BACKGROUND: The gold standard for diagnosing melanocytic neoplasms is by histopathologic examination. However, lack of agreement among expert dermatopathologists in evaluating these tumors has been well established in experimental settings. OBJECTIVE: This study examines the discordance among dermatopathologists in evaluating difficult melanocytic neoplasms in a clinical setting where the diagnosis impacts patient management. METHODS: Retrospective review of consultation reports over a 6-year period. RESULTS: There was complete agreement among the consultants in 54.5% of the cases. However, a high level of disagreement was found in 25% of the cases. LIMITATIONS: The analysis was limited to two consultant dermatopathologists. CONCLUSIONS: There are limitations to the practical applications of histologic criteria for diagnosing difficult melanocytic tumors. It is not malpractice for a pathologist to have rendered a diagnosis that did not predict clinical outcome as long as 'standard of care' has been followed in his/her evaluation of the specimen.
BACKGROUND: The gold standard for diagnosing melanocytic neoplasms is by histopathologic examination. However, lack of agreement among expert dermatopathologists in evaluating these tumors has been well established in experimental settings. OBJECTIVE: This study examines the discordance among dermatopathologists in evaluating difficult melanocytic neoplasms in a clinical setting where the diagnosis impacts patient management. METHODS: Retrospective review of consultation reports over a 6-year period. RESULTS: There was complete agreement among the consultants in 54.5% of the cases. However, a high level of disagreement was found in 25% of the cases. LIMITATIONS: The analysis was limited to two consultant dermatopathologists. CONCLUSIONS: There are limitations to the practical applications of histologic criteria for diagnosing difficult melanocytic tumors. It is not malpractice for a pathologist to have rendered a diagnosis that did not predict clinical outcome as long as 'standard of care' has been followed in his/her evaluation of the specimen.
Authors: Maija Kiuru; Danielle M Tartar; Lihong Qi; Danyang Chen; Lan Yu; Thomas Konia; John D McPherson; William J Murphy; Maxwell A Fung Journal: J Am Acad Dermatol Date: 2018-04-11 Impact factor: 11.527
Authors: Jeffrey P North; John T Vetto; Rajmohan Murali; Kevin P White; Clifton R White; Boris C Bastian Journal: Am J Surg Pathol Date: 2011-08 Impact factor: 6.394
Authors: Eugen C Minca; Rami N Al-Rohil; Min Wang; Paul W Harms; Jennifer S Ko; Angela M Collie; Ivanka Kovalyshyn; Victor G Prieto; Michael T Tetzlaff; Steven D Billings; Aleodor A Andea Journal: Mod Pathol Date: 2016-05-13 Impact factor: 7.842
Authors: Rahat S Azfar; Robert A Lee; Leslie Castelo-Soccio; Martin S Greenberg; Warren B Bilker; Joel M Gelfand; Carrie L Kovarik Journal: JAMA Dermatol Date: 2014-06 Impact factor: 10.282