title: Agreement in histologic assessments of the pituitary pars intermedia in aged horses.
abstract: OBJECTIVE
  To evaluate concordance among veterinary pathologists in the assessment of histologic findings in the pars intermedia of pituitary gland sections from aged horses with mild signs suggestive of pituitary pars intermedia dysfunction (PPID). Sample Population-10 pituitary glands from aged horses.
  
  
  METHODS
  7 pathologists were provided with signalment, clinical signs, and a single H&E-stained pituitary gland section from 10 aged horses with mild signs suggestive of PPID. Pathologists described histologic findings for each section and stated whether findings were consistent with PPID. Agreement among pathologists and with antemortem diagnostic test results was calculated.
  
  
  RESULTS
  Overall, only fair agreement was found among the pathologists as to which horses had histologic findings consistent with disease (mean +/- SE kappa value, 0.34 +/- 0.069). Interpretation of individual sections varied, with minimal agreement (4 or 5/7 pathologists) for 5 of 10 sections evaluated. Postmortem assessment was in agreement with an antemortem endocrine diagnostic test result 79% of the time.
  
  
  CONCLUSIONS
  Validation of antemortem diagnostic testing for PPID in horses often relies on the results of postmortem histologic evaluation. The lack of consensus in histologic interpretation of pituitary glands from aged horses with mild clinical signs in our study indicates that postmortem histologic evaluation of pituitary glands is an inappropriate standard in validation of antemortem diagnostic tests for detection of early PPID. Caution should be used when interpreting diagnostic test results in horses in which early PPID is suspected.
authors.affiliation: Department of Biomedical Sciences, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE C1A 4P3, Canada.
authors.forename: Dianne
authors.initials: D
authors.lastname: McFarlane
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Miller
authors.forename: Linden E
authors.initials: LE
authors.lastname: Craig
authors.forename: Noel O
authors.initials: NO
authors.lastname: Dybdal
authors.forename: Perry L
authors.initials: PL
authors.lastname: Habecker
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Miller
authors.forename: Jon S
authors.initials: JS
authors.lastname: Patterson
authors.forename: Alastair E
authors.initials: AE
authors.lastname: Cribb
mesh_terms: D000367:Age Factors; D000818:Animals; D003907:Dexamethasone / Q000378:metabolism; D006652:Histological Techniques / Q000662:veterinary; D006734:Horse Diseases / Q000175:diagnosis* / Q000473:pathology*; D006736:Horses; D010900:Pituitary Diseases / Q000175:diagnosis / Q000473:pathology / Q000662:veterinary*; D010902:Pituitary Gland / Q000473:pathology*; D000521:alpha-MSH / Q000097:blood
chemical_list: D000521:alpha-MSH; D003907:Dexamethasone