Influence of clinical and pathologic features on the pathologist's diagnosis of mycosis fungoides: a pilot study.
Although clinicopathologic correlation is critical in the diagnosis of early mycosis fungoides (MF), how clinical information directly affects the pathologist's interpretation is unknown. This pilot study aimed to assess the influence of provided clinical information and specific histopathologic features on the histopathologic diagnosis of MF vs. its inflammatory simulants. A computerized survey recorded diagnostic impressions by 24 dermatopathologists of 30 hematoxylin-eosin stained images, including 15 MF images and 15 dermatitis images. Images were accompanied by concordant clinical descriptions (33%), no clinical information (33%) or discordant clinical descriptions (33%). Percentage of correctly classified MF histopathologic images for the three scenarios of concordant clinical information, no clinical information or discordant clinical information were 32% (kappa 0.19), 56% (kappa 0.12) and 16% (kappa 0.33), respectively. The percentage of correctly classified slides presented with no clinical information was different from the other two groups (p < 0.0001). Pautrier collections were most associated with correct classification. Clinical information may play a significant role in the histopathologic diagnosis of MF, although there may be some value in initial blinded histopathologic interpretation. Specific histopathologic features differ in relative importance in the diagnosis of MF.
Department of Dermatology, Loyola University, Chicago, IL, USA.
Rebecca
R
Rovner
Carver College of Medicine, University of Iowa, Iowa City, IA, USA.|Medical Education Services, UnityPoint Health - Des Moines, Des Moines, IA, USA.
Hayden L
HL
Smith
Dermatology Associates of Wisconsin, Appleton, Wisconsin, USA.
Peter J
PJ
Katz
Carver College of Medicine, University of Iowa, Iowa City, IA, USA.|Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.|Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
Vincent
V
Liu
D003937:Diagnosis, Differential; D004485:Eczema / Q000276:immunology / Q000473:pathology; D006801:Humans; D007136:Immunoglobulins / Q000276:immunology; D009182:Mycosis Fungoides / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D010865:Pilot Projects; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D011795:Surveys and Questionnaires
D007136:Immunoglobulins
clinicopathologic correlation; cutaneous lymphoma; dermatitis; diagnostic accuracy; mycosis fungoides