Discrepancy between the clinical and histopathologic diagnosis of soft tissue vascular malformations
| Autor: | Sophie E.R. Horbach, Chantal M.A.M. van der Horst, Lorine B. Meijer-Jorna, Amalia Mulia Utami, Allard C. van der Wal, Phyllis I. Spuls, J.H. Sillevis Smitt |
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| Přispěvatelé: | APH - Quality of Care, APH - Methodology, Graduate School, Other departments, Dermatology, ACS - Amsterdam Cardiovascular Sciences, AMS - Amsterdam Movement Sciences, Plastic, Reconstructive and Hand Surgery, Pathology, APH - Personalized Medicine, ACS - Heart failure & arrhythmias, ACS - Diabetes & metabolism, ACS - Atherosclerosis & ischemic syndromes |
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Vascular Malformations Dermatology 030218 nuclear medicine & medical imaging Arteriovenous Malformations Cohort Studies 03 medical and health sciences Young Adult 0302 clinical medicine medicine Confidence Intervals Odds Ratio Humans Medical diagnosis Soft tissue vascular malformations Child Physical Examination Retrospective Studies Skin Analysis of Variance business.industry Vascular malformation Biopsy Needle Reproducibility of Results Arteriovenous malformation Odds ratio medicine.disease Immunohistochemistry Logistic Models 030220 oncology & carcinogenesis Multivariate Analysis Histopathology Female Radiology Dermatopathology business Venous malformation |
| Zdroj: | Journal of the American Academy of Dermatology, 77(5), 920-929.e1. Mosby Inc. |
| ISSN: | 1097-6787 0190-9622 |
| Popis: | Background Soft tissue vascular malformations are generally diagnosed clinically, according to the International Society for the Study of Vascular Anomalies (ISSVA) classification. Diagnostic histopathologic examination is rarely performed. Objective We sought to evaluate the validity of the current diagnostic workup without routinely performed diagnostic histopathology. Methods We retrospectively determined whether there were discrepancies between clinical and histopathologic diagnoses of patients with clinically diagnosed vascular malformations undergoing therapeutic surgical resections in our center (2000-2015). Beforehand, a pathologist revised the histopathologic diagnoses according to the ISSVA classification. Results Clinical and histopathologic diagnoses were discrepant in 57% of 142 cases. In these cases, the pathologist indicated the diagnosis was not at all a vascular malformation (n = 24; 17%), a completely different type of vascular malformation (n = 26; 18%), or a partially different type with regard to the combination of vessel-types involved (n = 31; 22%). Possible factors associated with the discrepancies were both clinician-related (eg, diagnostic uncertainty) and pathology-related (eg, lack of immunostaining). Limitations Retrospective analysis of a subgroup of patients undergoing surgery. Conclusion The large discrepancy between clinical and histopathologic diagnoses raises doubt about the validity of the current diagnostic workup for vascular malformations. Clear clinical and histopathologic diagnostic criteria might be essential for a uniform diagnosis. |
| Databáze: | OpenAIRE |
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