Completeness of Histopathological Reporting of Malignant Melanoma at Muhimbili National Hospital

Abstract

Background: Malignant melanoma is an aggressive tumor arising from melanocytes. Its incidence and mortality rate has been increasing worldwide though it is generally high in white population in comparison to Asian and African populations. Histological reporting remains to be the gold standard for the confirmatory diagnosis of malignant melanoma and is one of important prognostic tools. Therefore, pathology report should document all histological features that are of diagnostic and prognostic importance. Majority of pathology centers in low and middle resource setting including those in Tanzania employ narrative reporting practice over the currently advocated standardized synoptic reporting system. Nevertheless, narrative histopathological reporting approach may cause misinterpretation due to lack of important information and structure. On the other hand, synoptic reports are pages long, requiring extensive text editing and multiple intermediate steps. Therefore, there is a need to substantiate whether the traditional narrative reporting approach has justifiable shortcomings to warrant the change. The aim of this study is to assess whether the current histomorphological reporting system at Muhimbili National Hospital (MNH) in Tanzania, incorporates all important diagnostic and prognostic characteristics of malignant melanoma in order to form an unbiased decision to opt to synoptic reporting system. Broad objective: To assess the completeness of histopathological narrative reporting of malignant melanoma at MNH in order to objectively obtains an informed decision on the use of synoptic reporting approach. Methodology: This will be a cross sectional hospital based descriptive study conducted at MNH for 5 years’ duration from January 2015 to December 2019. Convenience sampling method will be used to obtain 99 cases of malignant melanoma retrieved from the archive. All histopathological reports present during the five years of the study period will be retrieved and there after slides for each case will be reviewed by the investigator and a senior pathologist. In each case the microscopical features on tissue section(s) will be filled in a prepared synoptic template and then be compared with features reported in a narrative report. Obtained data will be analyzed using Statistical Package for Social Sciences (SPSS) version 20. Correlation between microscopic features gathered in narrative reporting system versus those in synoptic template will be done using Pearson’s correlation coefficient(r) test. Budget: The estimated budget for this study will be 2,305,000 Tanzanian shillings this will be funded by Ministry of Health, Community, Development, Gender, Elderly and Children (MoHCDEC) of Tanzania.