THE VALUE OF LYMPH-NODE IMPRINT CYTODIAGNOSIS - AN ASSESSMENT OF INTEROBSERVER AGREEMENT AND DIAGNOSTIC-ACCURACY

Citation
Aj. Molyneux et al., THE VALUE OF LYMPH-NODE IMPRINT CYTODIAGNOSIS - AN ASSESSMENT OF INTEROBSERVER AGREEMENT AND DIAGNOSTIC-ACCURACY, Cytopathology, 8(4), 1997, pp. 256-264
Citations number
18
Categorie Soggetti
Pathology,"Cell Biology
Journal title
ISSN journal
09565507
Volume
8
Issue
4
Year of publication
1997
Pages
256 - 264
Database
ISI
SICI code
0956-5507(1997)8:4<256:TVOLIC>2.0.ZU;2-M
Abstract
The aim of this study was to assess the reliability of cytodiagnosis o f lymph node imprints without fixed tissue sections. One hundred rando mly selected archival cases were used in the study. These air-dried Ma y-Grunwald-Giemsa imprint slides were assessed independently and blind by three pathologists, Cases were assigned to one of four diagnostic categories: reactive changes, non-Hodgkin's lymphoma (NHL), Hodgkin's disease (HD) and secondary malignancy. Each broad diagnosis was compar ed with the 'correct' reviewed histological diagnosis to calculate int erobserver agreement and diagnostic accuracy. The overall kappa score (+0.59) was indicative of moderate agreement. The mean pathologist dia gnostic accuracy was 78%, with complete agreement with the histologica l diagnosis in 61% of cases. The main diagnostic difficulties were in the distinction between reactive changes and NHL and distinguishing NH L from HD. Further diagnostic classification, e.g. typing of lymphomas and subclassification of Hodgkin's disease, was not found to be relia ble using the imprints alone. With these limitations in mind, patholog ists should be able to use lymph node imprints for cytodiagnosis in se lected cases. The study also emphasized the utility of imprints as a c orollary to the histology and as a tool for cytology training and cont inuing education.