title: Comparison of lymphoid neoplasm classification. A blinded study between a community and an academic setting.
abstract: The revised European-American classification of lymphoid neoplasms has been reported as reproducible among expert pathologists and feasible in a community setting. We evaluated the reproducibility of lymphoid neoplasm diagnoses between a community and an academic center. We subtyped 188 lymphoid neoplasms using revised European-American classification criteria. Clinical findings, histologic or cytologic preparations, paraffin-section immunostains, and flow cytometry data were reviewed as appropriate. Diagnoses were compared only after completion of the study. Lymphoma subtype was concordant for 167 (88.8%) of 188 cases. Discordant cases included 15 B-cell, 2 T-cell, and 4 Hodgkin lymphomas. For B-cell neoplasms, discordance was most often due to classifying diffuse large cell lymphoma as another aggressive subtype of lymphoma (n = 6), marginal zone lymphoma as another subtype (n = 4), or follicle center lymphoma grade II as grade III (n = 3). For Hodgkin disease, discordance was most often due to classifying nodular sclerosis as mixed cellularity type (n = 3). Comparison of community and academic center diagnoses demonstrated high concordance for most revised European-American classification subtypes. Some sources of discordance have been addressed in the new World Health Organization classification of neoplastic diseases of the hematopoietic and lymphoid tissues.
authors.affiliation: Department of Pathology, OSF Saint Francis Medical Center, 530 NE Glen Oak Ave, Peoria, IL 61637, USA.
authors.forename: J D
authors.initials: JD
authors.lastname: Siebert
authors.forename: L A
authors.initials: LA
authors.lastname: Harvey
authors.forename: P A
authors.initials: PA
authors.lastname: Fishkin
authors.forename: J A
authors.initials: JA
authors.lastname: Knost
authors.forename: A
authors.initials: A
authors.lastname: Ehsan
authors.forename: B N
authors.initials: BN
authors.lastname: Smir
authors.forename: F E
authors.initials: FE
authors.lastname: Craig
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006764:Hospitals, Community; D006785:Hospitals, University; D006801:Humans; D016130:Immunophenotyping; D008223:Lymphoma / Q000145:classification* / Q000175:diagnosis* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results