Journal List > Korean J Cytopathol > v.19(2) > 1006541

Korean J Cytopathol. 2008 Sep;19(2):99-106. Korean.
Published online September 30, 2008.  https://doi.org/10.3338/kjc.2008.19.2.99
Copyright © 2008 The Korean Society for Cytopathology
Second Opinion Diagnoses of Cytologic Specimens on Consultation : Asan Medical Center Experience
Sohyung Park, M.D., Jae Y. Ro, M.D., Kyung-Ja Cho, M.D., Gyungyub Gong, M.D., Yong Mee Cho, M.D. and Shin Kwang Khang, M.D.
Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Received July 16, 2008; Accepted September 03, 2008.

Abstract

Background

Second opinion diagnosis of outside pathology slides is a common practice for efficient and proper patient management. We analyzed cytology slides from outside hospitals submitted for a second opinion diagnosis to determine whether the second opinion diagnosis had any influence on patient care.

Methods

We reviewed 1,153 outside cytology slides referred to Asan Medical Center for second opinions from January, 2007, to December, 2007. All cases were categorized into three groups; no diagnostic discrepancy, minor diagnostic discrepancies (no impact on the management), and major diagnostic discrepancies (significant impact on the management and subsequent follow-up).

Results

The thyroid was the most common organ system (933 cases, 80.9%). Forty cases (3.6%) belonged to the major diagnostic discrepancy group and 149 cases (12.8%) to the minor discrepancy group. For validation of second opinion diagnoses in major discrepancy cases, subsequent biopsy or surgical resection specimens and clinical information were reviewed, which were available in 29 cases. The second opinion diagnoses resulted in alteration of clinical management in 21 of 29 cases.

Conclusion

For all referred patients, second opinion diagnosis is important and mandatory for appropriate patient care.

Keywords: Second opinion; Diagnosis; Consultation; Cytology

Tables


 Table 1
Type of Institutes from which outside slides originated
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Table 2
Analysis of organs in consulted cases
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Table 3
Type of major discrepancy
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Table 4
Cases with major discrepancy in thyroid validated by histologic diagnoses
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Table 5
Cases with major discrepancy in other organs
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Table 6
Cases with major and minor discrepancy in thyroid
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