Histologic processing artifacts and inter-pathologist variation in measurement of inked margins of canine mast cell tumors

• Published in: Journal of veterinary diagnostic investigation Vol. 30; no. 3; pp. 377 - 385
• Main Authors: Kiser, Patti K., Löhr, Christiane V., Meritet, Danielle, Spagnoli, Sean T., Milovancev, Milan, Russell, Duncan S.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.05.2018
• Subjects: Animals; Biopsy - standards; Biopsy - veterinary; Dog Diseases - pathology; Dogs; Full Scientific Reports; Margins of Excision; Mastocytoma, Skin - pathology; Mastocytoma, Skin - veterinary; Observer Variation; Reproducibility of Results; Skin Neoplasms - pathology; Skin Neoplasms - veterinary; mast cell tumors; Canine; histologic tumor-free margin
• ISSN: 1040-6387; 1943-4936
• DOI: 10.1177/1040638718757582

Although quantitative assessment of margins is recommended for describing excision of cutaneous malignancies, there is poor understanding of limitations associated with this technique. We described and quantified histologic artifacts in inked margins and determined the association between artifacts and variance in histologic tumor-free margin (HTFM) measurements based on a novel grading scheme applied to 50 sections of normal canine skin and 56 radial margins taken from 15 different canine mast cell tumors (MCTs). Three broad categories of artifact were 1) tissue deformation at inked edges, 2) ink-associated artifacts, and 3) sectioning-associated artifacts. The most common artifacts in MCT margins were ink-associated artifacts, specifically ink absent from an edge (mean prevalence: 50%) and inappropriate ink coloring (mean: 45%). The prevalence of other artifacts in MCT skin was 4–50%. In MCT margins, frequency-adjusted kappa statistics found fair or better inter-rater reliability for 9 of 10 artifacts; intra-rater reliability was moderate or better in 9 of 10 artifacts. Digital HTFM measurements by 5 blinded pathologists had a median standard deviation (SD) of 1.9 mm (interquartile range: 0.8–3.6 mm; range: 0–6.2 mm). Intraclass correlation coefficients demonstrated good inter-pathologist reliability in HTFM measurement (κ = 0.81). Spearman rank correlation coefficients found negligible correlation between artifacts and HTFM SDs (r ≤ 0.3). These data confirm that although histologic artifacts commonly occur in inked margin specimens, artifacts are not meaningfully associated with variation in HTFM measurements. Investigators can use the grading scheme presented herein to identify artifacts associated with tissue processing.