Concordance of Expert Consultation Diagnoses in the Review of Pelvic Washing Specimens

Acta Cytol. 2015;59(6):452-6. doi: 10.1159/000443715. Epub 2016 Jan 28.

Abstract

Objectives: Cytologic specimens are routinely collected as part of gynecologic oncology surgery. Consultation cases often include cytology specimens. Outside diagnosis was compared to consultation diagnosis for cytopathology specimens that were part of larger oncologic cases.

Study design: Gynecologic pathology consultation cases containing pelvic washing (PW) material were queried. Cases had major discordance if the diagnosis changed from negative to positive or vice versa, and minor discordance if an atypical diagnosis was changed to positive or negative or vice versa.

Results: Of 237 cases, 9 showed major discordance (4%), 29 showed minor discordance (12%) and the remaining 199 no discordance (84%). The 9 major discordance cases involved PWs from cases that were performed for ovarian pathology. Treatment would have changed in only 2 of the cases with major discordance. Of the minor discordance cases, 21/29 (72%) involved PW from ovarian cases and 8/29 (28%) were PW from uterine cases.

Conclusions: Only a few cases showed major or minor discordance, and of those that were discordant, most involved ovarian specimens. Major discordance between original and consulting diagnoses would have changed treatment in only 2 cases.

MeSH terms

  • Ascitic Fluid / pathology*
  • Consensus
  • Cytodiagnosis*
  • Diagnostic Errors / prevention & control
  • Female
  • Gynecologic Surgical Procedures
  • Humans
  • Neoplasm Staging
  • Observer Variation
  • Ovarian Neoplasms / pathology*
  • Ovarian Neoplasms / surgery
  • Peritoneal Lavage*
  • Predictive Value of Tests
  • Referral and Consultation*
  • Reproducibility of Results
  • Specimen Handling*
  • Uterine Neoplasms / pathology*
  • Uterine Neoplasms / surgery