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Impact and importance of a centralised review panel for lymphoma diagnostics in the WHO era: a single-centre experience
  1. Kate Dinneen1,
  2. Ciara Ryan1,
  3. Cliona Grant1,
  4. Barbara Dunne1,
  5. Larry Bacon2,
  6. Elisabeth Vandenberghe2,
  7. Michael Jeffers3,
  8. Richard Flavin1
  1. 1 Department of Histopathology, St James's Hospital, Dublin, Ireland
  2. 2 Department of Haematology, St James's Hospital, Dublin, Ireland
  3. 3 Department of Histopathology, Tallaght University Hospital, Dublin, Ireland
  1. Correspondence to Dr Kate Dinneen, Histopathology, St James's Hospital, Dublin D03 VX82, Ireland; katedinneen4{at}gmail.com

Abstract

Lymphoma diagnosis is complex, requiring a wide array of adjunctive tests to reach accurate diagnoses. We retrospectively examined the rates of concordance between referral and review lymphoma diagnoses on cases referred to St James’s Hospital, Dublin for multidisciplinary team review between 2013 and 2016. Frequency and cost of adjunctive diagnostic tests performed were also analysed. The overall discordance rate was 7.8% (14/179), compared with rates of 6%–48% in the published literature. 13 discordant cases required a change in clinical management following review of the referred diagnosis. Of all referred cases, 33.5% (60/179) required extra analyses to reach a final diagnosis, costing the reference laboratory €35463.40. We conclude that establishment of centralised haematopathology diagnostic networks would help reduce the rate of revision made to lymphoma diagnoses by providing specialist haematopathologist input and access to ancillary testing.

  • lymphoma
  • diagnosis
  • ancillary testing
  • concordance rates

https://doi.org/10.1136/jclinpath-2018-205691

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    Footnotes

    • Handling editor Mary Frances McMullin.

    • Contributors The original idea for this project came from RF and MJ. All authors collected and reviewed the data for the paper. All authors reviewed and approved the final manuscript. KD and RF wrote the paper.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.