OBSERVER VARIABILITY IN THE HISTOPATHOLOGICAL REPORTING OF ABNORMAL RECTAL BIOPSY SPECIMENS

Aims-To study the consistency of reporting of abnormal rectal biopsy s pecimens, especially in the differentiation of inflammatory bowel dise ase from other causes of abnormality. Methods-Sixty rectal biopsy spec imens were identified from patients presenting with bloody diarrhoea. These were then circulated to the 11 consultant pathologists in the st udy who filled in a proforma with a List of 12 diagnostic categories a nd 22 features. Results-Forty one of the 60 cases were examples of inf lammatory bowel disease. In 33 of these cases nine or more pathologist s had made the diagnosis. Further categorisation into ulcerative colit is and Crohn's disease showed better recognition of ulcerative colitis . In the 19 cases of non-inflammatory bowel disease recognition of pse udomembranous colitis and solitary rectal ulcer syndrome was good, but the results were poorer in the case of infective colitis. Conclusion- The findings suggest that a group of consultant pathologists can diffe rentiate between inflammatory bowel disease and other causes of an abn ormal rectal biopsy specimen and can also recognise pseudomembranous c olitis and solitary rectal ulcer syndrome satisfactorily.