Interobserver agreement in salivary gland neoplasms by telepathology an analysis of 47 cases

PubMedID: 23700720OBJECTIVE: To assess the discrepancies that prevailed among the members of the Head and Neck Pathology Working Group in Turkey in diagnosing salivary gland tumors, classified primarily according to myoepithelial origin, by utilizing telepathology. STUDY DESIGN: At least 4 representative images were obtained from each case of a total of 47 salivary gland tumors, and these were studied by 14 participants. The tumors examined were classified into 2 categories under behavior as malignant or benign, and also grouped into 2 categories under differentiation: those showing and those not showing myoepithelial differentiation. Representative areas from hematoxylin and eosin-stained slides were imaged by experienced pathologists. Images from the cases were recorded and distributed via compact disc. RESULTS: The participants in this study had a mean of 12.8 years' experience in pathology. The agreement ratios on tumors showing myoepithelial differentiation and malignancy were 86% and 81%, respectively. Basal cell adenocarcinoma gathered the lowest agreement of the myoepithelial differentiation among the tumors by 64%. The highest agreement (100%) was for 17 myoepitheliomas. While adenoid cystic carcinoma attained the highest ratio (95%), myoepithelial carcinoma had the lowest ratio (47%) of agreement on malignancy among the 19 observers. Accordingly, regarding benign tumors the ratio of agreement on the benignancy was 70%, with the highest percentage being 91% for basal cell adenoma. CONCLUSION: Electronic media acting as a usable technological tool for the distribution of pathology expertise may be used to obtain a second opinion about sali-vary gland tumors.© Science Printers and Publishers, Inc

Inter-observer Agreement in Laryngeal Pre-neoplastic Lesions

In this series, laryngeal preneoplastic lesions were evaluated by the classifications of the World Health Organization (WHOC), Ljubljana (LC) and squamous intraepithelial neoplasia (SINC) by multiple observers. The inter-observer agreement (IA) by WHOC for laryngeal lesions had been previously evaluated, but to the best of our knowledge, there are no data for LC and SINC. H&E stained slides from 42 laryngeal biopsies were evaluated by fourteen participants according to WHOC and LC, and SINC was additionally applied by 6. The results were analyzed statistically. The diagnoses which were favored by most participants for each case, according to WHOC, were as follows: squamous cell hyperplasia (n = 5; 12%), mild dysplasia (n = 11; 26.2%), moderate dysplasia (n = 12; 28.6%), severe dysplasia (n = 7; 16.7%), carcinoma in situ (n = 5; 12%), and invasive squamous cell carcinoma (n = 2; 4.8%). There was a significant difference between the participants for all three classifications; some participants gave lower or higher scores than the others. The mean correlation coefficients (MCC) of the participants were higher for WHOC compared to LC (0.55 ± 0.15 and 0.48 ± 0.14, respectively). The mean linear-weighted kappa (wKappa) values of participants were not significantly different (0.42 ± 0.10, 0.41 ± 0.12 and 0.37 ± 0.07 for WHOC, LC and SINC, respectively). The kappa values in this series are in agreement with those in previous literature for WHOC, and the similar results obtained for LC and SINC are novel findings. Although the MCC of WHOC was higher, as the wkappa was not significantly different, the findings in this series are not in favor of any of the classifications for better IA for pre-neoplastic laryngeal lesions. © 2010 Humana

The effect of P53 expression and smoking/alcohol in P16(+) and P16(–) oropharyngeal carcinoma and risk classification: the Turkish Society of Radiation Oncology Head & Neck Study Group 01-002

Objective: The aim of this study is to categorize the risk groups of patients with oropharyngeal carcinoma (OPC) according to p16 and p53 status, smoking/alcohol consumption history, and other prognostic factors. Study Design: The immunostaining of p16 and p53 of 290 patients was retrospectively evaluated. The history of smoking/alcohol consumption of each patient was noted. p16 and p53 staining patterns were reviewed. The results were compared with demographic findings and prognostic factors. Risk groups have been classified for the p16 status of patients. Results: The median follow-up was 47 months (range 6-240). Five-year disease-free survival (DFS) rates for patients with p16 (+) and (–) were 76% and 36%, and overall survival rates were 83% vs 40%, respectively (HR = 0.34 [0.21-0.57], P .0001), HR = 0.22 [0.12-0.40] P .0001, respectively). p16(–), p53(+), heavy smoking/alcohol consumption, performance status; advanced T and N stages in patients with p16(–), and continuing smoking/alcohol consumption after treatment were found to be unfavorable risk factors. Five-year overall survival rates were 95%, 78%, and 36% for low, intermediate, and high-risk groups, respectively. Conclusions: The results of our study have shown that p16 negativity in patients with oropharyngeal cancer was found to be an important prognostic factor, especially for those with lower p53 expression and not smoking/consuming alcohol. © 2023 Elsevier Inc.The authors thank Prof Beste Atasoy, Prof Leyla Cinel, Prof Mine Genc, Prof Gulay Ozbilim, Associate Professor Candan Demiroz Abakay, Associate Professor Ozlem Saraydaroglu, Halil Cumhur Yildirim MD, Prof Nil Ustundag Comunoglu, Prof Fulya Cakalagaoglu, Associate Professor Yurday Ozdemir, Associate Professor Emine Tugba Canpolat, MD, Murteza Parvizi, MD, Fusun Gocen, Prof Umit Coban, Assoc Prof Emine Canyilmaz, Assoc Prof Eda Yirmibesoglu Erkal, Prof Guler Yavas, MD, Ahmet Tugrul Eruyar, Prof Pinar Karabagli, Prof Ozlem Canoz, Prof Serdar Altinay, Assoc Prof Mete Gundog, MD, Metin Figen, MD, and Seyhan Ozkoyuncu Hascicek for supporting patient data. Thanks to Didem Aytimur, MD, for providing support for English editing. This work was supported by the Ege University Rectorate Scientific Research Projects Coordinatorship (Project No: TGA-2019-20875 and Project No: TGA-2019-20866). None.TGA-2019-20866, TGA-2019-20875This work was supported by the Ege University Rectorate Scientific Research Projects Coordinatorship (Project No: TGA-2019-20875 and Project No: TGA-2019-20866)

Sclerosing Polycystic Adenosis of the Parotid Gland: Report of a Bifocal, Paucicystic Variant with Ductal Carcinoma in situ and Pronounced Stromal Distortion Mimicking Invasive Carcinoma

We present a case (female patient, age 45 years) with a bifocal, paucicystic variant of sclerosing polycystic adenosis of the parotid gland with cribriform ductal carcinoma in situ (DCIS) and pronounced stromal distortion affecting the in situ component to such an extent that it gave a distinct impression of intralesional invasive adenocarcinoma. P63–and calponin-positive myoepithelial cells were present in the periphery of the acini and ducts in the benign component, somewhat discontinuously in the DCIS-component, and even in the periphery of the small irregular atypical cell nests that appeared infiltrative on the haematoxylin and eosin stained sections. Strong cytoplasmic immunoreactivity for GCDFP-15 was detected in the benign component with a variable, patchy and mostly weak positivity in the DCIS. More than 90% of the cells in the DCIS component displayed strong nuclear immunoreactivity for androgen receptors and 10% of the benign ducts showed positivity. Weak to moderate nuclear immunoreactivity for estrogen receptors was seen in 30% of cells in the benign ductal component whereas the DCIS was negative. Occasional cells in the adenosis-component were weakly positive for PR. The proliferative activity (Mib-1/Ki-67) was low (1–2%) in the benign component whereas increased proliferation was seen in the DCIS and in the areas with pseudoinfiltration which also featured atypical mitoses