Variability in diagnostic opinion among pathologists for single small atypical foci in prostate biopsies.

摘要: Pathologists are increasingly exposed to prostate biopsies with small atypical foci, requiring differentiation between adenocarcinoma, acinar proliferation suspicious for malignancy, and a benign diagnosis. We studied the level of agreement such foci among experts in urologic pathology all-round reference pathologists European Randomized Screening study Prostate Cancer (ERSPC). For this purpose, we retrieved 20 (most <1 mm) foci. Hematoxylin eosin- stained slides, including 10 immunostained slides were digita- lized virtual microscopy. The lesional area was not marked. Five 7 ERSPC examined cases. Multirater k statistics applied determine significant differences pathologists. value (0.39; confidence interval, 0.29-0.49) significantly higher than that (0.21; 0.14-0.27). Full (100%) reached by 5 biopsies. Experts rendered diagnoses ranging from adenocarcinoma on same biopsy 9 biopsies, respectively. Most these lesions comprised 2 glands. diagnosed (49%) more often (32%) (P<0.001). As particularly poor comprising <6 glands, would encourage obtain intercollegial con- sultation specialized pathologist before carcinoma diagnosis, whereas clinicians may consider perform staging engaging deferred or definite therapy.