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False Positive Biopsy
All tests has four possible results: true postive, true negative, false positive, and false negative. Enclosed is an abstract about False Positive cancer cells in normal tissues of the cervix. The lesson is to request for a second opinion or second biopsy to confirm or disprove the initial diagnosis or opinion.
I have a close friend who was diagnosed to have a sarcoma at her thigh. The biospy result was read in Manila and was confirmed here at Bangor, Maine. She was advised to have amputation of her leg. We requested for a second opinion. The second opinion recommended “wide excision” and radiation. It was done and and it is longer than five years now after the surgery and she is doing fine with her two legs still and no spread at other part of the body.
Diagn Cytopathol 2003 Jan;28(1):23-7
False-positive squamous cell carcinoma in cervical smears: Cytologic-histologic correlation in 19 cases.
Levine PH, Elgert PA, Mittal K.
Department of Pathology, New York University School of Medicine, New York, New York.
Cytologic features of squamous intraepithelial lesions (SIL) can mimic those of invasive squamous-cell carcinoma. We compare and correlate the cytological findings of 19 false-positive squamous-cell carcinomas with follow-up cone biopsies or hysterectomy specimens to define which type of dysplasia is more prone to diagnostic errors on cervical Papanicolaou (Pap) smears. Out of 128 patients diagnosed with invasive squamous-cell carcinoma from 1994-2000, 19 (14.8%) with follow-up cone biopsies or hysterectomy specimens were false-positive cases, showing only cervical intraepithelial neoplasia (CIN). We reviewed tissue sections from these 19 cases of CIN for cytologic features of squamous-cell carcinoma, such as markedly pleomorphic and/or dysplastic squamous cells, necrosis, and nucleoli. Twelve of 19 patients (63%) were menopausal. The mean age was 50.5 yr. On review of cervical smears, 18 cases qualified for the cytologic diagnosis of squamous-cell carcinoma, keratinizing type, and one case qualified for squamous-cell carcinoma, nonkeratinizing type. Pleomorphic and/or keratinizing dysplasia was found in 15 out of 19 patients (79%), necrosis within superficial endocervical glands in 9 out of 19 patients (47%), and conspicuous nucleoli in 12 out of 19 patients (63%). One or more of these changes were seen in all but 2 patients (89%). Endocervical gland involvement was present and extensive in 18 of the 19 cases (94%). The mean age was older than expected for SIL (50.5 vs. a reported 40), and matched the mean age found in patients with invasive squamous-cell carcinoma. Pleomorphic and/or keratinizing dysplasia involving endocervical glands may exhibit the cytologic features of squamous-cell carcinoma on cervical Pap smears. Diagn. Cytopathol. 2003;28:23-27. Copyright 2003 Wiley-Liss, Inc.
PMID: 12508178 [PubMed - in process]
Example of Diagnostic Error
False Positive Biopsy
Prescription Error
Systems Errors
Flying Infusion Pump
Printed Prescription
Medical Errors a National Problem
Compunding Medication Error
Pediatric Surgery Errors
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