[Variability among pathologists in the histological diagnosis of diffuse interstitial lung diseases]. / Variabilidad entre patólogos en el diagnóstico histológico de las enfermedades intersticiales difusas del pulmón.

OBJECTIVE: Diffuse interstitial lung diseases (DILD) form a group of diseases which affect the alveolar interstitial space and share very similar clinical, radiological, and functional features, making lung biopsy essential for establishing diagnosis, prognosis, and treatment in many cases. We aimed to see whether there was agreement in histopathological diagnosis among different groups of pathologists in their assessment of these diseases. MATERIAL AND METHODS: Biopsies were studied from 33 patients suffering from noninfectious, nontumorous DILD. The biopsies had been assessed by 2 groups of pathologists: one specializing in this type of disease and another which was not a specialist group. RESULTS: There was disagreement in the histology reports of 10 out of the 33 cases studied (30.3%): 9 cases in the group of 22 cases of idiopathic interstitial pneumonia (40.9%) and 1 in the group of 3 DILD with known or associated causes. No discrepancies were found, however, in the diagnosis of primary DILD or DILD associated with other, less well-defined processes. CONCLUSIONS: We believe that idiopathic interstitial pneumonias are the DILD which pose most problems for pathologists. Therefore, the study of DILD requires specific dedication by pathologists and other professionals and specialists.

Variabilidad entre patólogos en el diagnóstico histológico de las enfermedades intersticiales difusas del pulmón / Variability among pathologists in the histological diagnosis of diffuse interstitial lung diseases

Objetivo: Las enfermedades pulmonares intersticiales difusas (EPID) son un conjunto de enfermedades que afecta al espacio alveolointersticial, con manifestaciones clínicas, radiológicas y funcionales muy similares, por lo que en muchos casos el estudio de la biopsia pulmonar será fundamental para el diagnóstico, pronóstico y tratamiento. Hemos querido ver si hay o no concordancia histopatológica diagnóstica, entre diferentes grupos de patólogos, en la valoración de estas enfermedades. Material y métodos: Se han estudiado las biopsias de 33 pacientes afectados de EPID no infecciosa ni tumoral, las cuales han sido valoradas por 2 grupos de patólogos: uno con especial interés por este tipo de enfermedades, y otro grupo no dedicado especialmente a esta enfermedad. Resultados: Al confrontar posteriormente los resultados, observamos en los informes histológicos una discordancia en el diagnóstico de 10 de los 33 casos estudiados (30,3%), 9 de ellos en el grupo de las 22 neumonías intersticiales idiopáticas (40,9%) y un caso en el grupo de las 3 EPID de causas conocidas o asociadas. Sin embargo, no encontramos ninguna discrepancia en el grupo de EPID primarias o asociadas a otros procesos no bien conocidos. Conclusiones: Creemos que las neumonías intersticiales idiopáticas son el grupo de EPID que más problemas de diagnóstico histológico pueden plantear al patólogo. Por tanto, es fundamental una especial dedicación por parte de estos profesionales y de los distintos especialistas que están relacionados con el estudio de las EPID

Objective: Diffuse interstitial lung diseases (DILD) form a group of diseases which affect the alveolar interstitial space and share very similar clinical, radiological, and functional features, making lung biopsy essential for establishing diagnosis, prognosis, and treatment in many cases. We aimed to see whether there was agreement in histopathological diagnosis among different groups of pathologists in their assessment of these diseases. Material and methods: Biopsies were studied from 33 patients suffering from noninfectious, nontumorous DILD. The biopsies had been assessed by 2 groups of pathologists: one specializing in this type of disease and another which was not a specialist group. Results: There was disagreement in the histology reports of 10 out of the 33 cases studied (30.3%): 9 cases in the group of 22 cases of idiopathic interstitial pneumonia (40.9%) and 1 in the group of 3 DILD with known or associated causes. No discrepancies were found, however, in the diagnosis of primary DILD or DILD associated with other, less well-defined processes. Conclusions: We believe that idiopathic interstitial pneumonias are the DILD which pose most problems for pathologists. Therefore, the study of DILD requires specific dedication by pathologists and other professionals and specialists