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Dermatopathologist accuracy in classifying angioinvasive fungal infections using virtual microscopy
Iris Harrison1, Basil Patel1, Elaine Kunzler1
1Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida, USA.
Journal of Cutaneous Pathology
|February 17, 2024
Summary
Dermatopathologists can frequently diagnose angioinvasive fungal infections using histopathology, achieving 74% accuracy. However, challenges and pitfalls exist, necessitating standardized reporting for improved fungal infection diagnosis.
Area of Science:
- Dermatopathology
- Medical Mycology
- Histopathology
Background:
- Histopathological categorization of angioinvasive fungal infections presents challenges.
- This leads to variability in dermatopathology reporting.
Purpose of the Study:
- To characterize the diagnosis of angioinvasive fungal infections via light microscopy.
- To assess the accuracy of virtual microscopy for fungal infection reclassification.
Main Methods:
- Analysis of 76 specimens from 33 patients over 11 years.
- Blinded reclassification of fungal infections using virtual microscopy.
- Evaluation of diagnostic accuracy in differentiating mucormycosis, hyalohyphomycosis, and phaeohyphomycosis.
Main Results:
- Mean diagnostic accuracy was 74% (range 65%-91%).
- Virtual microscopy showed variability in dermatopathologists' diagnostic accuracy.
- Common sources of diagnostic error were identified.
Conclusions:
- Histopathological categorization of angioinvasive fungal infections is frequently feasible.
- Accurate identification is limited by diagnostic pitfalls.
- Standardized and clinically useful reporting is recommended for fungal infections.
