System : Hematologic
Introduction
Lymphoma are rare and represent 10% of tumor malignancies. Lymphoma diagnosis has become more accurate since the introduction of the WHO classification in 2001 and 2008.
The updated WHO classification includes more than 80 lymphoma entities with some being very rare and difficult to recognize by non-experienced pathologists.
Importantly, the diagnosis of hematological malignancies currently requires multiple immunohistochemical (IHC) studies and additional tests such as fluorescence in situ hybridization (FISH) or PCR techniques that are not always available in routine laboratories.
Altogether the risk of error remains higher than in other areas of pathology, supporting the requirement for expert review.
The effective management of hematopoietic tumours depends on accurate pathological diagnosis, which is mandatory for giving an appropriate treatment for lymphoma patients.
Why refer cases for a second opinion ?
Despite the introduction of the WHO classification which offers a uniform scheme for distinguishing the different lymphoma subtypes, the risk of error remains higher than in other areas of pathology, since their diagnosis requires experience and large panel of ancillary tests.
Since 2010, the Lymphopath network has dealt with more than 70% of all new lymphoma cases in France and provided a prospective expert review for 65 000 samples of newly diagnosed or suspected lymphoma cases.
In a recent issue of the Journal of Clinical Oncology, we showed that, over a four-year period, expert review changed the diagnosis in almost 20% of patients with a potential impact on patient care in 17.4% according to the current medical guidelines (Laurent et al J clin Oncol 2017).
