Diagnostic Differences in Expert Second-Opinion Consultation Cases at a Tertiary Sarcoma Center.

Q2 Medicine

Sarcoma Pub Date : 2020-09-29 eCollection Date: 2020-01-01 DOI:10.1155/2020/9810170

Asha Rupani, Magnus Hallin, Robin L Jones, Cyril Fisher, Khin Thway

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引用次数: 15

Abstract

Soft tissue tumors are diagnostically challenging, and it is recommended that these are reported or reviewed by specialist soft tissue pathologists. We present our experience with second-opinion (consultation) cases in a specialist tertiary sarcoma center. The aim of this study was to determine areas of diagnostic difficulty in soft tissue pathology. We assessed 581 second-opinion cases which were reviewed by two experienced pathologists in a period of one year. There was 62% concordance between the original and the second-opinion diagnosis, with diagnostic discrepancy in 38%. The largest group of soft tissue neoplasms received for second opinion was fibroblastic/myofibroblastic tumors, and most major diagnostic problems were encountered in adipocytic and so-called "fibrohistiocytic" tumors. Major diagnostic errors impacting management were found in 148 cases (25%). Morphologic assessment of tumors, judicious use of molecular techniques, newer immunostains and their interpretation, along with importance of knowledge of rarer entities were found to be most useful in avoiding errors.

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第三期肉瘤中心专家第二意见咨询病例的诊断差异。

软组织肿瘤在诊断上具有挑战性，建议由专业的软组织病理学家报告或审查。我们介绍了我们在专科三级肉瘤中心的第二意见(咨询)病例的经验。本研究的目的是确定软组织病理诊断困难的领域。我们评估了581例由两名经验丰富的病理学家在一年内审查的第二意见病例。原始诊断与第二意见诊断的一致性为62%，诊断差异为38%。接受第二意见的最大的软组织肿瘤群体是纤维母细胞/肌纤维母细胞肿瘤，大多数主要的诊断问题是在脂肪细胞和所谓的“纤维组织细胞”肿瘤中遇到的。148例(25%)发现重大诊断错误影响治疗。对肿瘤进行形态学评估，明智地使用分子技术，更新的免疫染色及其解释，以及了解罕见实体的重要性，被发现对避免错误最有用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Sarcoma Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

5.00

自引率

0.00%

发文量

审稿时长

14 weeks

期刊介绍： Sarcoma is dedicated to publishing papers covering all aspects of connective tissue oncology research. It brings together work from scientists and clinicians carrying out a broad range of research in this field, including the basic sciences, molecular biology and pathology and the clinical sciences of epidemiology, surgery, radiotherapy and chemotherapy. High-quality papers concerning the entire range of bone and soft tissue sarcomas in both adults and children, including Kaposi"s sarcoma, are published as well as preclinical and animal studies. This journal provides a central forum for the description of advances in diagnosis, assessment and treatment of this rarely seen, but often mismanaged, group of patients.