Affiliation:
1. Department of Pathology, The Johns Hopkins Hospital, Baltimore, MD, USA
Abstract
Abstract
Objectives
The value of consultation in pathology has been well documented in surgical pathology, but there are few comprehensive studies of consultation cases in cytopathology. Here we report our experience with cytopathology consultation cases at a large academic center.
Methods
A review of consultation cases at our institution was performed by searching our laboratory information system. The contributing institution’s diagnosis was compared with that rendered by the reviewing cytopathologist to assess major and/or minor diagnostic discrepancies.
Results
In total, 928 cases were reviewed with the following distribution: fine-needle aspiration (FNA, 79.4%), exfoliative nongynecologic cytology (18.3%), and cases with both FNA and nongynecologic cytology (2.3%). There were 379 (40.8%) true consults and 549 (59.2%) confirming consults. A total of 586 (63.1%) cases were in agreement with the outside pathologist, 78 (8.4%) cases had major discrepancies, and 264 (28.4%) cases had minor discrepancies. Major discrepancies were most common for pancreas (38.5%), lymph node (11.5%), and soft tissue sites (9.0%).
Conclusions
Of the cases, 8.4% had major diagnostic discrepancies between the original diagnosis and the consultation diagnosis, which is consistent with reported values in surgical pathology consultation studies. The findings support the importance of second-opinion consultation in cytopathology to guide patient care.
Publisher
Oxford University Press (OUP)
Reference22 articles.
1. Consultations in surgical pathology. Association of Directors of Anatomic and Surgical Pathology;Am J Surg Pathol,1993
2. Mandatory second opinion in cytopathology;Lueck;Cancer,2009
3. The effect of interinstitution anatomic pathology consultation on patient care;Abt;Arch Pathol Lab Med.,1995
4. Mandatory second opinion surgical pathology at a large referral hospital;Kronz;Cancer,1999
5. Mandatory second opinion in surgical pathology referral material: clinical consequences of major disagreements;Manion;Am J Surg Pathol,2008
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