A study of interobserver reproducibility of morphologic lesions of focal segmental glomerulosclerosis
- 21 December 2012
- journal article
- research article
- Published by Springer Science and Business Media LLC in Virchows Archiv
- Vol. 462 (2), 229-237
- https://doi.org/10.1007/s00428-012-1355-3
Abstract
The morphology of focal segmental glomerulosclerosis (FSGS) includes collapsing, cellular, and sclerosing forms. The Columbia Working Classification of FSGS divides these into collapsing (COLL), cellular (CELL), tip lesion (TIP), perihilar (PH), and not otherwise specified (NOS) morphologic forms. This study examined the ability of renal pathologists to classify FSGS using single light microscopic images of glomeruli as a uniform data set. Sixty-one digital images of individual glomeruli with FSGS, stained by periodic acid-Schiff or Jones methenamine silver methods, were classified independently by six specialist renal pathologists. Diagnostic consistency was quantified using the kappa statistic for nominal categories. Agreement for 366 diagnoses by six observers was 75.2 % with a kappa value of 0.676. Six of six observers agreed in 31 of 61 cases (50.8 %) and four or more in 53 cases (86.9 %). Respective kappa values ranged from moderate to good: COLL 0.77, CELL 0.53, TIP 0.76, PH 0.84, and NOS 0.60. Capillary retraction with lobular expansion, hypercellularity, and sclerosis in the same glomerular segments, and the location of segmental lesions were sources of diagnostic inconsistency. The morphologic forms of FSGS defined by the Columbia system are reproducible between observers and have a low probability of confusion between forms. Individual glomeruli may have overlapping features of more than one form of FSGS.Keywords
This publication has 18 references indexed in Scilit:
- Fidelity and Evolution of Recurrent FSGS in Renal AllograftsJournal of the American Society of Nephrology, 2008
- Cellular focal segmental glomerulosclerosis: Clinical and pathologic featuresKidney International, 2006
- Clinical and pathologic characteristics of focal segmental glomerulosclerosis pathologic variantsKidney International, 2006
- Mechanisms of Disease: focal segmental glomerulosclerosisNature Clinical Practice Nephrology, 2005
- Pathologic classification of focal segmental glomerulosclerosis: a working proposalAmerican Journal of Kidney Diseases, 2004
- E pluribus unum: The riddle of focal segmental glomerulosclerosisSeminars in Nephrology, 2003
- Inherited PodocytopathiesJournal of the American Society of Nephrology, 2002
- Changing incidence of glomerular diseases in adultsAmerican Journal of Kidney Diseases, 2000
- Increasing incidence of focal-segmental glomerulosclerosis among adult nephropathies: A 20-year renal biopsy studyAmerican Journal of Kidney Diseases, 1995
- Focal segmental glomerular sclerosis: The cellular lesionKidney International, 1985