Histopathological diagnoses in soft tissue tumours: An experience from a tertiary centre in Malaysia

Nur Dini Jalaludin, Noraini Mohd Dusa, Mohd Rohaizat Hassan, Nordashima Abd. Shukor

Research output: Contribution to journalArticle

Abstract

Soft tissue tumours are a group of remarkably diverse neoplasms that frequently pose significant diagnostic challenges to general pathologists. This study aimed to compare the agreement of histopathological diagnoses between general pathologists from various referral institutes and the referred soft tissue pathologist in a tertiary centre. The common discrepancies and their causes are also presented here. A retrospective study was conducted on 243 cases of potential soft tissue tumours referred to Hospital Kuala Lumpur, Malaysia over a period of 5 years. Reports by the referring pathologists and the soft tissue pathologist were compared based on tumour classification and tumour behaviour. Overall, there was moderate agreement in soft tissue tumour diagnoses in both tumour classification (weighted κ = 0.423) and tumour behavior (weighted κ = 0.548). The highest agreement of tumour classification was seen in the adipocytic tumours (21/28 cases), Ewing sarcoma (5/7 cases) and smooth-muscle tumours (3/5 cases). The highest rates of discrepancies were the so-called fibrohistiocytic tumours (7/11 cases), vascular tumours (9/15 cases) and undifferentiated/ unclassified sarcomas (19/32 cases). Full agreement for tumour behaviour was seen in 178 cases and there were 21 cases of zero agreement. Liposarcoma, alveolar soft part sarcoma and benign fibrous histiocytoma were the most frequent benign/malignant diagnostic discrepancies. The most common causes of discrepancy were wrong morphological interpretation followed by insufficient immunohistochemical stains performed. In conclusion, review of diagnosis by a pathologist specialized in soft tissue improves the quality of diagnosis in these heterogenous and rare tumours. A good panel of immunohistochemical stains with additional molecular study is crucial in the general hospital laboratories practice.

Original languageEnglish
Pages (from-to)209-216
Number of pages8
JournalMalaysian Journal of Pathology
Volume39
Issue number3
Publication statusPublished - 1 Dec 2017

Fingerprint

Malaysia
Neoplasms
Coloring Agents
Alveolar Soft Part Sarcoma
Smooth Muscle Tumor
Benign Fibrous Histiocytoma
Liposarcoma
Hospital Laboratories
Ewing's Sarcoma
General Hospitals
Sarcoma
Blood Vessels
Pathologists
Referral and Consultation

Keywords

  • Agreement
  • Diagnosis
  • Discrepancies
  • Histopathology
  • Soft tissue tumours

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology
  • Cell Biology

Cite this

Histopathological diagnoses in soft tissue tumours : An experience from a tertiary centre in Malaysia. / Jalaludin, Nur Dini; Mohd Dusa, Noraini; Hassan, Mohd Rohaizat; Abd. Shukor, Nordashima.

In: Malaysian Journal of Pathology, Vol. 39, No. 3, 01.12.2017, p. 209-216.

Research output: Contribution to journalArticle

Jalaludin, Nur Dini ; Mohd Dusa, Noraini ; Hassan, Mohd Rohaizat ; Abd. Shukor, Nordashima. / Histopathological diagnoses in soft tissue tumours : An experience from a tertiary centre in Malaysia. In: Malaysian Journal of Pathology. 2017 ; Vol. 39, No. 3. pp. 209-216.
@article{b0238e83187e4620b6df4a2cd1dacc70,
title = "Histopathological diagnoses in soft tissue tumours: An experience from a tertiary centre in Malaysia",
abstract = "Soft tissue tumours are a group of remarkably diverse neoplasms that frequently pose significant diagnostic challenges to general pathologists. This study aimed to compare the agreement of histopathological diagnoses between general pathologists from various referral institutes and the referred soft tissue pathologist in a tertiary centre. The common discrepancies and their causes are also presented here. A retrospective study was conducted on 243 cases of potential soft tissue tumours referred to Hospital Kuala Lumpur, Malaysia over a period of 5 years. Reports by the referring pathologists and the soft tissue pathologist were compared based on tumour classification and tumour behaviour. Overall, there was moderate agreement in soft tissue tumour diagnoses in both tumour classification (weighted κ = 0.423) and tumour behavior (weighted κ = 0.548). The highest agreement of tumour classification was seen in the adipocytic tumours (21/28 cases), Ewing sarcoma (5/7 cases) and smooth-muscle tumours (3/5 cases). The highest rates of discrepancies were the so-called fibrohistiocytic tumours (7/11 cases), vascular tumours (9/15 cases) and undifferentiated/ unclassified sarcomas (19/32 cases). Full agreement for tumour behaviour was seen in 178 cases and there were 21 cases of zero agreement. Liposarcoma, alveolar soft part sarcoma and benign fibrous histiocytoma were the most frequent benign/malignant diagnostic discrepancies. The most common causes of discrepancy were wrong morphological interpretation followed by insufficient immunohistochemical stains performed. In conclusion, review of diagnosis by a pathologist specialized in soft tissue improves the quality of diagnosis in these heterogenous and rare tumours. A good panel of immunohistochemical stains with additional molecular study is crucial in the general hospital laboratories practice.",
keywords = "Agreement, Diagnosis, Discrepancies, Histopathology, Soft tissue tumours",
author = "Jalaludin, {Nur Dini} and {Mohd Dusa}, Noraini and Hassan, {Mohd Rohaizat} and {Abd. Shukor}, Nordashima",
year = "2017",
month = "12",
day = "1",
language = "English",
volume = "39",
pages = "209--216",
journal = "Malaysian Journal of Pathology",
issn = "0126-8635",
publisher = "Malaysian Society of Pathologists",
number = "3",

}

TY - JOUR

T1 - Histopathological diagnoses in soft tissue tumours

T2 - An experience from a tertiary centre in Malaysia

AU - Jalaludin, Nur Dini

AU - Mohd Dusa, Noraini

AU - Hassan, Mohd Rohaizat

AU - Abd. Shukor, Nordashima

PY - 2017/12/1

Y1 - 2017/12/1

N2 - Soft tissue tumours are a group of remarkably diverse neoplasms that frequently pose significant diagnostic challenges to general pathologists. This study aimed to compare the agreement of histopathological diagnoses between general pathologists from various referral institutes and the referred soft tissue pathologist in a tertiary centre. The common discrepancies and their causes are also presented here. A retrospective study was conducted on 243 cases of potential soft tissue tumours referred to Hospital Kuala Lumpur, Malaysia over a period of 5 years. Reports by the referring pathologists and the soft tissue pathologist were compared based on tumour classification and tumour behaviour. Overall, there was moderate agreement in soft tissue tumour diagnoses in both tumour classification (weighted κ = 0.423) and tumour behavior (weighted κ = 0.548). The highest agreement of tumour classification was seen in the adipocytic tumours (21/28 cases), Ewing sarcoma (5/7 cases) and smooth-muscle tumours (3/5 cases). The highest rates of discrepancies were the so-called fibrohistiocytic tumours (7/11 cases), vascular tumours (9/15 cases) and undifferentiated/ unclassified sarcomas (19/32 cases). Full agreement for tumour behaviour was seen in 178 cases and there were 21 cases of zero agreement. Liposarcoma, alveolar soft part sarcoma and benign fibrous histiocytoma were the most frequent benign/malignant diagnostic discrepancies. The most common causes of discrepancy were wrong morphological interpretation followed by insufficient immunohistochemical stains performed. In conclusion, review of diagnosis by a pathologist specialized in soft tissue improves the quality of diagnosis in these heterogenous and rare tumours. A good panel of immunohistochemical stains with additional molecular study is crucial in the general hospital laboratories practice.

AB - Soft tissue tumours are a group of remarkably diverse neoplasms that frequently pose significant diagnostic challenges to general pathologists. This study aimed to compare the agreement of histopathological diagnoses between general pathologists from various referral institutes and the referred soft tissue pathologist in a tertiary centre. The common discrepancies and their causes are also presented here. A retrospective study was conducted on 243 cases of potential soft tissue tumours referred to Hospital Kuala Lumpur, Malaysia over a period of 5 years. Reports by the referring pathologists and the soft tissue pathologist were compared based on tumour classification and tumour behaviour. Overall, there was moderate agreement in soft tissue tumour diagnoses in both tumour classification (weighted κ = 0.423) and tumour behavior (weighted κ = 0.548). The highest agreement of tumour classification was seen in the adipocytic tumours (21/28 cases), Ewing sarcoma (5/7 cases) and smooth-muscle tumours (3/5 cases). The highest rates of discrepancies were the so-called fibrohistiocytic tumours (7/11 cases), vascular tumours (9/15 cases) and undifferentiated/ unclassified sarcomas (19/32 cases). Full agreement for tumour behaviour was seen in 178 cases and there were 21 cases of zero agreement. Liposarcoma, alveolar soft part sarcoma and benign fibrous histiocytoma were the most frequent benign/malignant diagnostic discrepancies. The most common causes of discrepancy were wrong morphological interpretation followed by insufficient immunohistochemical stains performed. In conclusion, review of diagnosis by a pathologist specialized in soft tissue improves the quality of diagnosis in these heterogenous and rare tumours. A good panel of immunohistochemical stains with additional molecular study is crucial in the general hospital laboratories practice.

KW - Agreement

KW - Diagnosis

KW - Discrepancies

KW - Histopathology

KW - Soft tissue tumours

UR - http://www.scopus.com/inward/record.url?scp=85042255518&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85042255518&partnerID=8YFLogxK

M3 - Article

C2 - 29279582

AN - SCOPUS:85042255518

VL - 39

SP - 209

EP - 216

JO - Malaysian Journal of Pathology

JF - Malaysian Journal of Pathology

SN - 0126-8635

IS - 3

ER -