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Belluco S, Marano G, Lurier T, Avallone G, Brachelente C, Di Palma S, Rasotto R, Baiker K, Beineke A, Oevermann A, Seehusen F, de Sant'Ana FJF, Boracchi P, Pumarola M, Mandara MT. Standardization of canine meningioma grading: Validation of new guidelines for reproducible histopathologic criteria. Vet Comp Oncol 2023; 21:685-699. [PMID: 37635372 DOI: 10.1111/vco.12932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 08/07/2023] [Accepted: 08/10/2023] [Indexed: 08/29/2023]
Abstract
Canine meningiomas are currently graded using the human grading system. Recently published guidelines have adapted the human grading system for use in dogs. The goal of this study was to validate the new guidelines for canine meningiomas. To evaluate the inter-observer agreement, 5 veterinary surgical pathologists graded 158 canine meningiomas following the human grading system alone or with the new guidelines. The inter-observer agreement for histologic grade and each of the grading criteria (mitotic grade, invasion, spontaneous necrosis, macronucleoli, small cells, hypercellularity, pattern loss and anaplasia) was evaluated using the Fleiss kappa index. The diagnostic accuracy (sensitivity and specificity) was assessed by comparing the diagnoses obtained with the 2 grading systems with a consensus grade (considered the reference classification). The consensus histologic grade was obtained by agreement between 4 experienced veterinary neuropathologists following the guidelines. Compared with the human grading alone, the canine-specific guidelines increased the inter-observer agreement for: histologic grade (κ = 0.52); invasion (κ = 0.67); necrosis (κ = 0.62); small cells (κ = 0.36); pattern loss (κ = 0.49) and anaplasia (κ = 0.55). Mitotic grade agreement remained substantial (κ = 0.63). The guidelines improved the sensitivity in identifying grade 1 (95.6%) and the specificity in identifying grade 2 (96.2%) meningiomas. In conclusion, the new grading guidelines for canine meningiomas are associated with an overall improvement in the inter-observer agreement and higher diagnostic accuracy in diagnosing grade 1 and grade 2 meningiomas.
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Affiliation(s)
- Sara Belluco
- Université de Lyon, VetAgro Sup, ICE UPSP 2016.A104, Axe Cancérologie, Marcy l'Etoile, Lyon, France
| | - Giuseppe Marano
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - Thibaut Lurier
- INRAE, VetAgro Sup, UMR EPIA, Université Clermont Auvergne, Saint-Genès-Champanelle, France
- INRAE, VetAgro Sup, UMR EPIA, Université de Lyon, Lyon, France
| | - Giancarlo Avallone
- Dipartimento di Scienze Mediche Veterinarie, Università di Bologna, Bologna, Italy
| | - Chiara Brachelente
- Dipartimento di Medicina Veterinaria, Università degli Studi di Perugia, Perugia, Italy
| | | | - Roberta Rasotto
- Diagnostic Pathology, Dick White Referrals, Station Farm, Cambridgeshire, UK
| | - Kerstin Baiker
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Science, City University of Hong Kong, Kowloon, Hong Kong
| | - Andreas Beineke
- Stiftung Tierärztliche Hochschule Hannover, Institut für Pathologie, Hannover, Germany
| | - Anna Oevermann
- Division of Neurological Sciences, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Frauke Seehusen
- Institute of Veterinary Pathology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | | | - Patrizia Boracchi
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - Martí Pumarola
- Dept Medicina i Cirurgia, Animals, Facultat de Veterinària, Barcelona, Spain
| | - Maria Teresa Mandara
- Laboratorio di Neuropatologia, Dip. di Medicina Veterinaria, Università degli Studi di Perugia, Perugia, Italy
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2
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Krane GA, Shockley KR, Malarkey DE, Miller AD, Miller CR, Tokarz DA, Jensen HL, Janardhan KS, Breen M, Mariani CL. Inter-pathologist agreement on diagnosis, classification and grading of canine glioma. Vet Comp Oncol 2022; 20:881-889. [PMID: 35856268 PMCID: PMC9795880 DOI: 10.1111/vco.12853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/13/2022] [Accepted: 07/13/2022] [Indexed: 12/30/2022]
Abstract
Histopathological evaluation of tumours is a subjective process, but studies of inter-pathologist agreement are uncommon in veterinary medicine. The Comparative Brain Tumour Consortium (CBTC) recently published diagnostic criteria for canine gliomas. Our objective was to assess the degree of inter-pathologist agreement on intracranial canine gliomas, utilising the CBTC diagnostic criteria in a cohort of eighty-five samples from dogs with an archival diagnosis of intracranial glioma. Five pathologists independently reviewed H&E and immunohistochemistry sections and provided a diagnosis and grade. Percentage agreement and kappa statistics were calculated to measure inter-pathologist agreement between pairs and amongst the entire group. A consensus diagnosis of glioma subtype and grade was achieved for 71/85 (84%) cases. For these cases, percentage agreement on combined diagnosis (subtype and grade), subtype only and grade only were 66%, 80% and 82%, respectively. Kappa statistics for the same were 0.466, 0.542 and 0.516, respectively. Kappa statistics for oligodendroglioma, astrocytoma and undefined glioma were 0.585, 0.566 and 0.280 and were 0.516 for both low-grade and high-grade tumours. Kappa statistics amongst pairs of pathologists for combined diagnosis varied from 0.352 to 0.839. 8 % of archival oligodendrogliomas and 61% of archival astrocytomas were reclassified as another entity after review. Inter-pathologist agreement utilising CBTC guidelines for canine glioma was moderate overall but varied from fair to almost perfect between pairs of pathologists. Agreement was similar for oligodendrogliomas and astrocytomas but lower for undefined gliomas. These results are similar to pathologist agreement in human glioma studies and with other tumour entities in veterinary medicine.
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Affiliation(s)
- Gregory A. Krane
- Cellular and Molecular Pathology Branch, National Toxicology Program, National Institute of Environmental Health SciencesResearch Triangle ParkNorth CarolinaUSA,Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State UniversityRaleighNorth CarolinaUSA,Comparative Neuroimmunology and Neuro‐Oncology Laboratory, College of Veterinary Medicine, North Carolina State UniversityRaleighNorth CarolinaUSA,Present address:
ModernaCambridgeMassachusettsUSA
| | - Keith R. Shockley
- Biostatistics and Computational Biology Branch, Division of Intramural Research, National Institute of Environmental Health SciencesResearch Triangle ParkNorth CarolinaUSA
| | - David E. Malarkey
- Cellular and Molecular Pathology Branch, National Toxicology Program, National Institute of Environmental Health SciencesResearch Triangle ParkNorth CarolinaUSA
| | - Andrew D. Miller
- Section of Anatomic Pathology, Department of Biomedical Sciences, College of Veterinary Medicine, Cornell UniversityIthacaNew YorkUSA
| | - C. Ryan Miller
- Comprehensive Neuroscience Center, O'Neal Comprehensive Cancer Center, Division of Neuropathology, Department of Pathology, University of Alabama at BirminghamBirminghamAlabamaUSA
| | - Debra A. Tokarz
- Experimental Pathology LaboratoriesResearch Triangle ParkNorth CarolinaUSA,Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State UniversityRaleighNorth CarolinaUSA
| | - Heather L. Jensen
- Cellular and Molecular Pathology Branch, National Toxicology Program, National Institute of Environmental Health SciencesResearch Triangle ParkNorth CarolinaUSA
| | - Kyathanahalli S. Janardhan
- Integrated Laboratory SystemsResearch Triangle ParkNorth CarolinaUSA,Present address:
MerckWest PointPennsylvaniaUSA
| | - Matthew Breen
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State UniversityRaleighNorth CarolinaUSA
| | - Christopher L. Mariani
- Comparative Neuroimmunology and Neuro‐Oncology Laboratory, College of Veterinary Medicine, North Carolina State UniversityRaleighNorth CarolinaUSA,Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State UniversityRaleighNorth CarolinaUSA
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Papparella S, Crescio MI, Baldassarre V, Brunetti B, Burrai GP, Cocumelli C, Grieco V, Iussich S, Maniscalco L, Mariotti F, Millanta F, Paciello O, Rasotto R, Romanucci M, Sfacteria A, Zappulli V. Reproducibility and Feasibility of Classification and National Guidelines for Histological Diagnosis of Canine Mammary Gland Tumours: A Multi-Institutional Ring Study. Vet Sci 2022; 9:vetsci9070357. [PMID: 35878374 PMCID: PMC9325225 DOI: 10.3390/vetsci9070357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 07/04/2022] [Accepted: 07/06/2022] [Indexed: 11/30/2022] Open
Abstract
Simple Summary Tumours of the mammary gland are common in humans, as in canine species. They are very heterogenous with numerous morphological variants and different biologic behaviours. In the last few decades, several efforts have been made to classify these tumours histologically and establish the level of malignancy by using histologic grading systems. However, reproducibility and diagnostic agreement of such classification and grading have been only rarely assessed. In this study, we tested the variability in diagnoses performed by 15 pathologists using the same classification and grading system. Prior to the study, pathologists agreed on guidelines regarding how to apply these systems. Pathologists worked blindly on 36 digital histologic slides of canine mammary tumours. The agreement was statistically analysed using Cohen’s kappa coefficient that, when equal to 1, indicates perfect agreement. The overall agreement in the identification of hyperplastic-dysplastic/benign/malignant lesions was substantial (kappa 0.76), while outcomes on morphological classification had only a moderate agreement (k = 0.54). Tumour grade assigned by pathologists was the least concordant and kappa could not be calculated. Although promising, the results underline that each diagnostic/grading system should be assessed and optimized for standardization and high diagnostic agreement. Abstract Histological diagnosis of Canine Mammary Tumours (CMTs) provides the basis for proper treatment and follow-up. Nowadays, its accuracy is poorly understood and variable interpretation of histological criteria leads to a lack of standardisation and impossibility to compare studies. This study aimed to quantify the reproducibility of histological diagnosis and grading in CMTs. A blinded ring test on 36 CMTs was performed by 15 veterinary pathologists with different levels of education, after discussion of critical points on the Davis-Thompson Foundation Classification and providing consensus guidelines. Kappa statistics were used to compare the interobserver variability. The overall concordance rate of diagnostic interpretations of WP on identification of hyperplasia-dysplasia/benign/malignant lesions showed a substantial agreement (average k ranging from 0.66 to 0.82, with a k-combined of 0.76). Instead, outcomes on ICD-O-3.2 morphological code /diagnosis of histotype had only a moderate agreement (average k ranging from 0.44 and 0.64, with a k-combined of 0.54). The results demonstrated that standardised classification and consensus guidelines can produce moderate to substantial agreement; however, further efforts are needed to increase this agreement in distinguishing benign versus malignant lesions and in histological grading.
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Affiliation(s)
- Serenella Papparella
- Department of Veterinary Medicine and Animal Production, Unit of Pathology, University of Naples Federico II, 80138 Naples, Italy; (S.P.); (V.B.); (O.P.)
| | - Maria Ines Crescio
- National Reference Center for the Veterinary and Comparative Oncology (CEROVEC), Experimental Zooprophylactic Institute of Piedmont, Liguria and Valle d’Aosta, 10154 Turin, Italy;
| | - Valeria Baldassarre
- Department of Veterinary Medicine and Animal Production, Unit of Pathology, University of Naples Federico II, 80138 Naples, Italy; (S.P.); (V.B.); (O.P.)
| | - Barbara Brunetti
- Department of Veterinary Medical Sciences, University of Bologna, 40126 Bologna, Italy;
| | - Giovanni P. Burrai
- Department of Veterinary Medicine, University of Sassari, 07100 Sassari, Italy;
- Mediterranean Center for Disease Control (MCDC), University of Sassari, 07100 Sassari, Italy
| | - Cristiano Cocumelli
- Experimental Zooprophylactic Institute of Lazio and Toscana M. Aleandri, 00178 Rome, Italy;
| | - Valeria Grieco
- Department of Veterinary Medicine, University of Milan, 26900 Lodi, Italy;
| | - Selina Iussich
- Department of Veterinary Science, University of Turin, 10095 Turin, Italy; (S.I.); (L.M.)
| | - Lorella Maniscalco
- Department of Veterinary Science, University of Turin, 10095 Turin, Italy; (S.I.); (L.M.)
| | - Francesca Mariotti
- School of Bioscience and Veterinary Medicine, University of Camerino, 62032 Camerino, Italy;
| | - Francesca Millanta
- Department of Veterinary Sciences, University of Pisa, 56124 Pisa, Italy;
| | - Orlando Paciello
- Department of Veterinary Medicine and Animal Production, Unit of Pathology, University of Naples Federico II, 80138 Naples, Italy; (S.P.); (V.B.); (O.P.)
| | - Roberta Rasotto
- Independent Researcher, Via Messer Ottonello 1, 37127 Verona, Italy;
| | | | | | - Valentina Zappulli
- Department of Comparative Biomedicine and Food Science, University of Padua, 35020 Padua, Italy
- Correspondence: ; Tel.: +39-049-8272962
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Jahns H, McElroy MC. Bovine intracranial neoplasia: A retrospective case series. Vet Pathol 2022; 59:824-835. [PMID: 35638647 PMCID: PMC9358308 DOI: 10.1177/03009858221100433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This case series describes the clinical and pathological findings of intracranial
neoplasms in cattle, a rare entity. Data and archived tissues from 24
intracranial tumors were reviewed and investigated by immunohistochemistry for
S100, glial fibrillary acidic protein, synaptophysin, pancytokeratin, vimentin,
neuron-specific enolase, oligodendrocyte transcription factor 2, and isocitrate
dehydrogenase 1. Ages of affected cattle ranged from 6 months to 14 years (5.7 ±
3.6 years; mean ± SD). Predominant clinical signs were altered mental state,
central vestibular dysfunction, and cerebellar incoordination. Twelve gliomas,
all high grade, were the most common tumors observed: oligodendrogliomas (n =
6), astrocytomas (n = 4), and undefined gliomas (n = 2). The oligodendrogliomas
were located in the brainstem and extended into the ventricles, whereas all
astrocytomas were located in the forebrain. Isocitrate dehydrogenase 1 gene
mutation as described in humans was not detected. The 5 meningiomas exhibited
microcystic, chordoid, atypical, papillary, and anaplastic subtypes. Metastatic
carcinomas (n = 4) were the only secondary tumor type present, and these were
located at the level of the medulla with infiltration of cranial nerves and in
one case leptomeningeal carcinomatosis. In addition, 2 medulloblastomas and 1
choroid plexus carcinoma were diagnosed. Immunohistochemistry for vimentin and
pancytokeratin was particularly useful to distinguish meningiomas and choroid
plexus carcinoma (positive for vimentin only) from mestastatic carcinomas
(positive for cytokeratin only) as all showed a papillary growth pattern.
Overall, the morphological features were comparable with other species and the
human and canine classifications could be applied.
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Affiliation(s)
| | - Maire C McElroy
- Department of Agriculture, Food and the Marine, Celbridge, Ireland
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Pupin RC, Rissi DR, Gomes DC, Gimelli A, Palumbo MIP. High‐grade astrocytoma with ventricular invasion in a dog. VETERINARY RECORD CASE REPORTS 2019. [DOI: 10.1136/vetreccr-2019-000958] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Rayane Chitolina Pupin
- Anatomic Pathology LaboratoryUniversidade Federal de Mato Grosso do SulCampo GrandeMSBrazil
| | - Daniel R Rissi
- Department of Pathology and Athens Veterinary Diagnostic LaboratoryUniversity of Georgia College of Veterinary MedicineAthensGeorgiaUSA
| | - Danilo Carloto Gomes
- Anatomic Pathology LaboratoryUniversidade Federal de Mato Grosso do SulCampo GrandeMSBrazil
| | - Amanda Gimelli
- Professional Residence in Veterinary MedicineFederal University of Mato Grosso do SulCampo GrandeBrazil
| | - Mariana Isa Poci Palumbo
- Small Animal Medical ClinicFederal University of Mato Grosso do SulCampo GrandeMato Grosso do SulBrazil
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