Discrepancies in the diagnosis of lymphoproliferative neoplasias. A need for change

Abstract

Abstract Introduction The classification of lymphomas by the World Health Organization (WHO) and its updates is widely known and adopted by hematopathologists. However, its application in clinical practice is poorly understood. Objective Analyze and compare an initial evaluation by a general pathologist in relation to an evaluation by a hematopathologist. Material and methods Retrospective case series, which included patients with the novo lymphoma diagnosis, relapse and resistance/failure of treatment. An initial evaluation was issued by a general pathologist, which was then sent to a hematopathologist for a revision. Discrepancies were sorted by: “Major”, where the therapeutic approach was modified, “Minor”, where the diagnosis changed, but therapeutic approach remain the same, and “In Accordance”, meaning full concordance between initial evaluation and revision. Results Fourteen cases were analyzed (5 females and 9 males). Mean age was 44 years. In Accordance were found in 2 cases (14%), Major discrepancies were found in 11 (79%) and Minor Discrepancies were found in 1 (7%). Immunohistochemical studies were performed, presenting a variance between initial evaluation and revision of 5 (0–8) and 9.5 (6–18), respectively. Conclusion There is a great need to generate pathologists with the necessary training and experience to perform the diagnostics attached to the current WHO classification.