Quality of pathology reports for advanced ovarian cancer: are we missing essential information? An audit of 479 pathology reports from the EORTC-GCG 55971/NCIC-CTG OV13 neoadjuvant trial.

OBJECTIVE: To assess the quality of surgical pathology reports of advanced stage ovarian, fallopian tube and primary peritoneal cancer. This quality assurance project was performed within the EORTC-GCG 55971/NCIC-CTG OV13 study comparing primary debulking surgery followed by chemotherapy with neoadjuvant chemotherapy and interval debulking surgery. METHODS: Four hundred and seventy nine pathology reports from 40 institutions in 11 different countries were checked for the following quality indicators: macroscopic description of all specimens, measuring and weighing of major specimens, description of tumour origin and differentiation. RESULTS: All specimens were macroscopically described in 92.3% of the reports. All major samples were measured and weighed in 59.9% of the reports. A description of the origin of the tumour was missing in 20.5% of reports of the primary debulking group and in 23.4% of the interval debulking group. Assessment of tumour differentiation was missing in 10% of the reports after primary debulking and in 20.8% of the reports after interval debulking. Completeness of reports is positively correlated with accrual volume and adversely with hospital volume or type of hospital (academic versus non-academic). Quality of reports differs significantly by country. CONCLUSION: This audit of ovarian cancer pathology reports reveals that in a substantial number of reports basic pathologic data are missing, with possible adverse consequences for the quality of cancer care. Specialisation by pathologists and the use of standardised synoptic reports can lead to improved quality of reporting. Further research is needed to better define pre- and post-operative diagnostic criteria for ovarian cancer treated with neoadjuvant chemotherapy.

Magnetic resonance imaging of primary lymphoma of the cervix.

Although uterus and cervix infiltration is a frequent finding in the later stages of lymphomatous disease, primary lymphoma of the cervix is very uncommon; however, this entity can occasionally be distinguished from cervical carcinoma by means of MRI. This is an important fact as treatment and prognosis differ between these neoplasms. We present a case of primary cervical lymphoma studied with high-field (1.5 T) MRI and we make an extensive review of the literature. The cervical mass was found in a routine pelvic examination in a patient with no previous history of gynecologic disorders. This is an uncommon way of presentation of this disease. T2-weighted turbo spin-echo (TSE) sequences in the axial, sagittal, and coronal planes, and T1-weighted SE pre- and post-contrast images, were obtained. The lack of involvement of the mucosa, as well as sparing of cervical stroma and uterine junctional zone, are the most important findings to differentiate cervical lymphoma from carcinoma, and are best evaluated with T2 TSE sequences. Post-contrast images help to delineate the extent of the disease.