Observer variation in the histological diagnosis of plasmacytoid leukemia (marine anemia)

The reliability of past histological criteria for the diagnosis of plasmacytoid leukemia was investigated by studying observer variation in the diagnosis of the disease. Participants blindly evaluated a series of histological samples and classified them as positive, negative or questionable cases of the disease. Intra- and interpathologist agreement were used to assess reliability and were determined by calculating the observed agreement in diagnosis and the kappa statistic. There was poor overall agreement for the classification of sample cases. Questionable cases were most frequently misclassified but marked disagreement also existed for positive and negative samples. Access to historical information prior to histological examination influenced agreement. The results show that previously described histological criteria alone were insufficient for establishing the diagnosis of plasmacytoid leukemia.