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Published by : PROFESSIONAL MEDICAL PUBLICATIONS |
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ISSN 1681-715X |
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ORIGINAL ARTICLE |
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Volume 24 |
October - December 2008 (Part-II) |
Number 6 |
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Second opinion in pathology of
lymphoid lesions – an audit
Syed Naeem Raza Hamdani1, Muhammad Ashraf Sharif2,
Sajid Mushtaq3,
Nadira Mamoon4, Muhammad Tahir Khadim5
ABSTRACT
Objective: Errors in medical practice remain under intense scrutiny because of their human costs in terms of disability and suffering. Second opinion in histopathology is a safeguard against misdiagnosis before instituting major therapeutic endeavor. Lymphoid lesions are peculiar for their diagnostic evaluation as they require ancillary techniques and expertise in most cases. This review was undertaken to assess the magnitude of diagnostic discrepancies in lymph node lesions of surgical pathology.
Methodology: Forty cases of lymph node lesions initially reported from different centres and referred for second opinion during the year 2005 were included in the study. Special stains and immunohistochemistry were applied and initial diagnosis was compared with the review diagnosis. The discrepancies were divided into different categories keeping in view the implications on patient management.
Results: Of the 40 cases included in the study, there was agreement with the initial diagnosis on review in 11 cases. There was discrepancy between the initial and review diagnosis in 29 cases.
Conclusions: Review is a sensitive and effective method for quality control and to identify areas of disagreement. Mandatory second opinion is a good policy in patient management where crucial therapeutic decisions are involved. It is highly suggested in cases where the histpathologist initially reporting the case does not have requisite ancillary techniques like immunohistochemistry.
KEY WORDS: Audit, Surgical pathology, Immunohistochemistry, Medical error, Second opinion.
Pak J Med Sci October - December 2008 (Part-II) Vol. 24 No. 6 798-802
How to cite this article:
Hamdani SNR, Sharif MA, Mushtaq S, Mamoon N, Khadim MT. Second opinion in pathology of lymphoid lesions– An audit. Pak J Med Sci 2008;24(6):798-802.
1. Dr. Syed Naeem Raza Hamdani,
MBBS, FCPS
Registrar Histopathology,
2. Dr. Muhammad Ashraf Sharif, MBBS, FCPS
Registrar Histopathology,
3. Brig. Dr. Sajid Mushtaq, MBBS, FCPS, FRC Path
Head Department of Histopathology, AFIP
4. Lt Col Dr. Nadira Mamoon, MBBS, FCPS
Consultant Histopathologist,
5. Colonel Dr. Muhammad Tahir Khadim, MBBS, FCPS
Consultant Histopathologist,
1-5: Armed Forces Institute of Pathology,
Rawalpindi - Pakistan.
Correspondence
Dr. Muhammad Ashraf Sharif,
House 107, Street - 110,
Sector G-11/3,
Islamabad - Pakistan.
Email: ashrafof@gmail.com
* Received for Publication: March 26, 2008
* Accepted: September 26, 2008
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