Lithuanian Laboratory Implementation Guide
0.0.1 - ci-build
Lithuanian Laboratory Implementation Guide
0.0.1 - ci-build
Lithuanian Laboratory Implementation Guide, published by Lithuanian Medical Library. This guide is not an authorized publication; it is the continuous build for version 0.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7LT/ig-lt-lab/ and changes regularly. See the Directory of published versions
<DiagnosticReport xmlns="http://hl7.org/fhir">
<id value="diagnosticreport-pathology-report-example"/>
<meta>
<profile
value="https://hl7.lt/fhir/lab/StructureDefinition/pathology-report-lt-lab"/>
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<language value="lt"/>
<text>
<status value="generated"/>
<div xml:lang="lt" lang="lt"><hr/><p><b>Lithuanian</b></p><hr/><p class="res-header-id"><b>Generated Narrative: DiagnosticReport diagnosticreport-pathology-report-example</b></p><a name="lt-diagnosticreport-pathology-report-example"> </a><a name="lt-hcdiagnosticreport-pathology-report-example"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Language: en</p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-pathology-report-lt-lab.html">ServiceRequest: Pathology Report (Lt)</a></p></div><h2><span title="Codes:{http://snomed.info/sct 714797009}">Histologic test (procedure)</span> </h2><table class="grid"><tr><td>Subject</td><td>Jonas Petrauskas(official) Male, DoB: 1985-01-01 ( http://hospital-lt.lt/patient-id#HOSPLT-10005 (use: usual, ))</td></tr><tr><td>When For</td><td>2022-10-25 13:35:00+0100</td></tr><tr><td>Performer</td><td> <a href="Practitioner-practitioner-example.html">Practitioner Registrar</a></td></tr><tr><td>Identifier</td><td> <code>http://hospital.lt/sid/pathology-report-number</code>/3f69e0a5-2177-4540-baab-7a5d0877428f</td></tr></table><p><b>Report Details</b></p><table class="grid"><tr><td><b>Code</b></td><td><b>Value</b></td><td><b>Flags</b></td><td><b>Note</b></td><td><b>When For</b></td></tr><tr><td><a href="Observation-observation-specimen-adequacy-example.html"><span title="Codes:{http://snomed.info/sct 371507005}">Adequacy of specimen (observable entity)</span></a></td><td><span title="Codes:{http://snomed.info/sct 125152006}">Specimen satisfactory for evaluation (finding)</span></td><td>Final, <span title="Codes:">normal</span></td><td><blockquote><div><p>The breast tissue specimen is deemed adequate for histopathological evaluation.</p>
</div></blockquote></td><td>2025-01-15 11:00:00+0200</td></tr><tr><td colspan="5"><i>The observation 'Observation/observation-estrogen-status' could not be resolved</i></td></tr><tr><td colspan="5"><i>The observation 'Observation/observation-progesterone-status' could not be resolved</i></td></tr><tr><td><a href="Observation-observation-her2-receptor-status-example.html"><span title="Codes:{http://loinc.org 31150-6}">ERBB2 gene duplication [Presence] in Tissue by FISH</span></a></td><td><span title="Codes:{https://tx.hl7.lt/fhir/CodeSystem/her2-receptor-status 1}">Her2 overexpressed or gene amplified</span></td><td>Final</td><td/><td/></tr><tr><td><a href="Observation-observation-specimen-measurement-example.html"><span title="Codes:{http://snomed.info/sct 371475003}">Specimen size</span></a></td><td/><td>Final</td><td/><td>2024-06-01 10:00:00+0000</td></tr><tr><td><a href="Observation-observation-tumor-observable-example.html"><span title="Codes:{http://snomed.info/sct 395531003}">Neoplasm observable (observable entity)</span></a></td><td/><td>Final</td><td/><td>2025-01-10 09:15:00+0200</td></tr><tr><td><a href="Observation-observation-tumor-measurement-example.html"><span title="Codes:{http://snomed.info/sct 263605001}">Tumor size</span></a></td><td/><td>Final</td><td/><td>2024-06-01 10:00:00+0000</td></tr></table><div><p>Histopathological examination of the breast tissue specimens confirms the presence of invasive ductal carcinoma in the right breast and benign fibrocystic changes in the left breast.</p>
</div><p><b>Coded Conclusions:</b></p><ul><li><span title="Codes:{http://hl7.org/fhir/sid/icd-10 C10.1}, {http://terminology.hl7.org/CodeSystem/icd-o-3 8140/2}">Anterior surface of epiglottis</span></li></ul></div>
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<system value="http://hospital.lt/sid/pathology-report-number"/>
<value value="3f69e0a5-2177-4540-baab-7a5d0877428f"/>
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<basedOn>🔗
<reference value="ServiceRequest/servicerequest-pathology-order-example"/>
</basedOn>
<basedOn>🔗
<reference
value="ServiceRequest/servicerequest-pathology-prostate-order-example"/>
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<status value="final"/>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="714797009"/>
<display value="Histologic test (procedure)"/>
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<subject>🔗
<reference value="Patient/patient-example"/>
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<effectiveDateTime value="2022-10-25T13:35:00+01:00"/>
<performer>🔗
<reference value="Practitioner/practitioner-example"/>
</performer>
<specimen>🔗
<reference value="Specimen/specimen-right-breast-example"/>
</specimen>
<specimen>🔗
<reference value="Specimen/specimen-left-breast-example"/>
</specimen>
<result>🔗
<reference value="Observation/observation-specimen-adequacy-example"/>
</result>
<result>
<reference value="Observation/observation-estrogen-status"/>
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<result>
<reference value="Observation/observation-progesterone-status"/>
</result>
<result>🔗
<reference value="Observation/observation-her2-receptor-status-example"/>
</result>
<result>🔗
<reference value="Observation/observation-specimen-measurement-example"/>
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<result>🔗
<reference value="Observation/observation-tumor-observable-example"/>
</result>
<result>🔗
<reference value="Observation/observation-tumor-measurement-example"/>
</result>
<composition>🔗
<reference value="Composition/composition-pathology-example"/>
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<conclusion
value="Histopathological examination of the breast tissue specimens confirms the presence of invasive ductal carcinoma in the right breast and benign fibrocystic changes in the left breast."/>
<conclusionCode>
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<display value="Anterior surface of epiglottis"/>
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<coding>
<system value="http://terminology.hl7.org/CodeSystem/icd-o-3"/>
<code value="8140/2"/>
<display value="Adenocarcinoma in situ, NOS"/>
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</DiagnosticReport>