title: Conflicting pathology reports: a diagnostic dilemma.
abstract: The differential diagnosis of a brain lesion with two discordant pathology reports includes the presence of collision tumor, metaplastic changes, and labeling errors that occurred during the processing of the specimen. The authors present a case in which the first brain biopsy from a 47-year-old patient with a history of heavy smoking was compatible with metastatic small cell carcinoma, and the second biopsy taken during decompression craniotomy 3 weeks later was compatible with WHO Grade IV glioblastoma. Using short tandem repeat (STR) analysis of the two specimens and nontumor-derived patient DNA, the authors found that the two specimens did not belong to the same individual. The authors conclude that allele imbalance or loss of heterozygosity detected by STR analysis is a reliable and valuable diagnostic tool for clarifying discrepancies in discordant pathology reports.
authors.affiliation: Departments of 1 Neurosurgery.
authors.forename: Tal
authors.initials: T
authors.lastname: Shahar
authors.forename: Uri
authors.initials: U
authors.lastname: Rozovski
authors.forename: Yuval
authors.initials: Y
authors.lastname: Shapira
authors.forename: Erez
authors.initials: E
authors.lastname: Nossek
authors.forename: Bracha
authors.initials: B
authors.lastname: Zelikovich
authors.forename: Joseph
authors.initials: J
authors.lastname: Jossiphov
authors.forename: Zvi
authors.initials: Z
authors.lastname: Ram
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Kanner
authors.forename: Tali
authors.initials: T
authors.lastname: Siegal
authors.forename: Deborah T
authors.initials: DT
authors.lastname: Blumenthal
authors.forename: Iris
authors.initials: I
authors.lastname: Lavon
mesh_terms: D000483:Alleles; D001706:Biopsy; D001932:Brain Neoplasms / Q000235:genetics / Q000473:pathology* / Q000628:therapy; D018288:Carcinoma, Small Cell / Q000235:genetics / Q000473:pathology* / Q000628:therapy; D003131:Combined Modality Therapy; D004273:DNA, Neoplasm / Q000235:genetics; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D005909:Glioblastoma / Q000235:genetics / Q000473:pathology* / Q000628:therapy; D006801:Humans; D019656:Loss of Heterozygosity / Q000235:genetics; D008297:Male; D018895:Microsatellite Repeats / Q000235:genetics; D008875:Middle Aged; D010338:Pathology, Clinical; D015203:Reproducibility of Results
chemical_list: D004273:DNA, Neoplasm
keywords: LOH; LOH = loss of heterozygosity; PCR = polymerase chain reaction; STR = short tandem repeat; brain metastasis; clonality; collision tumor; diagnostic pathology errors; glioblastoma; loss of heterozygosity; oncology