Lessons we learn from hematopathology consultation in Taiwan.
The appropriate management of hematology patients depends first on correct diagnoses. Expert review is important in reaching accurate diagnoses. To improve diagnostic accuracy, the Taiwan Society of Pathology and the Taiwan Division of the International Academy of Pathology has been conducting an expert consultation program for general pathologists since 2001. As per this program, we have received a total of 395 cases (406 samples) for review. We found that meaningful diagnostic discrepancies occurred frequently in hematopathology reviews. Ambiguous or nondiagnostic original reports were the major causative factor for the major discrepancy cases, which demonstrates that diagnostic uncertainty is a big problem for referring pathologists. However, the World Health Organization lymphoma classification may be poorly reproducible in countries where extensive use of an ancillary technique is not used by general pathologists. This review is intended to report the misdiagnoses most commonly seen in the hematopathology practice in Taiwan. Awareness of the easily misinterpreted entities helps to achieve the right diagnosis and improve patient care.
Department of Pathology, College of Medicine, National Cheng Kung University and Hospital, Tainan, Taiwan.
Chen
C
Chan
Clinical Research Center, College of Medicine, National Cheng Kung University and Hospital, Tainan, Taiwan.
Shih-Wen
SW
Huang
Department of Pathology, College of Medicine, National Cheng Kung University and Hospital, Tainan, Taiwan; Division of Infectious Diseases, National Health Research Institute, Tainan, Taiwan.
Ih-Jen
IJ
Su
Department of Pathology, College of Medicine, National Cheng Kung University and Hospital, Tainan, Taiwan. Electronic address: changkc@mail.ncku.edu.tw.
Kung-Chao
KC
Chang
D002277:Carcinoma / Q000473:pathology*; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D006405:Hematology; D006801:Humans; D008223:Lymphoma / Q000473:pathology*; D012017:Referral and Consultation; D013624:Taiwan
consultation; differential diagnosis; discrepancy; hematopathology; misdiagnoses