PMID- 37639446
OWN - NLM
STAT- MEDLINE
DCOM- 20240425
LR  - 20240425
IS  - 1543-2165 (Electronic)
IS  - 0003-9985 (Linking)
VI  - 148
IP  - 5
DP  - 2024 May 1
TI  - Debating Deposits, Redux: Substantial Interobserver Agreement Exists in 
      Distinguishing Tumor Deposits From Nodal Metastases in Small Bowel Neuroendocrine 
      Tumors.
PG  - 581-587
LID - 10.5858/arpa.2023-0169-OA [doi]
AB  - CONTEXT: Recent data suggest mesenteric tumor deposits (MTDs) indicate poor 
      prognosis in small bowel well-differentiated neuroendocrine tumors (SB-NETs), 
      including compared to positive lymph nodes, making their distinction crucial. 
      OBJECTIVE: To study interobserver agreement in distinguishing SB-NET MTDs from 
      positive nodes. DESIGN: Virtual slides from 36 locally metastatic SB-NET foci 
      were shared among 7 gastrointestinal pathologists, who interpreted each as an MTD 
      or a positive node. Observers ranked their 5 preferred choices among a supplied 
      list of potentially useful histologic features, for both options. Diagnostic 
      opinions were compared using Fleiss multirater and Cohen weighted kappa analyses. 
      RESULTS: Preferred criteria for MTD included irregular shape (n = 7, top choice 
      for 5), perineural invasion/nerve entrapment (n = 7, top choice for 2), encased 
      thick-walled vessels (n = 7), and prominent fibrosis (n = 6). Preferred criteria 
      for positive nodes included peripheral lymphoid follicles (n = 6, top choice for 
      4), round shape (n = 7, top choice for 2), peripheral lymphocyte rim (n = 7, top 
      choice for 1), subcapsular sinuses (n = 7), and a capsule (n = 6). Among 36 foci, 
      10 (28%) each were unanimously diagnosed as MTD or positive node. For 13 foci 
      (36%), there was a diagnosis favored by most observers (5 or 6 of 7): positive 
      node in 8, MTD in 5. Only 3 cases (8%) had a near-even (4:3) split. Overall 
      agreement was substantial (kappa = .64, P < .001). CONCLUSIONS: Substantial 
      interobserver agreement exists for distinguishing SB-NET MTDs from lymph node 
      metastases. Favored histologic criteria in making the distinction include 
      irregular shape and nerve/vessel entrapment for MTD, and peripheral 
      lymphocytes/lymphoid follicles and round shape for positive nodes.
CI  - (c) 2024 College of American Pathologists.
FAU - Gonzalez, Raul S
AU  - Gonzalez RS
AD  - From the Department of Pathology and Laboratory Medicine, Emory University 
      Hospital, Atlanta, Georgia (Gonzalez).
FAU - Rosa, Stefano La
AU  - Rosa S
AD  - Unit of Pathology, Department of Medicine and Surgery, University of Insubria, 
      Varese, Italy (La Rosa).
FAU - Ma, Changqing
AU  - Ma C
AD  - Department of Pathology and Immunology, Washington University School of Medicine, 
      Saint Louis, Missouri (Ma).
FAU - Polydorides, Alexandros D
AU  - Polydorides AD
AD  - Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of 
      Medicine at Mount Sinai, New York, New York (Polydorides).
FAU - Shi, Chanjuan
AU  - Shi C
AD  - Department of Pathology, Duke University Medical Center, Durham, North Carolina 
      (Shi).
FAU - Yang, Zhaohai
AU  - Yang Z
AD  - Department of Pathology and Laboratory Medicine, University of Pennsylvania 
      Perelman School of Medicine, Philadelphia (Yang).
FAU - Cox, Brian
AU  - Cox B
AD  - Pacific Rim Pathology, San Diego, California (Cox).
FAU - Karamchandani, Dipti M
AU  - Karamchandani DM
AD  - the Department of Pathology, UT Southwestern Medical Center, Dallas, Texas 
      (Karamchandani).
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Arch Pathol Lab Med
JT  - Archives of pathology & laboratory medicine
JID - 7607091
SB  - IM
MH  - Humans
MH  - *Neuroendocrine Tumors/pathology/diagnosis
MH  - *Observer Variation
MH  - *Lymphatic Metastasis/diagnosis/pathology
MH  - *Intestinal Neoplasms/pathology/diagnosis
MH  - *Intestine, Small/pathology
MH  - Lymph Nodes/pathology
MH  - Diagnosis, Differential
MH  - Mesentery/pathology
MH  - Female
COIS- The authors have no relevant financial interest in the products or companies 
      described in this article.
EDAT- 2023/08/28 18:41
MHDA- 2024/04/25 18:56
CRDT- 2023/08/28 13:35
PHST- 2023/06/15 00:00 [accepted]
PHST- 2024/04/25 18:56 [medline]
PHST- 2023/08/28 18:41 [pubmed]
PHST- 2023/08/28 13:35 [entrez]
AID - 495430 [pii]
AID - 10.5858/arpa.2023-0169-OA [doi]
PST - ppublish
SO  - Arch Pathol Lab Med. 2024 May 1;148(5):581-587. doi: 10.5858/arpa.2023-0169-OA.