Table 4

Possible causes of diagnostic discordance related to time of diagnosis

Possible causes

Pat. ID

Sex

Year

Our tentative HES diagnosis

Primarily registered MM diagnoses changed to:


Right histological diagnosis

(without use of IHC) not

accepted by clinicians,

registered as MM in Cancer Registry

5

3

6

M

M

M

1986

1988

1988

MM/LMS

MM

MM/C

undetermined: sarcoma, lung or pleura/sarcomatous MM, pleura

AC, lung

pleomorphic carcinoma, lung


No IHC

9

M

1991

MM/C

pleomorphic carcinoma, lung


Use of non-specific markers

57

72

31

49

M

M

M

F

1989

1996

1998

1998

MM

MM/C

Mal. tu.

S/LMS?

undetermined: sarcoma, lung or pleura/sarcomatous MM,

pleura

AC, lung

pleomorphic carcinoma, lung

undetermined: sarcoma/sarcomatoid carcinoma,

peritoneum


Differences in IR1

58

F

1999

MM/C

AC, peritoneum


Not appropriate conclusions2

32

63

12

M

M

M

1999

2001

2002

MM

Ben./MM?

Mal. Mel.

undetermined: sarcoma, lung or pleura/sarcomatous MM, pleura

undetermined: sarcoma, lung or pleura/sarcomatous MM, pleura

undetermined: AC, lung > MM, pleura


1 between the primary laboratory and our laboratory, in addition misinterpretation of IR of another marker (one case: 58; Ber-Ep4 from negative IR in primary diagnosis to positive IR in our diagnosis, EMA positive IR only in cytoplasm)

2 based on a few relevant MM markers that showed no typical MM pattern

AC - adenocarcinoma; C - carcinoma; S - sarcoma; LMS - leiomyosarcoma; Mal. - malignant; Tu. - tumor; Ben. - benign; Mel. - melanoma

None of these cases had been referred to a second opinion.

All cases were registered as MM, partially despite of histological diagnoses.

Primary histological diagnoses were:

Pat. 5: Malignant mesenchymal tumour, MM possible, no epithelial component seen

Pat. 3: Poorly differentiated carcinoma most likely, MM less likely

Pat. 6: Carcinoma most likely

Pat. 9: MM

Pat. 57: MM likely

Pat. 72: MM likely

Pat. 31: MM possible

Pat. 49: MM

Pat. 58: MM

Pat. 32: MM most likely

Pat. 63: MM, sarcomatous type

Pat. 12: MM

Sandeck et al. Diagnostic Pathology 2010 5:47   doi:10.1186/1746-1596-5-47

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