TY - JOUR
T1 - The Value of Second-Opinion Consultation in Nongynecologic Cytopathology
AU - Bailey, Gabrielle E.
AU - Graham, Ashleigh
AU - Kahler, Jessica
AU - Williamson, Bonnie
AU - Adams, Christina
AU - Maleki, Zahra
AU - Rodriguez, Erika F.
N1 - Publisher Copyright:
© 2021 American Society for Clinical Pathology, 2021. All rights reserved.
PY - 2022/5/1
Y1 - 2022/5/1
N2 - Objectives: The value of consultation in pathology has been well documented in surgical pathology, but there are few comprehensive studies of consultation cases in cytopathology. Here we report our experience with cytopathology consultation cases at a large academic center. Methods: A review of consultation cases at our institution was performed by searching our laboratory information system. The contributing institution's diagnosis was compared with that rendered by the reviewing cytopathologist to assess major and/or minor diagnostic discrepancies. Results: In total, 928 cases were reviewed with the following distribution: fine-needle aspiration (FNA, 79.4%), exfoliative nongynecologic cytology (18.3%), and cases with both FNA and nongynecologic cytology (2.3%). There were 379 (40.8%) true consults and 549 (59.2%) confirming consults. A total of 586 (63.1%) cases were in agreement with the outside pathologist, 78 (8.4%) cases had major discrepancies, and 264 (28.4%) cases had minor discrepancies. Major discrepancies were most common for pancreas (38.5%), lymph node (11.5%), and soft tissue sites (9.0%). Conclusions: Of the cases, 8.4% had major diagnostic discrepancies between the original diagnosis and the consultation diagnosis, which is consistent with reported values in surgical pathology consultation studies. The findings support the importance of second-opinion consultation in cytopathology to guide patient care.
AB - Objectives: The value of consultation in pathology has been well documented in surgical pathology, but there are few comprehensive studies of consultation cases in cytopathology. Here we report our experience with cytopathology consultation cases at a large academic center. Methods: A review of consultation cases at our institution was performed by searching our laboratory information system. The contributing institution's diagnosis was compared with that rendered by the reviewing cytopathologist to assess major and/or minor diagnostic discrepancies. Results: In total, 928 cases were reviewed with the following distribution: fine-needle aspiration (FNA, 79.4%), exfoliative nongynecologic cytology (18.3%), and cases with both FNA and nongynecologic cytology (2.3%). There were 379 (40.8%) true consults and 549 (59.2%) confirming consults. A total of 586 (63.1%) cases were in agreement with the outside pathologist, 78 (8.4%) cases had major discrepancies, and 264 (28.4%) cases had minor discrepancies. Major discrepancies were most common for pancreas (38.5%), lymph node (11.5%), and soft tissue sites (9.0%). Conclusions: Of the cases, 8.4% had major diagnostic discrepancies between the original diagnosis and the consultation diagnosis, which is consistent with reported values in surgical pathology consultation studies. The findings support the importance of second-opinion consultation in cytopathology to guide patient care.
KW - Consultation in cytology
KW - Discrepancy in cytopathology
KW - Interinstitutional review of cytopathology specimens
KW - Quality assurance in cytology
KW - Second opinion in cytology
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U2 - 10.1093/ajcp/aqab182
DO - 10.1093/ajcp/aqab182
M3 - Article
C2 - 34724037
AN - SCOPUS:85129997460
SN - 0002-9173
VL - 157
SP - 724
EP - 730
JO - American journal of clinical pathology
JF - American journal of clinical pathology
IS - 5
ER -