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Diagnostic concordance in cases of appendiceal mucinous neoplasia referred to a tertiary referral centre
  1. Aliasger Amin,
  2. Norman Carr
  1. Peritoneal Malignancy Unit, Basingstoke and North Hampshire NHS Foundation Trust, Basingstoke, UK
  1. Correspondence to Dr Aliasger Amin, Peritoneal Malignancy Unit, Basingstoke and North Hampshire NHS Foundation Trust, Basingstoke RG24 9NA, Hampshire, UK; docaaa{at}


Accurate diagnosis of appendiceal tumours and any associated peritoneal disease is clinically important but can be difficult. We retrieved the records of patients referred to the Peritoneal Malignancy Institute, Basingstoke, in the years 2016, 2017 and 2018 with a diagnosis of mucinous appendiceal neoplasia and identified 323 patients in which slides were reviewed as part of the referral pathway. Comparing the local report from the referring centre with the central review report, in 57 (18%) we identified a discrepancy. In 39 (12%) the discrepancy was in overall diagnosis, including 22 (7%) in which the local diagnosis was low-grade appendiceal mucinous neoplasm whereas the review diagnosis was reactive mucosal changes, usually due to ruptured diverticulum, with no evidence of neoplasia. Our findings support the practice of central review of histopathology slides by experienced pathologists at tertiary referral centres. They also suggest that improvements in diagnostic criteria are needed.

  • appendix
  • neoplasms
  • histopathology

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  • Handling editor Runjan Chetty.

  • Contributors AA involved in collecting the data and looked for patients with discordant histology. NC helped with confirming the discrepancy in histology. AA then wrote the paper and NC was very much involved with editing and guiding throughout the process.

  • 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.