Errors in interpretation of neck levels in postoperative pathological specimens.
Accurate orientation of pathological specimens is of fundamental importance, and specimens that are divided postoperatively may be misinterpreted. We asked surgeons and pathologists to identify boundaries between nodal levels on a clinical photograph of a neck dissection specimen. Few participants were able to identify the boundaries between levels accurately, with several important errors where a marked level contained none of the relevant anatomical tissue. Most errors were in level I, and the number decreased towards level IV. Errors were made by both pathologists and surgeons. The boundaries of level IIA were consistently overestimated, which may have implications for previous studies that evaluated patterns of nodal spread.
Academic Unit of Oral & Maxillofacial Surgery, University of Sheffield, 19 Claremont Crescent, Sheffield S10 2TA, United Kingdom. Electronic address: iainvarley@gmail.com.
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Varley
Academic Unit of Oral & Maxillofacial Pathology, The University of Sheffield, 19 Claremont Crescent, Sheffield S10 2TA, United Kingdom.
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Howe
Academic Unit of Oral & Maxillofacial Pathology, The University of Sheffield, 19 Claremont Crescent, Sheffield S10 2TA, United Kingdom.
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Hunter
Department of Maxillofacial Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Sheffield S10 2JF, United Kingdom.
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Smith
D003951:Diagnostic Errors; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D037981:Neck Dissection; D011184:Postoperative Period; D015203:Reproducibility of Results; D013048:Specimen Handling
Histopathology; Lymph node; Neck dissection; Oral cancer