scholarly journals Comparison between imprint cytology and frozen sections in intraoperative consultation of ovarian tumours

2020 ◽  
Vol 8 (9) ◽  
pp. 3315
Author(s):  
Reily Ann Ivan ◽  
Kuruvilla P. Chacko ◽  
Pramod Thomas
Keyword(s):  
Malignant Tumors ◽  
Frozen Section ◽  
Mucinous Carcinoma ◽  
Ovarian Tumors ◽  
Serous Carcinoma ◽  
Imprint Cytology ◽  
Primary Tumors ◽  
Intraoperative Diagnosis ◽  
Borderline Tumors ◽  
Ovarian Tumours

Background: The ovaries frequently are the site for various primary tumors. Correct intraoperative diagnosis is crucial. The application of imprint cytology is very useful where frozen section facility is not available. The present study is a comparison of imprint cytology and frozen section during intraoperative consultation for various types of benign and malignant ovarian neoplasms in different age groups.Methods: Seventy-six cases of ovarian tumors were examined using both imprint cytology and frozen section and evaluated, taking histopathological report as gold standard. The histopathological diagnoses consisted of benign (54), borderline (9), and malignant (13). The malignant tumors consisted of various types including serous carcinoma, mucinous carcinoma, endometrioid carcinoma, clear cell carcinoma and carcinoid.Results: All 54 benign cases were accurately diagnosed as benign by imprint cytology. With frozen section 53 cases were correctly diagnosed as benign but one case was over diagnosed as borderline. Among 13 malignant cases 11 (84.6%) were correctly diagnosed with both techniques. Borderline tumors were not able to be diagnosed with imprint smear, 3 out of 9 cases were correctly diagnosed with frozen section.Conclusion: When compared with frozen section, imprint cytology is a simple, inexpensive and useful diagnostic tool in intraoperative diagnosis of benign and malignant ovarian tumors. Imprint smear is not useful in borderline tumors where only frozen section is useful. Imprint cytology can be used as an adjunct to frozen section for better diagnosis.

scholarly journals Influence of the primary malignant tumor site on the incidence and features of metastatic ovarian tumors

2007 ◽  
Vol 64 (10) ◽  
pp. 691-696 ◽  
Author(s):  
Zorica Stanojevic ◽  
Biljana Djordjevic ◽  
Danijela Zivanovic
Keyword(s):  
Malignant Tumor ◽  
Malignant Tumors ◽  
Statistical Significance ◽  
Menopausal Status ◽  
Ovarian Tumors ◽  
Metastatic Tumors ◽  
Primary Tumors ◽  
Primary Malignant Tumor ◽  
Group A ◽  
Group B

Background/Aim. Ovary is the organ of the female reproductive system most commonly affected by metastases. The aim of the study was to determine the frequency and features of metastatic ovarian tumors (MOT) depending on the site of the primary malignant tumor. Methods. The study group consisted of 488 patients with histopathologically confirmed ovarian cancers treated at the Clinic of Oncology, Clinical Center Nis, in the period from 1 January 1998 to 31 December 2005. MOT were found in 41 patients. Regarding the site of the primary malignant tumor, those with secondary ovarian tumor were divided into two groups: group A - primary malignant tumor involving the genital organs (n = 30) and group B - primary malignant tumor of extragenital origin (n = 11). Results. MOT were confirmed in 8.40% (41/488) of the patients. Secondary ovarian malignancies were the consequence of endometrial carcinoma spreading in 73.17%, breast carcinoma in 19.51%, stomach carcinoma in 4.88% and colon carcinoma in 2.44% of the cases. No significant differences were found between the group A and group B by the factors of age, body mass index, parity and menopausal status. Contrary to the group A, metastatic tumors in the group B patients were more commonly asymptomatic (p < 0.001), bilateral (p < 0.05), with larger ovarian diameter (p < 0.05), associated with ascites (p < 0.001) and abdominal metastases (p < 0.01), all of statistical significance. Conclusions. Metastatic tumors made up 8.40% of ovarian neoplasmas. With non-genital primary tumors, secondary ovarian deposits were frequently asymptomatic, bilateral, associated with larger ovarian diameter, ascites and abdominal metastatic deposits, compared to malignant tumors of genital origin.

Immunoexpression of Inhibin α Subunit, Inhibin/Activin βA Subunit and CD99 in Ovarian Tumors

2000 ◽  
Vol 124 (4) ◽  
pp. 563-569 ◽  
Author(s):  
Yoon-La Choi ◽  
Hy-Sook Kim ◽  
Geunghwan Ahn
Keyword(s):  
Differential Diagnosis ◽  
Granulosa Cell ◽  
Mucinous Carcinoma ◽  
Ovarian Tumors ◽  
Serous Carcinoma ◽  
Α Subunit ◽  
Stromal Tumors ◽  
Epithelial Tumors ◽  
Krukenberg Tumors ◽  
Sex Cord Stromal Tumors

Abstract Objective.—Anti–inhibin α and inhibin/activin βA subunit and anti-CD99 monoclonal antibodies (mAbs) have recently been demonstrated to be able to label ovarian granulosa cells; thus, they may be of value in the diagnosis of granulosa cell tumors. The present study aimed to determine what combination of these mAbs may be useful for the differential diagnosis of sex cord–stromal tumors of ovary. Design.—Immunohistochemical analyses with anti–inhibin α and inhibin/activin βA subunit antibody and anti-CD99 mAb were performed on 42 ovarian tumors, including sex cord–stromal tumors (29), ovarian epithelial cancers (10), and Krukenberg tumors (3). Results.—All sex cord–stromal tumors were positive for inhibin α subunit, and 17 cases (58.6%) of sex cord–stromal tumors were immunoreactive for inhibin/activin βA subunit. Epithelial tumors and Krukenberg tumors were all negative for inhibin/activin βA subunit except mucinous carcinoma, which showed strong cytoplasmic immunoreactivity. All sex cord–stromal tumors except one granulosa cell tumor showed membranous staining for CD99. A case of serous carcinoma and a case of mucinous carcinoma were positive for CD99, and the remaining epithelial tumors and Krukenberg tumor were all negative for CD99. Conclusions.—The results of immunohistochemical analysis, together with literature review, suggest that inhibin α subunit may be a useful diagnostic marker for sex cord–stromal tumor of the ovary. In addition, anti-CD99 antibody may be useful for the differential diagnosis between ovarian tumors. Inhibin/activin βA subunit has a limited usefulness in the differential diagnosis of ovarian tumor because of its wider immunoreactivity for both sex cord–stromal tumors and mucinous carcinomas. The differential diagnosis of sex cord–stromal tumors of the ovary would be better made with a combined use of both anti–inhibin α subunit and anti-CD99 mAbs.

scholarly journals Comparative Study of Imprint Cytology and Frozen Section in the Intraoperative Diagnosis of Thyroid Lesions

1970 ◽  
Vol 24 (1) ◽  
pp. 12-15 ◽  
Author(s):  
Sukumar Shaha ◽  
AJE Nahar Rahman
Keyword(s):  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Frozen Section ◽  
Cost Effective ◽  
Imprint Cytology ◽  
Intraoperative Diagnosis ◽  
Fresh Specimen ◽  
Sensitivity Specificity ◽  
Thyroid Lesions

 Imprint cytology can provide a useful adjunct to the frozen section diagnosis and may be used safely in the intraoperative diagnosis of thyroid nodules, especially in the centres where frozen section facilities are not available. This study was conducted to compare imprint cytology and frozen section in terms of diagnostic accuracy, sensitivity, specificity, positive predictive value and to assess the value of imprint cytology in the intraoperative diagnosis of thyroid lesions. A total of 57 consecutive patients were enrolled in the study. All of the patients underwent frozen section in the department of pathology, BSMMU, Dhaka. Imprints were taken from the fresh specimen sent for frozen section from departments of otolaryngology and surgery of BSMMU. Imprint slides were stained with rapid H & E staining method. Then the tissues were submitted for frozen section by standard method. In this study, diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value of imprint cytology were 81.25%, 66.66%, 82.59%, 87.12% respectively. Frozen section revealed the diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive as 88.46%, 72.72%, 100%, 100%, 83.33% respectively. Imprint cytology was found to be comparable with frozen section in diagnostic accuracy and sensitivity. Since imprint cytology is a simple and cost-effective procedure it can be used as an alternative to frozen section in hospitals where frozen section facilities are not available. Key Words: Imprint cytology, frozen section, intraoperative diagnosis of thyroid lesions  doi: 10.3329/bjpath.v24i1.2876 Bangladesh J Pathol 24 (1) : 12-15   

Diagnostic Discordance in Intraoperative Frozen Section Diagnosis of Ovarian Tumors: A Literature Review and Analysis of 871 Cases Treated at a Japanese Cancer Center

2020 ◽  
pp. 106689692096051
Author(s):  
Hiroshi Yoshida ◽  
Hiroki Tanaka ◽  
Takafumi Tsukada ◽  
Naoko Abeto ◽  
Mayumi Kobayashi-Kato ◽  
...  
Keyword(s):  
Literature Review ◽  
Frozen Section ◽  
Malignant Potential ◽  
Ovarian Tumors ◽  
Serous Carcinoma ◽  
Low Grade ◽  
Borderline Tumor ◽  
Mucinous Tumor ◽  
Ovarian Metastases ◽  
Frozen Section Diagnosis

Background This study examined the accuracy and pitfalls associated with frozen section diagnosis of primary ovarian tumors and ovarian metastases based on the 2014 World Health Organization classification (WHO) criteria and proposed improvements from a pathologist’s perspective. Methods We microscopically reviewed 871 cases of primary ovarian tumor (N = 802) and ovarian metastasis (N = 69) and compared the results of frozen sections with the final diagnosis. Malignant potential concordance (benign, borderline, or malignant) and specific discordant diagnosis rates were analyzed. Finally, we conducted a unique literature review of specific diagnostic errors in the frozen section diagnosis of primary ovarian tumors. Results Of 802 primary ovarian tumors, 50 (6.2%) cases showed discordant diagnoses in which mucinous carcinoma (40.5%), low-grade serous carcinoma (LGSC; 31.3%), and mucinous borderline tumor (18.4%) were frequently misinterpreted. Of 69 ovarian metastases, all 4 cases of low-grade appendiceal mucinous neoplasm (LAMN) were misdiagnosed as primary ovarian mucinous tumor. A literature review revealed that mucinous/serous borderline tumor or carcinoma accounted for approximately 70% of 217 reported discordant diagnoses. Conclusion In the present study, the concordance rate of malignant potential of the tumor was comparable to that previously reported. Even in the 2014 WHO classification, primary ovarian mucinous borderline tumor/carcinoma and LGSC still comprised the majority of discordant cases. Grossing methods that reduce sampling error are required. LAMN was frequently misinterpreted as a benign or borderline ovarian mucinous tumor. To prevent this error, a differential algorithm integrating clinical information and gross findings should be developed.

scholarly journals Intraoperative frozen section analysis of ovarian tumors: a 11-year review of accuracy with clinicopathological correlation in a Hong Kong Regional hospital

2019 ◽  
Vol 29 (4) ◽  
pp. 772-778 ◽  
Author(s):  
Fred Yau-Lung Kung ◽  
Alex Koon-ho Tsang ◽  
Ellen Lok-man Yu
Keyword(s):  
Regression Analysis ◽  
Diagnostic Accuracy ◽  
Diagnostic Performance ◽  
Malignant Tumors ◽  
Early Stage ◽  
Frozen Section ◽  
Ovarian Tumors ◽  
Stage I ◽  
Clinicopathological Parameters ◽  
Staging Surgery

ObjectiveIntra-operative frozen section (IFS) can provide an instinct guide for treatment of ovarian tumors intra-operatively, though limitations exist. This study intended to evaluate the diagnostic performance of IFS and possible clinicopathological factors influencing the diagnostic accuracy of IFS.MethodsA retrospective review of IFS of ovarian lesions from 2006 to 2016 was done. The diagnostic performance of benign, borderline, and malignant IFS diagnosis was evaluated. Logistic regression analysis was used to assess the influence of clinicopathological parameters on the likelihood of underdiagnosis.ResultsThere were 1143 consecutive cases during the study period. The overall accuracy was 93.7%. For benign diagnoses, the IFS diagnostic accuracy, sensitivity, and specificity were 97.20%, 100%, and 92.51%, respectively. If borderline and malignant diagnoses were considered as a single group, the IFS diagnostic accuracy was 97.20%, with 92.51% sensitivity and 100% specificity. At univariate regression analysis, intact capsules at time of delivery (ORunadj = 1.9), stage I lesions (ORunadj = 3.76) and ultrasound (USG) score 0 (ORunadj = 2.52) were positively associated with underdiagnosis. Further multivariate analysis showed that only stage I lesions (OR = 3.62) and USG score 0 (OR = 2.32) were positively associated with underdiagnosis. For the cases with underdiagnosed IFS, 54% (34/63) received incomplete primary staging surgery.ConclusionsThe study demonstrated that IFS provided excellent specificity to differentiate borderline or malignant tumors from benign lesions. IFS in early-stage ovarian cancers needs to be interpreted with caution, though IFS is most important for this group of lesions. A reliable IFS diagnosis often requires efficient communication between surgeons and pathologists.

scholarly journals Role of intraoperative frozen section in the diagnosis of ovarian tumors: Experience at Gujarat Cancer and Research Institute

2016 ◽  
Author(s):  
Ruchi Arora
Keyword(s):  
Surgical Management ◽  
Ovarian Neoplasms ◽  
Frozen Section ◽  
Ovarian Tumors ◽  
Borderline Tumors ◽  
Intraoperative Frozen Section ◽  
Histopathologic Diagnosis ◽  
Frozen Section Diagnosis ◽  
Line Of Therapy

Background: The surgical management of ovarian tumors depends on their correct categorization as benign, borderline or malignant. Ovarian neoplasms are an important cause of morbidity and mortality in women. This study was undertaken to evaluate the accuracy of intra-operative frozen section in the diagnosis of various categories of ovarian neoplasms. Methods: Intraoperative frozen section diagnosis was retrospectively evaluated in 125 patients with suspected ovarian neoplasms who underwent surgery as primary line of therapy at our institution. This was compared with the final histopathologic diagnosis on paraffin sections. Results: In 125 patients frozen section report had a sensitivity of 100%, 95.55% and 50% for benign, malignant and borderline tumors respectively. The corresponding specificities were 92.45%, 98.75% and 99.14% respectively. The overall accuracy of frozen section diagnosis was 95.2%. The majority of cases of disagreement were in the mucinous and borderline tumors. Conclusion: Intraoperative frozen section has high accuracy in the diagnosis of suspected ovarian neoplasms. It is a valuable tool to guide the surgical management of these patients and should be routinely used in all major oncology centers.

The combined use of cytological imprint and frozen section in the intraoperative diagnosis of ovarian tumors

1990 ◽  
Vol 31 (1) ◽  
pp. 43-46 ◽  
Author(s):  
S. Souka ◽  
M. Kamel ◽  
M. Rocca ◽  
M. El-Assi ◽  
N. Hebeishy ◽  
...  
Keyword(s):  
Frozen Section ◽  
Ovarian Tumors ◽  
Intraoperative Diagnosis ◽  
Combined Use

Accuracy of frozen-section analysis in the diagnosis of ovarian tumors: a systematic quantitative review

2005 ◽  
Vol 15 (2) ◽  
pp. 192-202 ◽  
Author(s):  
L. R. Medeiros ◽  
D. D. Rosa ◽  
M. I. Edelweiss ◽  
A. T. Stein ◽  
M. C. Bozzetti ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Ovarian Tumor ◽  
Frozen Section ◽  
Ovarian Tumors ◽  
Frozen Sections ◽  
Borderline Tumors ◽  
Frozen Section Analysis ◽  
Accuracy Rates ◽  
Section Result ◽  
Section Analysis

A quantitative systematic review was performed to estimate the diagnostic accuracy of frozen sections in ovarian tumors. Studies that compared frozen sections and paraffin sections within subjects for diagnosis of ovarian tumors were included. Fourteen primary studies were analyzed, which included 3 659 women. For benign ovarian vs borderline/malignant tumor cases, the occurrence of a positive frozen-section result for benignity (pooled likelihood ratio [LR], 8.7; 95% confidence interval [CI], 7.3–10.4) and posttest probability for benign diagnosis was 95% (95% CI, 94–96%). A positive frozen-section result for malignant vs benign diagnosis (pooled LR, 303; 95% CI, 101–605) increased the probability of ovarian cancer to 98% (95% CI, 97–99%). In borderline vs benign ovarian tumor cases, a positive frozen-section result (pooled LR, 69; 95% CI, 45–106) increased the probability of borderline tumors to 79% (95% CI, 71–85%). In borderline vs malignant ovarian tumor cases, a positive frozen-section result (pooled LR, 18; 95% CI, 13–26) increased the probability of borderline tumors to 51% (95% CI, 42–60%). We conclude that diagnostic accuracy rates for frozen-section analysis is high for malignant and benign ovarian tumors, but the accuracy rates in borderline tumors remain relatively low.

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