sign outs. Methods: This cross sectional prospective study was conducted over a period of six months. Self-generated questionnaire was shared with the supervisors of surgical pathology training programs working in local