The diagnosis and classification of Hodgkin's disease is still a problem

The initial histopathologic diagnosis and Rye classification of 172 cases of Hodgkin's disease referred to a regional cancer centre during a period of 8 years was reviewed prospectively by a pathologist in the cancer center who referred 82 cases to a panel made up of pathologists practicing in the region. The proportion of cases with errors in the diagnosis of Hodgkin's disease or Rye classification fell from 47.6% in the first year to 23.1% in the third year and 17.4% in the final year. The performance of the panelists did not vary in any consistent way over the 8-year period. The mean level of agreement among the panelists was 86.7% for the diagnosis of Hodgkin's disease and 63.3% for the Rye classification. A regional program for the ongoing prospective review of all histological diagnoses of Hodgkin's disease can improve the accuracy of initial diagnosis and Rye classification but significant discrepancies persist.