Discordance in the histopathologic diagnosis of difficult melanocytic neoplasms in the clinical setting
Article first published online: 10 MAR 2008
Blackwell Munksgaard 2008
Journal of Cutaneous Pathology
Volume 35, Issue 4, pages 349–352, April 2008
How to Cite
Lodha, S., Saggar, S., Celebi, J. T. and Silvers, D. N. (2008), Discordance in the histopathologic diagnosis of difficult melanocytic neoplasms in the clinical setting. Journal of Cutaneous Pathology, 35: 349–352. doi: 10.1111/j.1600-0560.2007.00970.x
- Issue published online: 10 MAR 2008
- Article first published online: 10 MAR 2008
- Accepted for publication November 27, 2007
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.