Pathology is a specific field that involves the detailed inspection of cells and tissues under a microscope in conjunction with other tests in order to come to the right conclusion and diagnosis of a disease. Pathological diagnosis is the highest standard when it involves cancer and its classification. And because treatments and therapeutic decisions are based on the pathology findings, any misdiagnosis or incorrect conclusions can result in needless, wrong and perhaps harmful treatments for diseases such as mesothelioma.
Regrettably, studies in the last two decades have revealed that even pathology diagnosis can lead to errors and is not dependable 100% of the time. Retrospective studies have demonstrated that one pathologist may come to a different conclusion than another pathologist about the same tissues and cells.
For suspected cases of malignant mesothelioma, getting an accurate diagnosis is critical. But this can be challenging because the diagnosis of malignant mesothelioma is still laden with challenges despite modern diagnostic techniques. Today, immunohistochemistry is used to detect the specific DNA and proteins of tumor cells. These profiles can help pathologists determine if they are seeing mesothelioma or another cancer such as ovarian cancer or adenocarcinoma that may resemble mesothelioma. Even these assays, however, have issues. Today, different hospitals may use different tests as there is no one standard mesothelioma assay accepted around the world.
Mesothelioma is not the only cancer where diagnosis is challenging and there may be discrepancies in pathology among different pathologists. Here are some examples taken from the medical literature:
Pathologists may differ with each other and have different opinions.
One study suggested that there were significant discrepancies noted in pathology of some patients; and in fact, a wrong pathology may have led to needless cystectomies.
One study revealed that approximately 13% of pathology slides of 43 women diagnosed with ovarian cancer were shown later not to have cancer.
Pathology reports of 535 men were reviewed and it was found that 6 led to unnecessary prostatectomies as they were found to have a benign pathology.
Soft Tissue Lesions
There are several instances where malignant lesions were considered benign and benign lesions were considered malignant. According to one study, in about 25% of cases, major discrepancies were revealed.
In summary, when dealing with pathology reports and diagnosis of various cancers including mesothelioma, it may be wise to obtain a second opinion so as to minimize any discrepancies. If you are a patient you should talk to your doctor about this.
Discrepancies my only affect a small percentage of patients but if you are that patient it can have a dramatic effect in both your treatment and the time to getting appropriate therapy. Because mesothelioma is rare, only a small number of pathologists see a great number of these cases. Therefore it can be beneficial to discuss getting a second opinion with your doctors.
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Disclaimer: The information in this article is for educational and informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this article