The diagnostic accuracy of frozen section compared to. First, frozen sections are difficult to interpret, and are more likely to be misinterpreted by a pathologist than are usual permanent slides. The frozen section fs diagnosis in patient care is dependent. It includes new frozen section specimens, the most current diagnostic guidelines, and discussion of the advancements in tissue staining. Frozen section diagnosis is very useful and highly accurate procedure. Touch impression cytology versus frozen section as. Patient files in the pathology department provided data regarding the frozen section cases.
Intraoperative frozen section a golden tool for diagnosis. During an operation, tissue is transferred to the frozen tissue lab directly from the operating room. It can be timeconsuming, costly and stressful, and is not meant to be used by surgeons merely to satisfy their curiosity about the nature of a lesion. Gross examination of the tumor removed was done by inspection and.
Pdf diagnostic accuracy of frozen section in comparison. To increase the diagnostic accuracy, the combined use of imprints and frozen sections are recommended. The diagnostic accuracy of imprint cytology in breast lesions. Pathologists cap, have documented the precision, accuracy, and reliability. All the datas were retrived from the bound report book and the. Development of frozen section technology is subject of. The manual of surgical pathology 2 in a section titled frozen sections are not. This indicates that the amount of agreement between the two tests was strong, thus the frozen section would be considered as a valid indicator of postoperative pathology results. Accuracy of intraoperative frozen section in the diagnosis of. All cases were analyzed by touch imprint cytology followed by frozen section. A specimen processed in this manner is not satisfactory for detailed study of the cells, but it is valuable because it is quick and gives the surgeon immediate information regarding the. Accuracy of intraoperative consultation in lesions of the salivary glands.
Diagnostic pathology of ovarian tumors offers a focus on the pathology of ovarian neoplasia with detailed clinically relevant information for practicing pathologists not found in other more general volumes of gynecologic pathology. Accuracy of intraoperative frozen section in the diagnosis. We found diagnostic accuracy of both procedures comparable. However, upon pathology report a week later, it did show papillary cancer on both sides. The diagnosis and treatment of salivary gland lesions proceeds in stages.
In my case ovarian cancer was diagnosed from ct scan and ca125 test 4 months before i had surgery. Pretransplant frozen section evaluation for macrovesicular steatosis has long been used as a guide for donor liver utility, but may not agree with the permanent section evaluation. The frozen section results in comparison to final diagnoses were then categorized into three groups. With more than 400 high resolution figures, the atlas of mohs and frozen section cutaneous pathology is the premier textbook on the topic, serving as a highly practical guide to microscopic analysis, diagnosis, and discrimination of common and problematic cutaneous neoplasms. I take a very practical approach to this situation. There, it is placed on a freezing microtome machine where the bottom of the sample is frozen within seconds. Frozen section resulted from need for rapid intraoperative diagnostics. The diagnostic accuracy of frozen section compared to permanent. Cytology plus frozen section is more accurate than either alone am j clin pathol 2002. Limitations at time of frozen section fs are relatively well known, and misinterpretation may occur potentially leading to over and undertreatment. Utility of frozen section pathology with endometrial pre. To determine the accuracy of cytology in intraoperative diagnosis of ovarian tumors and to compare it with frozen section f.
We examined 60 cases from various sites of the body that were referred for intraoperative consultation. Oct 14, 2014 patient files in the pathology department provided data regarding the frozen section cases. Frozen section diagnosis american journal of clinical pathology. Imprint cytology and frozen section together provide a quick, safe, and reliable intraoperative provisional tissue diagnosis in skeletal tumors and tumorlike conditions. To my knowledge, no recent books or publications in the literature have dealt with this important topic. In my experience when the frozen section is sitting cold on the stage the effect of drying is minimal. In this study, the diagnostic accuracy and pitfalls of using frozen section fs of. Although the frozen section is the focus, the central idea behind this book is. Diagnostic accuracy of frozen section tests for surgical. Assessment of liver transplant donor biopsies for steatosis. Accuracy of frozen section diagnosis in surgical pathology. Diagnostic accuracy of frozen section of central nervous system. Frozen section fs analysis during surgery is another method for determining the histopathology of these tumors if the preoperative diagnosis was not conclusive. When a frozen section is performed, the histopathology laboratory will initially be notified that the surgical specimen is on its way from theatre, allowing time to prepare to receive the sample.
When asked to perform a frozen section on a small sample the pathologist is often faced with the decision of how much tissue to use for the frozen section and how much to save for permanent sections. The diagnostic accuracy of imprint cytology in breast. It illustrates the practical use of the frozen section in the management of clinical problems, especially tumors. Utility of frozen section in the evaluation of borderline. In the seventh addition of ackermans surgical pathology, juan rosai 1 the frozen section is described as one of the most important and difficult procedures a pathologist performs during his practice. No one told me about any interim frozen section biopsy and the only document ive seen about 2 weeks after surgery was full pathology report showing high grade ovarian adenocarcinoma stage 3c.
However, when used in the context of modern medical treatment, the term is often used in a more narrow fashion to refer to. The technical name for this procedure is cryosection the quality of the slides produced by frozen section is of lower quality than formalin fixed paraffin embedded tissue processing. Department of pathology, university of hamburg, hamburg, germany. Frozen section technique i fs technique ii fs technique iii fs technique iv. The most examined organ in this study was the thyroid, with 111 25. Avoid pressing tissue to the cryostat stage which can result in adhesion of the tissue to the stage, especially in fatty.
Pathology is the study of the causes and effects of disease or injury. Elsevier is a leading publisher of health science books and journals, helping to advance medicine by delivering superior education, reference information and decision support tools to doctors, nurses, health practitioners and students. Frozen section of the gastrointestinal tract, appendix. The role, value, and limitations of frozen section and gross consultation. The frozen section developed in the wake of several medical advances that. Cullen at johns hopkins hospital in baltimore also involved frozen section, but only. Diagnostic accuracy of frozen section in comparison with fine needle aspiration cytology in thyroid lesions a prospective study article pdf available in iranian journal of pathology 84. A method for preparation of frozen sections ihc world, llc. Out of 21 cases, 19 cases of frozen sections coincided with histopathological diagnosis and 20 cases of fine needle aspiration cytology coincided with histopathological diagnosis. Whether completed by mobile or insurgery units, reliance equipment and pathologists are available around the clock for scheduling. In the international literature, several studies have been published in which the value of fnac was analyzed for the diagnosis of salivary gland tumors. The present study was a retrospective analysis of 404 cases of frozen section biopsy, reported in the bpkmch pathological department between january 2003 to december 2007. From the time the tissue touches a warm slide it starts to under go significant drying artifact with loss of nuclear detail and leakage of fluids from the cytoplasm. Oct 01, 2009 this new volume of the biopsy interpretation series is a practical, superbly illustrated guide to the technical and interpretive aspects of a frozen section.
Intraoperative frozen section a golden tool for diagnosis of. The frozen section procedure is a pathological laboratory procedure to perform rapid microscopic analysis of a specimen. We compared the accuracy of intraoperative cytology i. The demands of patient care require knowledge of the assets and limitations of. However, when used in the context of modern medical treatment, the term is often used in a more narrow fashion to refer to processes and tests which fall within the contemporary. For example, benign inflammatory cells can be difficult to distinguish from infiltrating lobular carcinoma on frozen sections. The frozen section diagnoses were compared to that of the permanent sections, to assess the accuracy of the technique. Diagnostic accuracy of frozen section tests for surgical diseases. Surgeon did a frozen section right there during surgery, came back benign for any cancer. Role of intraoperative pathology consultation in skeletal.
Standard ii specimens to be transported to the pathology department should be placed in the proper container to preserve and protect the specimen. Providing pathological diagnoses using the frozen section technique is one of the most important and difficult procedures in the practice of surgical pathology. It requires experience, knowledge of clinical medicine and pathology, the capacity to make quick decisions under pressure, good judgment, an. We evaluated all cases of bots submitted for fs in our institution to determine the accuracy of intraoperative diagnosis when compared with the final pathology, and possibly identify features. Frozen section of the gastrointestinal tract, appendix, and. This diagnosis is provided by preoperative fnac and more specifically by intraoperative imprint or frozen section. Figure 4c illustrates that by being extremely delicate with the brush. This important work focuses almost entirely on strategies for accurate diagnosis and histologic subclassification, and the clinical correlates of these diagnoses. Frozen section biopsy reliable cancer survivors network. The frozen section procedure as practiced today in medical laboratories is based on the description by dr louis b. Frozen section technique iii pathology innovations.
This newspaper story created community exposure about the role of pathology and pathologists in delivering quality healthcare. Frozen section definition of frozen section by medical. The correlation of intraoperative frozen section diagnosis with final diagnosis on permanent section is an integral part of quality assurance in surgical pathology. Pdf intraoperative diagnosis using the frozen section technique. This is an extremely important aspect of the frozen section preparation. The authors give pathologists a thorough knowledge of the utility and.
The accuracy of intraoperative aspiration cytology in. Frozen section fs, one of the most valuable intraoperative tools for case management, 1,2 involves teamwork among pathologists, pathology trainees, and sometimes pathology assistants. Frozen section diagnosis american journal of clinical. The aim of the work is to evaluate the accuracy of intraoperative frozen section in the diagnosis of ovarian neoplasms in zagazig university. In the initial stage, clinical, radiologic, and fineneedle aspiration cytology fnac are used to categorize cases into surgical or nonsurgical groups figure 1 decision 1. Finally, we suggest that a similar survey of fs be periodically performed in every pathology department as part of its quality assurance program. The late late show with james corden recommended for you. This study sought to evaluate the accuracy of frozen section in an active transplant service. In that way, tumor type and grade could be specified for all tumors. Frequently asked questions department of pathology and. The word pathology also refers to the study of disease in general, incorporating a wide range of bioscience research fields and medical practices.
In general, patients with neoplastic disease are referred for surgical treatment, whereas patients with nonneoplastic disease receive other modes. Intraoperative pathologic consultation on hysterectomy. Moreover, in different series the diagnostic accuracy of frozen section examination is variable according to the anatomic site studied 11,12,18,19. The overall rate of frozen section accuracy was 97. Richly illustrated, containing abundant tables and figures as well as bulleted points of information, diagnostic pathology of ovarian tumors is the first text offering chapters written by practicing gynecologists on how clinical data can enhance pathologic diagnostic accuracy, how pathologists can efficiently convey their diagnostic opinions to. The focus is on use of the frozen section in intraoperative management of patients, particularly those with tumors. S in 105 cases of ovarian tumors received in urmia imam khomeini and shahid motahari hospitals during. During frozen sections, the reassuring eye of a senior pathologist is always. Falsenegative rate of intraoperative frozen section margin analysis for complex head and.
1462 769 501 920 729 964 879 801 978 960 314 349 702 275 959 1022 755 1085 602 50 401 1123 37 1378 1163 487 977 8 1239 169 260 1487 1348 224 425 1101 1384 500 342 161 985 1295 446 1201 446 431 474 143