Inter-pathologist Agreement on Structured Histopathology Reporting in Chronic Rhinosinusitis

Area of Science:

• Otolaryngology
• Pathology
• Rhinology

Background:

• Structured histopathology reporting is vital for characterizing chronic rhinosinusitis endotypes.
• It aids in guiding management decisions post-sinus surgery.

Purpose of the Study:

• To evaluate the inter-observer agreement in structured histopathology reporting for rhinology cases.
• Assess the reliability of specific histopathologic variables.

Main Methods:

• Two experienced head and neck pathologists independently reviewed 92 tissue samples from endoscopic sinus surgeries.
• Cohen's kappa coefficients were calculated to measure inter-pathologist agreement for each variable.

Main Results:

• Substantial agreement was found for tissue eosinophil count (κ=0.64), eosinophil aggregates (κ=0.62), and fungal elements (κ=0.74).
• Moderate agreement was observed for inflammation (κ=0.56) and squamous metaplasia (κ=0.46).
• Fair to slight agreement was noted for neutrophil infiltrates, hyperplastic changes, fibrosis, and subepithelial edema, with non-significant agreement for basement membrane thickening and ulceration.

Conclusions:

• High inter-pathologist agreement exists for key variables like eosinophil counts and aggregates in structured rhinology histopathology reports.
• Improving the reproducibility of structured reporting may require refining definitions for certain histopathologic variables.