Interobserver variation is a significant limitation in the diagnosis of Burkitt lymphoma
| Autor: | Daksha Prabhat, Keyuri Patel, Swati Narurkar, Meenal S. Hastak, Gwendolyn Fernandes, Tanuja Shet, Ketki Shah, Satyakam Sawaimoon, Chitra V Madiwale, Sanica Bhele, Chandralekha Tampi, Swapnil Rane, Sweety Shinde, Epari Sridhar, Laxmi Shah, Vaishali Gaikwad, Shubhangi Vinayak Agale, Purnima Lad |
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| Rok vydání: | 2014 |
| Předmět: |
concordance
medicine.medical_specialty Pathology business.industry non-Hodgkin lymphoma Concordance Burkitt lymphoma Context (language use) inter-observer variation medicine.disease Lymphoma Cohen's kappa Oncology Interobserver Variation Pediatrics Perinatology and Child Health medicine Original Article Radiology Medical diagnosis business Diffuse large B-cell lymphoma Kappa |
| Zdroj: | Indian Journal of Medical and Paediatric Oncology : Official Journal of Indian Society of Medical & Paediatric Oncology |
| ISSN: | 0975-2129 0971-5851 |
| DOI: | 10.4103/0971-5851.133721 |
| Popis: | Context: The pathology of classic Burkitt lymphoma (BL) remains a challenge despite being a well-defined entity, in view of the significant overlap with atypical BL and B-cell lymphoma intermediate between DLBL (diffuse large B cell lymphoma) and BL. They are difficult to be segregated in resource-limited setups which lack molecular testing facilities. This is further affected by interobserver variability and experience of the reporting pathologist. Aims: The aim of our study was to quantitate variability among a group of pathologists with an interest in lymphomas (albeit with variable levels of experience) and quantitate the benefit of joint discussions as a tool to increase accuracy and reduce interobserver variability of pathologists, in the diagnosis of BL in a resource-limited setup. Materials and Methods: A set of 25 non-Hodgkin lymphoma cases in which a diagnosis of BL was entertained were circulated to 14 participating pathologist within the Mumbai lymphoma study group. A proforma recorded the morphologic and immunohistochemical features perceived during the initial independent diagnosis followed by a consensus meeting for discussion on morphology and additional information pertinent to the case. Statistical analysis and Results: The concordance was poor for independent diagnosis among all the pathologists with kappa statistics (±SE) of 0.168 (±0.018). Expert lymphoma pathologists had the highest (albeit only fair) concordance (kappa = 0.373 ± 0.071) and general pathologists the lowest concordance (kappa = 0.138 ± 0.035). Concordance for morphological diagnosis was highest among expert lymphoma pathologists (kappa = 0.356 ± 0.127). Revision of diagnoses after consensus meeting was highest for B-cell lymphoma intermediate between DLB and BL. To conclude, interobserver variation is a significant problem in BL in the post WHO 2008 classification era. Experience with a larger number of cases and joint discussion exercises such as the one we conducted are needed as they represent a simple and effective way of improving diagnostic accuracy of pathologists working in a resource-limited setup. |
| Databáze: | OpenAIRE |
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