Revisiting old slides - How worthwhile is it?

Retrospective review of surgical pathology cases is a sensitive and effective method for identifying diagnostic discrepancies. As such studies from developing countries are limited, we undertook a retrospective review of 2408 surgical pathology cases (excluding skin, liver, and kidney biopsies) by two review pathologists to evaluate the quality of histopathology reporting, to identify the variations therein, and to classify them as major and minor according to the impact these would have on patient diagnosis, prognosis, or management. Diagnostic concordance was achieved in 93.1% of cases. The frequencies of overall and major differences in opinion were 6.9% and 3.4%, respectively. Major discrepancies were more common in non-neoplastic lesions than tumors. Endometrial pathologies were misdiagnosed maximally. The overall diagnostic agreement rate in the present study is in tune with those reported earlier although the frequency of major differences is higher. This is definitely a cause for concern and calls for remedial action.