Obtaining expert opinions in diagnostically difficult cases

Sir, Klebe et al. describe their experience with expert review of difficult mesothelial proliferations. They found only 57% complete concordance between the expert and referring pathologists diagnosis, with some 9.5% of cases having significant disagreement (benign versus malignant, or mesothelioma versus another tumour type). Whilst disturbing, this will come as no surprise to those of us with subspecialty interests in other rare tumour types such as sarcoma or GIST, and no doubt in other organ systems as well