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At least 19 recordsLinked to original sources
PubMed1991

The diagnosis of ovarian cancer by pathologists: how often do diagnoses by contributing pathologists agree with a panel of gynecologic pathologists?

The Cancer and Steroid Hormone Study, a multicenter, population-based, case-control study of ovarian, breast, and endometrial cancer in women 20 to 54 years of age, permitted the diagnoses of contributing pathologists to be compared with those of a panel of three gynecologic pathologists. A diagnosis of ovarian cancer was made by contributing pathologists on 477 subjects. Agreement between the two groups of pathologists was 97% for primary epithelial ovarian cancer and 89% for primary nonepithelial ovarian malignancies. Agreement on diagnosis of major cellular subtypes of ovarian malignancy ranged between 73% for endometrioid cancer and 100% for clear cell carcinomas. We conclude that the diagnosis of pathologic features of primary ovarian cancer is highly predictable. Nonetheless, diagnosis by histologic type varies sufficiently that a review process should be considered for clinical or investigative decisions involving specific histologic diagnoses of ovarian cancer.

Adult↗
PubMed1991

Antimicrobial susceptibility testing trends and accuracy in the United States. A review of the College of American Pathologists Microbiology Surveys, 1972-1989. Microbiology Resource Committee of the College of American Pathologists.

The ability of the College of American Pathologists Microbiology Surveys subscriber laboratories to perform antimicrobial susceptibility testing accurately has improved slightly since 1984. Currently (1989 surveys), the accuracies for disk diffusion and minimum inhibitory concentration antimicrobial susceptibility testing were 98.2% and 96.1%, respectively. Disk diffusion testing has recently (since 1986) become more popular, along with rapid automated systems, such as the AMS-Vitek System (St Louis, Mo). Rapid tests for beta-lactamase and chloramphenicol acetyltransferase have performed well. Quality control procedures have switched to a cost-effective weekly frequency pattern for nearly 70% of laboratories. Some antimicrobial susceptibility testing problems still exist among anaerobic bacterial methods, procedures for fastidious organisms (Haemophilus, Streptococcus species, Moraxella, pneumococci, gonococci), tests for oxacillin-resistant staphylococci, and the methods for use against nonenteric gram-negative or gram-positive bacilli. Antimicrobial susceptibility testing users subscribing to the College of American Pathologists surveys should strictly follow the National Committee for Clinical Laboratory Standards interpretive and quality control criteria to assure the best performance with the Clinical Laboratory Improvement Act, 1988, compliant College of American Pathologists proficiency sample program.

Bacteria↗
PubMedDate not supplied

The pathologist's examination of the "lumpectomy"--the pathologists' view of surgical margins.

Despite the widespread conservative management of breast cancer, the pathologists' examination of these specimens is far from uniform. Pathologists sample margins differently, and even disagree on what constitutes a positive margin. This variability in the pathologic examination of the lumpectomy creates tremendous problems in analyzing the existing literature on the importance of positive margins. Herein is a discussion of the available data on the significance of margin assessment. We furthermore suggest a practical approach to examining margins with an emphasis on a functional orientation of the specimen with respect to the nipple. Only by adopting a uniform system of margin assessment can we begin to critically evaluate the importance of positive margins in segmental resections of the breast.

Biopsy↗
PubMed1992

Relation between cardiovascular pathologic conditions and malignant tumours as seen by pathologist. I. Frequency of malignant neoplasms in the population with myocardial hypertrophy as seen by pathologist.

Relatively low co-existence of malignant neoplasms and chronic cardiovascular disease was documented in this work the emphasis being put on the conditions running with myocardial hypertrophy. The percentage of malignancy in the total autopsy material of 5821 men and 6849 women was 27.8 and 23.0 resp., and in the subgroup with heart weight 300-400 g, 36.8 and 31.0 resp. This percentage was significantly lower in separated subgroups of: a. arterial hypertension, 6.6 and 10.2, b. cardio-pulmonary syndrome, 23.0 and 18.5, c. healed myocardial infarct accompanied by myocardial hypertrophy, 13.3 and 11.7, d. acquired valvar deformity, 15.3 and 10.1. The subgroup of heart weight 150-250 g showed 57.2% and 46.6% of cases with malignancy while that of cardiac weight over 600 g-7.4% and 5.7%. In the subgroup of normal right-(2-3 mm) and left-ventricular (10-12 mm) wall thickness corresponding percentage equalled 29.4 and 30.1, in the subgroup of right-ventricular wall thickness over 6 mm--14.4 and 8.8, and in that of left-ventricular wall thickness over 18 mm--12.5 and 9.4. Scanty available information suggests some antimitotic activity of catecholamines believed to condition that of chalones. Catecholamines are also attributed with the stimulation of myocardial hypertrophy. The correlation of our findings with assumptions mentioned above seem to justify a hypothesis, or only a possibility, that compensatory mechanisms active in the cardiovascular diseases create an unfavourable background for the development of neoplasm.

Adult↗
PubMed1989

Therapy-relevant discrepancies between diagnoses of institutional pathologists and experienced hematopathologists in the diagnosis of malignant lymphoma.

We have studied therapy-relevant discrepancies in the diagnoses of institutional pathologists and a panel of 4 experienced hematopathologists in 375 cases from patients with malignant lymphoma. Two hundred and fifty four cases (68%) were contributed by non-panel pathologists and 121 (32%) by individual panel pathologists. Overall, in 24% (91/375) of the cases, therapy-relevant discrepancies were present between institutional pathologists and panel diagnoses. Thirty-four percent (87/254) therapy-relevant discrepancies were present in cases contributed by non-panel pathologists, whereas in only 3% (4/121) discrepancies were found in cases forwarded by individual panel pathologists. The percentages erroneously diagnosed Hodgkin's disease by non-panel pathologists and individual panel pathologists were 8 and 0% respectively and faulty diagnosed Non-Hodgkin lymphomas 5 and 0%, whereas the number of consultation cases, in which the referring pathologist was not certain of his diagnosis, appeared to be 24 and 3% for non-panel and panel pathologists respectively. In addition, in 14% of panel confirmed NHL contributed by non-panel pathologists, therapy-relevant discrepancies in the degree of malignancy grading according to the Working Formulation were present, whereas no discrepancies in malignancy grading were noted between individual panel members and panel diagnoses. Apart from extensive hematopathological experience, a reason for the higher diagnostic accuracy of the panel pathologists could well be the frequency in which the diagnoses were supplemented by immunophenotyping: in 22% of the cases from non-panel pathologists and 63% of the cases from panel pathologists immunophenotyping on frozen sections was carried out.(ABSTRACT TRUNCATED AT 250 WORDS)

Diagnosis, Differential↗
PubMed1977

Comparison of the classification by microscopic level (stage) of malignant melanoma by three independent groups of pathologists.

The ability of groups of pathologists to classify and stage malignant melanoma varies with their familiarity with the new nomenclature proposed for that process. Primary lesions of malignant melanoma from 79 patients were independently examined and classified by community pathologists, university pathologists, and a referee pathologist all without access to each others diagnoses. The diagnoses of these groups were compared for agreement in variety of melanoma as well as depth of dermal penetration (stage or level). Greatest success (agreement with the referee) of both the community pathologists and the university pathologists was achieved when assessment of level of invasion (+/- 1) of the referee was compared (community pathologists = 94% +/- 12% agreement, university pathologists = 99% +/- 2% agreement). Our survey demonstrates that only a relatively small number of community pathologists (23%) employ the new nomenclature, but they do so with a facility equal to that of the university pathologists. Based upon this study and our continuing experiences, we recommend the review of all primary lesions of malignant melanoma by a pathologist or group experienced in the diagnosis and microscopic staging of the disease.

Diagnostic Errors↗