title: [Second expert review on lymphoma: assessment of a one year activity in a general hospital].
abstract: A standardized second histological review for lymphomas was established by the French National Cancer Institute in 2010. The objective of our study was to assess the clinical impact of this process between a general hospital (reader 1) and an expert (reader 2). This prospective study was conducted between April 1st 2010 and April 1st 2011. Fifty-four cases of lymphoma were subjected to an expert review following the "LYMPHOPATH" recommendations and diagnoses of readers 1 and 2 were compared according to the WHO 2008 classification of lymphomas. We distinguished serious discrepancies (lymphoma versus other malignancy) from subtyping disagreement with or without impact on therapeutic strategy. We also determined the delays between the initial reception of the sample and reader 1's (period A) and reader 2's (period B) reports, respectively. Any additional analysis performed by second reader was also reported. Our study revealed one case of subtyping discordance (1.85%). The mean delays were 7 days for period A and 20 days for period B, respectively. Additional immunohistochemical techniques were requested by reader 2 in 11 cases (20.4%). These data provide evidence to suggest that in our department, a second review targeted on difficult diagnoses, rare lymphomas or when further analyses are required would be more relevant than a standardized second review.
authors.affiliation: Service d'anatomie pathologique, CHR La Source, BP 86709, 45067 Orléans cedex 2, France. patrick.michenet@chr-orleans.fr
authors.forename: Patrick
authors.initials: P
authors.lastname: Michenet
authors.forename: Charlotte
authors.initials: C
authors.lastname: Bouchy
authors.forename: Carole
authors.initials: C
authors.lastname: Bonneau
authors.forename: Rémy
authors.initials: R
authors.lastname: Kerdraon
authors.forename: Anne
authors.initials: A
authors.lastname: Heitzmann
authors.forename: Claire
authors.initials: C
authors.lastname: Blechet
authors.forename: Josette
authors.initials: J
authors.lastname: Brière
mesh_terms: D015703:Antigens, CD / Q000032:analysis; D000951:Antigens, Neoplasm / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy / Q000379:methods; D002983:Clinical Competence; D057210:Delayed Diagnosis; D003951:Diagnostic Errors; D019468:Disease Management; D006769:Hospitals, General / Q000706:statistics & numerical data*; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008223:Lymphoma / Q000737:chemistry / Q000145:classification / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D015588:Observer Variation; D010297:Paris; D010337:Pathology Department, Hospital; D010338:Pathology, Clinical; D011446:Prospective Studies; D011785:Quality Assurance, Health Care; D012017:Referral and Consultation / Q000592:standards* / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D013048:Specimen Handling / Q000379:methods / Q000592:standards
chemical_list: D015703:Antigens, CD; D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor