[Request of second opinion for difficult diagnosis in surgical pathology. Assessment of a one year activity in a general hospital].
OBJECTIVE
The objective of this study was to evaluate our practices concerning difficult lesions sent for second opinion to an expert.


METHODS
We analyzed retrospectively all the requests for second opinion carried out over one year in our laboratory. The following data were indexed: organ, pathology (tumoral or not), type of sampling, the time, additional techniques carried out by the expert and comparison of the initial diagnosis with that of the expert. A provisional report was systematically performed before sending the observation to the expert.


RESULTS
Among the 54 cases, 40 lesions were tumoral and 31 malignant. The type of pathology which were more often sent for opinion were lymphomas (18.5%) and soft tissue tumors (11%). The average time between reception of the sampling in our laboratory and the answer of the expert was 32.8 days. In 40.7% of the cases, additional techniques like immunohistochemistry (19 cases) or molecular biology (7 cases) were carried out by the expert and concerned especially lymphomas or soft tissue pathology. The comparison of the initial diagnosis with that of the expert showed no change in 53.7% of cases, 13% of divergence from benign-malignant (6 cases) or malignant-benign (1 case) type, 16.7% of changes of classification without modification of the benignity or the malignity, and 16.7% of difficult interpretation.


CONCLUSIONS
This study seems to be a good means of evaluating our professional practices related to difficult lesions and confirms the importance of deep-freezing tumors, holding multidisciplinary meetings and participating in specialized working groups.
Cormier
Bénédicte
B
Service d'anatomie pathologique, CHR La Source, BP 86709, 45067 Orléans Cedex 2.
Bonneau
Carole
C
Kerdraon
Rémy
R
Heitzmann
Anne
A
Garnaud
Sylvie
S
Michenet
Patrick
P
D001706:Biopsy; D001927:Brain Diseases / Q000473:pathology; D005602:France; D006769:Hospitals, General / Q000706:statistics & numerical data*; D006801:Humans; D009369:Neoplasms / Q000473:pathology*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies