Discrepancy in Nancy index grading of hematoxylin and eosin-stained biopsy images by pathologists (IMAGE)
Caption
Sigmoid colon biopsy from a patient with treated ulcerative colitis showing chronic inflammation in the lamina propria and a focal area (black arrow in a) with intraepithelial and lamina propria neutrophils (arrowheads in b). At the first review, 8/12 pathologists assigned Grade 2, 3/12 assigned Grade 3, and 1/12 assigned Grade 1. At the second review, 7/12 pathologists assigned Grade 2, and 5/12 assigned Grade 3. Of note, 11/12 pathologists at review 1 and 12/12 at review 2 indicated that this biopsy had active disease. Rectal biopsy from a patient with treated ulcerative colitis showing chronic inflammatory infiltrate in the lamina propria (c) and a possible ulceration with granulation tissue-like appearance (d). At the first review, 7/12 pathologists assigned Grade 4, 4/12 assigned Grade 1, and 1/12 assigned Grade 2. At the second review, 7/12 pathologists assigned Grade 4, 2/12 assigned Grade 2, and Grades 0, 1, and 3 were each assigned by 1/12 pathologists. Notably, 9/12 pathologists at review 1 and 10/12 at review 2 indicated that this biopsy had active disease. (Hematoxylin-eosin stain; original magnifications: 3.2× in a, 20× in b, 4× in c, and 20× in d).
Credit
Xiuli Liu
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CC BY-NC