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1.
J Clin Pathol ; 75(5): 302-309, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-33547095

RESUMO

AIMS: Accurate and reliable diagnosis is essential for lung cancer treatment. The study aim was to investigate interpathologist diagnostic concordance for pulmonary tumours according to WHO diagnostic criteria. METHODS: Fifty-two unselected lung and bronchial biopsies were diagnosed by a thoracic pathologist based on a broad spectrum of immunohistochemical (IHC) stainings, molecular data and clinical/radiological information. Slides stained with H&E, thyroid transcription factor-1 (TTF-1) clone SPT24 and p40 were scanned and provided digitally to 20 pathologists unaware of reference diagnoses. The pathologists independently diagnosed the cases and stated if further diagnostic markers were deemed necessary. RESULTS: In 31 (60%) of the cases, ≥80% of the pathologists agreed with each other and with the reference diagnosis. Lower agreement was seen in non-small cell neuroendocrine tumours and in squamous cell carcinoma with diffuse TTF-1 positivity. Agreement with the reference diagnosis ranged from 26 to 45 (50%-87%) for the individual pathologists. The pathologists requested additional IHC staining in 15-44 (29%-85%) of the 52 cases. In nearly half (17 of 36) of the malignant cases, one or more pathologist advocated for a different final diagnosis than the reference without need of additional IHC markers, potentially leading to different clinical treatment. CONCLUSIONS: Interpathologist diagnostic agreement is moderate for small unselected bronchial and lung biopsies based on a minimal panel of markers. Neuroendocrine morphology is sometimes missed and TTF-1 clone SPT24 should be interpreted with caution. Our results suggest an intensified education need for thoracic pathologists and a more generous use of diagnostic IHC markers.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Carcinoma de Células Escamosas , Neoplasias Pulmonares , Biomarcadores Tumorais , Biópsia , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma de Células Escamosas/patologia , Humanos , Imuno-Histoquímica , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/patologia
2.
BMJ Case Rep ; 20102010 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-22767687

RESUMO

A 40-year-old man presented with acute abdominal pain and falling haemoglobin after a history of minor abdominal trauma. Radiological imaging showed a large soft tissue mass situated between the anterior stomach wall and peritoneum. At diagnostic laparoscopy, intra-abdominal blood and an encapsulated haematoma were found. The procedure was converted to midline laparotomy and the mass was excised, including a stalk of tissue that connected the mass to the anterior prepyloric stomach wall. The patient recovered well and was discharged after 9 days. Histology confirmed a gastrointestinal stromal tumour surrounded by haematoma formation.


Assuntos
Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/cirurgia , Neoplasias Gastrointestinais/diagnóstico , Tumores do Estroma Gastrointestinal/diagnóstico , Hematoma/etiologia , Traumatismos Abdominais/complicações , Traumatismos Abdominais/diagnóstico , Dor Abdominal/diagnóstico , Dor Abdominal/etiologia , Adulto , Biópsia por Agulha , Serviço Hospitalar de Emergência , Seguimentos , Hemorragia Gastrointestinal/diagnóstico por imagem , Neoplasias Gastrointestinais/complicações , Neoplasias Gastrointestinais/cirurgia , Tumores do Estroma Gastrointestinal/complicações , Tumores do Estroma Gastrointestinal/cirurgia , Hematoma/diagnóstico por imagem , Hematoma/cirurgia , Humanos , Imuno-Histoquímica , Escala de Gravidade do Ferimento , Laparoscopia/métodos , Laparotomia/métodos , Masculino , Radiografia , Medição de Risco , Ruptura/cirurgia , Resultado do Tratamento
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