Expert second-opinion pathology review of lymphoma in the era of the World Health Organization classification Journal Article


Authors: Matasar, M. J.; Shi, W.; Silberstein, J.; Lin, O.; Busam, K. J.; Teruya-Feldstein, J.; Filippa, D. A.; Zelenetz, A. D.; Noy, A.
Article Title: Expert second-opinion pathology review of lymphoma in the era of the World Health Organization classification
Abstract: Background: The World Health Organization (WHO) classification of hematologic malignancies, published in 2000, was designed to improve diagnostic accuracy by incorporating the latest in scientific understanding. The impact of the WHO classification on the frequency of diagnostic discrepancy in lymphoma is unknown. Methods: We reviewed all second-opinion pathology of lymphoma at our National Cancer Institute-designated Comprehensive Cancer Center (NCI-CCC) from January to June 2001 and from January to June 2006. Discrepancies between submitted and second-opinion diagnoses were scored based upon an a priori grading schema. Results: Major diagnostic revision was rendered in 65 of 365 cases (17.8%) in 2001 and 58 of 354 (16.4%) in 2006 (P = NS). Including cases reviewed and revised beforehand at another NCI-CCC, rates of major diagnostic revision were 21.4% and 18.6%, respectively (P = NS). Discrepancy rates varied by diagnosis, from Hodgkin lymphoma (10%) to Burkitt's lymphoma (75%). No association was seen for age, gender, race/ethnicity, biopsy type, or nature of referring center. Conclusions: Clinically meaningful diagnostic revision occurs frequently with expert pathology review for a diagnosis of lymphoma. Despite the WHO classification, rates of diagnostic revision at our institution in 2001 and 2006 did not differ significantly. Given the potential harm from misdiagnosis, expert hematopathology review should be considered the standard of care. © The Author 2011. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.
Keywords: pathology; lymphoma; second opinion
Journal Title: Annals of Oncology
Volume: 23
Issue: 1
ISSN: 0923-7534
Publisher: Oxford University Press  
Date Published: 2012-01-01
Start Page: 159
End Page: 166
Language: English
DOI: 10.1093/annonc/mdr029
PROVIDER: scopus
PUBMED: 21415238
DOI/URL:
Notes: --- - "Export Date: 1 February 2012" - "Art. No.: mdr029" - "CODEN: ANONE" - "Source: Scopus"
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MSK Authors
  1. Weiji Shi
    111 Shi
  2. Ariela Noy
    206 Noy
  3. Julie T Feldstein
    288 Feldstein
  4. Oscar Lin
    231 Lin
  5. Andrew D Zelenetz
    554 Zelenetz
  6. Matthew J Matasar
    121 Matasar
  7. Klaus J Busam
    536 Busam
  8. Daniel A Filippa
    102 Filippa