Impact and importance of a centralised review panel for lymphoma diagnostics in the WHO era: a single-centre experience

J Clin Pathol. 2019 Jul;72(7):506-509. doi: 10.1136/jclinpath-2018-205691. Epub 2019 Mar 25.

Abstract

Lymphoma diagnosis is complex, requiring a wide array of adjunctive tests to reach accurate diagnoses. We retrospectively examined the rates of concordance between referral and review lymphoma diagnoses on cases referred to St James's Hospital, Dublin for multidisciplinary team review between 2013 and 2016. Frequency and cost of adjunctive diagnostic tests performed were also analysed. The overall discordance rate was 7.8% (14/179), compared with rates of 6%-48% in the published literature. 13 discordant cases required a change in clinical management following review of the referred diagnosis. Of all referred cases, 33.5% (60/179) required extra analyses to reach a final diagnosis, costing the reference laboratory €35463.40. We conclude that establishment of centralised haematopathology diagnostic networks would help reduce the rate of revision made to lymphoma diagnoses by providing specialist haematopathologist input and access to ancillary testing.

Keywords: ancillary testing; concordance rates; diagnosis; lymphoma.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Humans
  • Lymphoma / diagnosis*
  • Lymphoma / pathology
  • Middle Aged
  • Referral and Consultation
  • Retrospective Studies
  • World Health Organization
  • Young Adult