Diagnostic problems in the subtyping of renal tumors encountered by five pathologists

Intan Kümmerlin, Fiebo ten Kate, Frank Smedts, Thomas Horn, Ferran Algaba, Isabel Trias, Jean de la Rosette, M. Pilar Laguna

Research output: Contribution to journalArticleResearchpeer-review

12 Citations (Scopus)


The diagnostic problems in the subtyping of renal tumors were evaluated by a panel of five pathologists studying a set of selected tumors. Five pathologists independently assessed a single hematoxylin-and-eosin (HE)-stained slide from 28 selected renal tumors. After this independent assessment, the pathologists reevaluated and discussed all discordant cases. Additional HE-stained sections and immunohistochemically (IHC) stained slides were available. The generalized kappa for interobserver agreement was calculated. After independent assessment of the HE-stained slides, the five pathologists unanimously reached an agreement in the decision between malignant and benign in 82% of the cases. Fifty percent of the cases were correctly subclassified. The overall generalized kappa value for the five pathologists was 0.320 (CI 95% 0.090-0.551), which is considered a moderate agreement. A 100% agreement was reached for all 28 cases after examination of more slides from different tumor areas and IHC-stained sections. An accurate histologic distinction between benign and malignant renal tumors is possible on one HE-stained section. Correct assignment of the subtype is difficult on one slide alone and relies on IHC-markers and additional slides. Tumors composed of an eosinophilic cell type and tumors with a papillary growth pattern were the major causes of an incorrect diagnosis on an HE-stained section alone. © 2008 Elsevier GmbH. All rights reserved.
Original languageEnglish
Pages (from-to)27-34
JournalPathology Research and Practice
Issue number1
Publication statusPublished - 15 Jan 2009


  • Diagnosis
  • Kidney
  • Kidney neoplasms
  • Observer variation


Dive into the research topics of 'Diagnostic problems in the subtyping of renal tumors encountered by five pathologists'. Together they form a unique fingerprint.

Cite this