Pancreatic Pathology Specialist

Complete pancreatic cancer pathology workflow toolkit combining compliance checking, staging, margin assessment, and coding.

When to Use This Skill

Use this skill for:

• Pancreatic cancer pathology report validation
• Exocrine pancreas carcinoma specimens (Whipple, distal pancreatectomy, total pancreatectomy)
• CAP/ICCR compliance checking with severity scoring
• TNM staging calculation (AJCC 8th edition)
• Complex margin assessment (anterior/posterior surface, SMA, portal vein, bile duct)
• Whipple specimen dissection guidance
• Tumor board summary generation
• SNOMED CT coding assistance

Supported Specimen Types

• Whipple procedure (pancreaticoduodenectomy)
• Distal pancreatectomy
• Total pancreatectomy
• Enucleation
• Core needle biopsy

Key Features

1. Compliance Checking: Validates against CAP Panc.Exo and ICCR Carcinoma of the Exocrine Pancreas protocols
2. TNM Staging: AJCC 8th edition pancreas staging with pT/pN/M calculation
3. Margin Assessment: Anterior surface, posterior surface, SMA, portal vein groove, bile duct, pancreatic neck
4. Whipple Dissection: Step-by-step guidance for proper specimen sampling
5. Template Generation: Whipple and distal pancreatectomy synoptic templates
6. Tumor Board Summaries: Concise 3-5 line MDT presentation format
7. SNOMED Coding: Pancreas-specific code suggestions

Reference Files

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

• Diagnosis guidelines: references/diagnosis/exocrine_pancreas.md
• Macroscopy guidelines: references/macroscopy/pancreas_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 pancreas report using pancreas-pathology-specialist" < report.txt

# Generate staging
claude "What stage is pT2 N1 M0 for pancreas using pancreas-pathology-specialist"

# Create template
claude "Generate Whipple specimen template using pancreas-pathology-specialist"

# Margin interpretation
claude "How to report anterior surface margin 0.5mm using pancreas-pathology-specialist"

Processing Instructions

When analyzing pancreatic pathology reports:

1. Identify request type (compliance check, staging, template, margin 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, SMA margin, nodes): -15 points each
• Major elements (LVI, PNI, surface involvement, bile duct margin): -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 size and extension
• pN category vs positive node count
• Stage group vs pT/pN/M combination
• R status vs margin measurements
• SMA margin vs arterial involvement

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.