Accuracy of Pathology Reports on Neck Dissection Specimens: A Retrospective Case Series Study

Anton Warshavsky, Roni Rosen, Uri Neuman, Narin Nard-Carmel, Udi Shapira, Leonor Trejo, Dan M. Fliss, Gilad Horowitz*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: Accuracy of the number and location of pathological lymph nodes (LNs] in the pathology report of a neck dissection (ND) is of vital importance. Objectives: To quantify the error rate in reporting the location and number of pathologic LNs in ND specimens. Methods: All patients who had undergone a formal ND that included at least neck level 1 for a clinical N1 disease between January 2010 and December 2017 were included in the study. The error rate of the pathology reports was determined by various means: comparing preoperative imaging and pathological report, reporting a disproportionate LN distribution between the different neck levels, and determining an erroneous location of the submandibular gland (SMG) in the pathology report. Since the SMG must be anatomically located in neck level 1, any mistake in reporting it was considered a categorical error. Results: A total of 227 NDs met the inclusion criteria and were included in the study. The study included 128 patients who had undergone a dissection at levels 1-3, 68 at levels 1-4, and 31 at levels 1-5. The best Kappa score for correlation between preoperative imaging and final pathology was 0.50. There were nine cases (3.9%) of a disproportionate LN distribution in the various levels. The SMG was inaccurately reported outside neck level 1 in 17 cases (7.5%). Conclusions: At least 7.5% of ND reports were inaccurate in this investigation. The treating physician should be alert to red flags in the pathological report.

Original languageEnglish
Pages (from-to)85-88
Number of pages4
JournalIsrael Medical Association Journal
Issue number2
StatePublished - Feb 2022


  • lymph node
  • neck dissection
  • pathology


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