11. Reproducibility of malignant pleural mesothelioma histopathologic subtypingLuka Brčić, Gregor Vlačić, Franz Quehenberger, Izidor Kern, 2018, original scientific article Abstract: Context. Malignant pleural mesothelioma (MPM) is a rare tumor with poor prognosis. Several studies have analyzed potential prognostic markers, but histologic type remains the single most important prognostic factor. Histologic subtypes of epithelioid MPM seem to have prognostic and therapeutic implications. Interobserver agreement in histologic pattern classification should be high. Objective. To assess interobserver and intraobserver reproducibility in histologic differentiation between the main types of MPMs, and in further subtyping of epithelioid-type mesothelioma. Design. One representative hematoxylin-eosin-stained slide was selected from the archive for each of 200 patients with MPM. They were reviewed independently by 3 pathologists and classified according to the current World Health Organization classification of pleural tumors. After the first round of evaluations, a consensus meeting was organized where problems were addressed and representative images for each histologic category were selected. Two months later, cases were reevaluated by all 3 pathologists. Results. After the first round, overall interobserver agreement for histologic subtyping of mesothelioma was fair (k, 0.36). The agreement was increased to substantial (k, 0.63) in the second round. Improvement was found in interobserver agreement for all types of MPM, and for most epithelioid subtypes. Conclusions. Moderate to substantial agreement in histologic typing and subtyping of MPM can be achieved. However, training with additional clarification of diagnostic criteria, their strict application, and help from consensus-based illustrative images is needed.
Keywords: connective and soft tissue neoplasms -- pathology, malignant pleural mesothelioma, histopathology
Published in DiRROS: 30.11.2020; Views: 5993; Downloads: 470
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12. Global impact of the COVID-19 pandemic on cytopathology practice : results from an international survey of laboratories in 23 countriesElena Vigliar, Rima Cepurnaite, Eduardo Alcaraz-Mateos, Syed Z. Ali, Zubair W. Baloch, Claudio Bellevicine, Massimo Bongiovanni, Pavlina Botsun, Dario Bruzzese, Lukas Bubendorf, Izidor Kern, 2020, original scientific article Abstract: Background: To the authors' knowledge, the impact of the coronavirus disease 2019 (COVID-19) pandemic on cytopathology practices worldwide has not been investigated formally. In the current study, data from 41 respondents from 23 countries were reported. Methods: Data regarding the activity of each cytopathology laboratory during 4 weeks of COVID-19 lockdown were collected and compared with those obtained during the corresponding period in 2019. The overall number and percentage of exfoliative and fine-needle aspiration cytology samples from each anatomic site were recorded. Differences in the malignancy and suspicious rates between the 2 periods were analyzed using a meta-analytical approach. Results: Overall, the sample volume was lower compared with 2019 (104,319 samples vs 190,225 samples), with an average volume reduction of 45.3% (range, 0.1%-98.0%). The percentage of samples from the cervicovaginal tract, thyroid, and anorectal region was significantly reduced (P < .05). Conversely, the percentage of samples from the urinary tract, serous cavities, breast, lymph nodes, respiratory tract, salivary glands, central nervous system, gastrointestinal tract, pancreas, liver, and biliary tract increased (P < .05). An overall increase of 5.56% (95% CI, 3.77%-7.35%) in the malignancy rate in nongynecological samples during the COVID-19 pandemic was observed. When the suspicious category was included, the overall increase was 6.95% (95% CI, 4.63%-9.27%). Conclusions: The COVID-19 pandemic resulted in a drastic reduction in the total number of cytology specimens regardless of anatomic site or specimen type. The rate of malignancy increased, reflecting the prioritization of patients with cancer who were considered to be at high risk. Prospective monitoring of the effect of delays in access to health services during the lockdown period is warranted.
Keywords: pathology, neoplasms, COVID-19, coronavirus disease 2019, fine-needle aspiration, malignancy rate
Published in DiRROS: 09.11.2020; Views: 3257; Downloads: 1430
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