Researchers find discordance common between physicians conducting histopathologic analyses-- Monica Smith
Friday, May 14, 2010 (Last Updated: 05/17/2010)
FRIDAY, May 14 (HealthDay News) -- Though histopathologic analysis is still the gold standard for the pathologic diagnosis of melanoma, the discordance rate in routine histopathologic interpretation of melanocytic neoplasms can be high, according to research published in the May issue of the Journal of the American Academy of Dermatology.
B. Aika Shoo, M.D., of the University of California in San Francisco (UCSF), and colleagues evaluated melanoma or benign nevus diagnoses of 392 patients made initially by an outside dermatopathologist or surgical pathologist and then re-evaluated by routine histopathologic examination at the UCSF Dermatopathology Service, looking for discordance, defined as a lack of agreement between two pathologists rendering a benign, malignant or ambiguous diagnosis.
The researchers found discordant histopathological diagnoses in 56 cases (14.3 percent), 31 of which were initially reviewed by a dermatopathologist, 20 by a general surgical pathologist, and five where the pathologists' level of training was not determined.
"These results, taken together with the previous studies of discordance in the pathological diagnosis of melanoma, demonstrate the need for an evidence-based, hierarchical approach to the application of histologic criteria for the diagnosis of melanoma. In addition, they suggest the clinical usefulness of molecular assays that are being developed to assist in the assessment of melanocytic neoplasms," the authors write.
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