Colorectal Pathology Specialist

Complete colorectal cancer pathology workflow toolkit combining compliance checking, staging, MSI/MMR reporting, and coding.

When to Use This Skill

Use this skill for:

• Colorectal cancer pathology report validation
• Colon and rectal carcinoma specimens (colectomy, polypectomy, TEM)
• CAP/ICCR compliance checking with severity scoring
• TNM staging calculation (AJCC 8th edition)
• MSI/MMR testing interpretation
• Mesorectal excision quality grading (rectal specimens)
• Tumor board summary generation
• SNOMED CT coding assistance

Supported Specimen Types

• Right hemicolectomy (cecum, ascending colon)
• Left hemicolectomy (descending colon)
• Sigmoid colectomy
• Low anterior resection (rectal)
• Abdominoperineal resection (rectal)
• Total mesorectal excision (TME)
• Polypectomy specimens
• Transanal excision (TEM/TAMIS)

Key Features

1. Compliance Checking: Validates against CAP ColoRectal and ICCR Colorectal Cancer protocols
2. TNM Staging: AJCC 8th edition colorectal staging with pT/pN/M calculation
3. MSI/MMR Reporting: Microsatellite instability and mismatch repair interpretation
4. Mesorectal Quality: TME quality grading (complete/nearly complete/incomplete)
5. Template Generation: Colon and rectal specimen synoptic templates
6. Tumor Board Summaries: Concise 3-5 line MDT presentation format
7. SNOMED Coding: Colorectal-specific code suggestions

Reference Files

When processing reports, reference these files on-demand (DO NOT load at startup):

• Diagnosis guidelines: references/diagnosis/colorectal_resection.md
• Macroscopy guidelines: references/macroscopy/colorectal_macroscopy.md
• TNM staging: ../../shared-references/staging/tnm_stage_calculator.md
• Synoptic templates: ../../shared-references/templates/synoptic_templates.md
• SNOMED codes: ../../shared-references/coding/snomed_ct_codes.md

Usage Examples

# Validate report compliance
claude "Check this colorectal report using colorectal-pathology-specialist" < report.txt

# Generate staging
claude "What stage is pT3 N1b M0 for colorectal using colorectal-pathology-specialist"

# Create template
claude "Generate rectal TME template using colorectal-pathology-specialist"

# MSI interpretation
claude "Interpret MLH1 loss, PMS2 loss, MSH2 intact, MSH6 intact using colorectal-pathology-specialist"

Processing Instructions

When analyzing colorectal pathology reports:

1. Identify request type (compliance check, staging, template, MSI interpretation, summary, coding)
2. Read relevant reference file on-demand based on request
3. Process the report using appropriate guidelines
4. Generate output in requested format
5. DO NOT load all reference files upfront

Compliance Scoring

Use severity-based weighting:

• Critical elements (tumor size, grade, margins, CRM, nodes, MSI): -15 points each
• Major elements (LVI, PNI, tumor deposits, perforation): -5 points each
• Minor elements (tumor location, distance from margins): -2 points each

Scoring: 90-100 (Compliant) | 70-89 (Minor issues) | 50-69 (Major issues) | <50 (Critical)

Cross-Validation Checks

Always validate:

• pT category vs tumor invasion depth
• pN category vs positive node count
• Stage group vs pT/pN/M combination
• CRM status (rectal) vs margin measurements
• MSI status vs MMR immunohistochemistry pattern

Language Support

Supports English and Turkish - detect from user prompt and use appropriate template file.

Note: This is a minimal skill definition. Large reference files are loaded on-demand only when processing requests, not at skill startup.