scholarly journals Permanent Section

2020 ◽  
Author(s):  
Keyword(s):  
Permanent Section

Accuracy of Frozen Section Diagnosis of the Salivary Gland

1987 ◽  
Vol 96 (4) ◽  
pp. 325-330 ◽  
Author(s):  
Douglas R. Gnepp ◽  
Willa Rae Rader ◽  
Stewart F. Cramer ◽  
Linda L. Cook ◽  
James Sciubba
Keyword(s):  
Salivary Gland ◽  
Malignant Tumor ◽  
Benign Tumor ◽  
Malignant Tumors ◽  
Frozen Section ◽  
Frozen Sections ◽  
Acinic Cell ◽  
Frozen Section Examination ◽  
Permanent Section ◽  
Frozen Section Diagnosis

Three hundred and one salivary gland lesions (162 benign, 72 malignant, and 67 benign non-neoplastic) of 677 cases were evaluated by use of intraoperative frozen sections by 66 pathologists. In seven patients, the diagnosis was deferred for permanent sections. In four cases (1.3%), the diagnosis at permanent section changed from one category of benign tumor to another, and in five cases (1.7%), from one category of malignant tumor to another. In four tumors, a frozen section diagnosis of benign was changed to malignant on permanent sectioning; all four involved acinic cell carcinomas. Only two tumors were incorrectly diagnosed as malignant. We conclude that diagnoses of most salivary gland lesions based on frozen section examination are reliable and accurate. However, the literature does indicate that caution should be exercised when malignant tumors are dealt with.

scholarly journals Breast Sentinel Lymph Node Frozen Section Practice: An Enterprise Audit as a Guide for Moving Forward

2020 ◽  
Author(s):  
Rebecca Czaja ◽  
Ruizhe Wu ◽  
Julie M. Jorns
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Lymph Nodes ◽  
Sampling Error ◽  
Frozen Section ◽  
Academic Institution ◽  
Serial Sectioning ◽  
False Negatives ◽  
Permanent Section ◽  
Section Level

Context.— In recent years, there has been a shift to less aggressive surgical management of the axilla in breast cancer. Consequently, sentinel lymph node evaluation by frozen section (FS) has declined. Additionally, there has been an impetus to decrease efforts in identifying small sentinel lymph node metastases. Objectives.— To critically evaluate our enterprise performance in evaluating axillary sentinel lymph node submitted for FS prior to considering changes in processing. Design.— A retrospective review (August 1, 2017–July 31, 2019) was conducted to identify sentinel and nonsentinel lymph nodes from 1 academic institution and 2 community sites. Cases were evaluated for grossing technique and discordance between FS and permanent section (PS) due to sampling and/or interpretive error. Clinicopathologic features were assessed. Results.— Lymph nodes from 426 patients with 432 neoplasms were sent for FS. Serial sectioning at 2-mm intervals was adhered to in 338 of 432 (78.2%). Serial sectioning was significantly lower at the community sites (14 of 60; 23.3%) versus at the academic institution (324 of 372; 87.1%; P < .001). Discordant cases were all false negatives (21 of 432; 4.8%). A total of 7 of 21 false negatives (33.3%) had macrometastatic (>2 mm) disease; of these, 3 were post–neoadjuvant chemotherapy, 3 were neither serially sectioned nor posttherapy, and 1 was a small (0.3-cm) focus. A total of 15 of 16 false negatives due to sampling error were detected on the first permanent section level. Conclusions.— Standard serial sectioning of sentinel lymph node at 2-mm intervals resulted in infrequent false negatives due to macrometastatic disease. A single additional permanent section level is reasonable, given adherence to serial sectioning.

scholarly journals Clinicopathological Characteristics of Hirschsprung’s Disease With Emphasis on Diagnosis and Management: A Single-Center Study in the Kingdom of Saudi Arabia

2019 ◽  
Vol 6 ◽  
pp. 2333794X1984886
Author(s):  
Abdulaziz Howsawi ◽  
Hanaa Bamefleh ◽  
Saud Al Jadaan ◽  
Stanley Crankson ◽  
Rakan Alkhilaiwi ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Neonatal Period ◽  
Ganglion Cells ◽  
Care Center ◽  
Tertiary Care ◽  
Motor Disorder ◽  
Permanent Section ◽  
Pull Through

Introduction: Hirschsprung’s Disease (HD) is a motor disorder of the gut caused by the failure of neural crest cells to migrate craniocaudally into the bowel during intestinal development, resulting in a functional obstruction. The majority of patients with HD are diagnosed in the neonatal period when they present with symptoms of distal intestinal obstruction. Aim: This study aims to identify the clinic-pathological characteristic of HD patients in our institution in KSA and comparing it with local and international data. Materials and Methods: This retrospective cohort study was conducted in King Abdulaziz Medical City (KAMC), a tertiary care center in Riyadh, Kingdome of Saudi Arabia (KSA). Results: A total of 54 patients (72% male) were diagnosed with HD. Forty-eight patients (89%) were born at term, and 6 were pre-term. Sixty-three percent of the patients presented in the neonatal period. Twenty-two patients (41%) underwent one-stage endorectal pull-through procedure, 23 patients (43%) two-stage endorectal pull-through, and 9 patients (16%) had three-stage endorectal pull-through. Five out of 54 patients had ganglion cells seen on FS but were absent in the permanent section. Therefore, the concordance rate was 90.8%. Conclusion: FS biopsy is a necessary method to determine the level of aganglionosis intraoperatively in HD, but the definitive diagnosis should be with permanent section. Also, the choice of surgical operation type (single-stage or multi-stage pull-through) depends on the patient’s clinical condition.

Stimulated Raman histology for rapid and accurate intraoperative diagnosis of CNS tumors: prospective blinded study

2019 ◽  
pp. 1-7
Author(s):  
Daniel G. Eichberg ◽  
Ashish H. Shah ◽  
Long Di ◽  
Alexa M. Semonche ◽  
George Jimsheleishvili ◽  
...  
Keyword(s):  
Frozen Section ◽  
Cns Tumors ◽  
Rapid Acquisition ◽  
Novel Technology ◽  
Permanent Section ◽  
Diagnostic Time ◽  
Blinded Study ◽  
Histological Data ◽  
Histological Images ◽  
Stimulated Raman

OBJECTIVEIn some centers where brain tumor surgery is performed, the opportunity for expert intraoperative neuropathology consultation is lacking. Consequently, surgeons may not have access to the highest quality diagnostic histological data to inform surgical decision-making. Stimulated Raman histology (SRH) is a novel technology that allows for rapid acquisition of diagnostic histological images at the bedside.METHODSThe authors performed a prospective blinded cohort study of 82 consecutive patients undergoing resection of CNS tumors to compare diagnostic time and accuracy of SRH simulation to the gold standard, i.e., frozen and permanent section diagnosis. Diagnostic accuracy was determined by concordance of SRH-simulated intraoperative pathology consultation with a blinded board-certified neuropathologist, with official frozen section and permanent section results.RESULTSOverall, the mean time to diagnosis was 30.5 ± 13.2 minutes faster (p < 0.0001) for SRH simulation than for frozen section, with similar diagnostic correlation: 91.5% (κ = 0.834, p < 0.0001) between SRH simulation and permanent section, and 91.5% between frozen and permanent section (κ = 0.894, p < 0.0001).CONCLUSIONSSRH-simulated intraoperative pathology consultation was significantly faster and equally accurate as frozen section.

The Value of Monitoring Frozen Section–Permanent Section Correlation Data Over Time

2006 ◽  
Vol 130 (3) ◽  
pp. 337-342
Author(s):  
Stephen S. Raab ◽  
Joseph A. Tworek ◽  
Rhona Souers ◽  
Richard J. Zarbo
Keyword(s):  
Frozen Section ◽  
Linear Modeling ◽  
Improvement Program ◽  
Continuous Quality ◽  
Permanent Section ◽  
The Mean ◽  
Long Term Monitoring ◽  
Term Monitoring ◽  
Over Time

Abstract Context.—The effectiveness of the long-term monitoring of errors detected by frozen section–permanent section correlation is unknown. Objective.—To determine factors important in laboratory improvement in frozen section–permanent section discordant and deferral rates by participation in a multi-institutional continuous quality improvement program. Design.—Participants in the College of American Pathologists Q-Tracks program self-reported the number of anatomic pathology frozen–permanent section discordant and deferred cases in their laboratories by prospectively performing secondary review of intraoperative consultations. Laboratories participated in the program for 1 to 5 years and reported their data every quarter. We calculated mean and median discordant and deferred case frequencies and used mixed linear modeling to determine if length of participation in the program was associated with improved performance. Participants.—One hundred seventy-four laboratories self-reported data. Main Outcome Measures.—Mean frozen–permanent section discordant and deferred diagnostic frequencies and changes in these frequencies over time were measured. Results.—The mean and median frozen–permanent section discordant frequencies were 1.36% and 0.70%, respectively. The mean and median deferred diagnostic frequencies were 2.35% and 1.20%, respectively. Longer participation in the Q-Tracks program was significantly associated (P = .04) with lower discordant frequencies; 4- or 5-year participation showed a decrease in discordant frequency of 0.99%, whereas 1-year participation showed a decrease in discordant frequency of 0.84%. Longer participation in the Q-Tracks monitor was associated with lower microscopic sampling frequencies for discordant diagnoses (P = .04). Increased length of participation in the Q-Tracks program was significantly associated (P = .04) with lower deferred diagnostic frequencies. Conclusions.—Long-term monitoring of frozen–permanent section correlation is associated with sustained improvement in performance.

Treatment of Cutaneous Melanoma of the Face by Mohs Micrographic Surgery

2003 ◽  
Vol 7 (1) ◽  
pp. 25-30 ◽  
Author(s):  
Tasha N. Bienert ◽  
Martin J. Trotter ◽  
John P. Arlette
Keyword(s):  
Malignant Melanoma ◽  
Frozen Section ◽  
Mohs Micrographic Surgery ◽  
Micrographic Surgery ◽  
Melanoma In Situ ◽  
Permanent Section ◽  
Formalin Fixed Paraffin ◽  
Formalin Fixed Paraffin Embedded ◽  
The Face

Background: The treatment of cutaneous malignant melanoma of the face presents a challenge to ensure eradication of disease with maximum preservation of tissue. Mohs micrographic surgery provides a means for histologically controlled removal of malignant melanoma. Objective: This study evaluates the efficacy of Mohs micrographic surgery, at a single institution, for the treatment of facial melanoma and assesses the accuracy of margin control by frozen section techniques. Methods: Ninety-seven patients with biopsy-confirmed melanoma in situ or invasive melanoma of the face were treated by Mohs micrographic surgery over a 6-year period. In 25 patients, tissue margins defined as negative for melanoma at the time of frozen section were re-evaluated on permanent section histology of formalin-fixed, paraffin-embedded tissue. Results: Ninety-two of 97 patients had followup information available (8–72 months; mean 33 months). There were no cases of local recurrence. Eighty-nine of the 92 patients were alive and well with no evidence of disease. One patient died of metastatic melanoma. In situ or invasive melanoma was not identified on permanent sections of 117 tissue margins which had been interpreted as negative on frozen section. Conclusion: Mohs micrographic surgery appears to be an effective treatment for facial melanomas. Our study showed complete correlation between frozen section tissue margins and permanent section controls.

scholarly journals Efficacy of staged excision with permanent section margin control for melanoma in situ

2020 ◽  
Vol 83 (4) ◽  
pp. 1163-1164
Author(s):  
H. Harris Reynolds ◽  
Eugen Stancut ◽  
Peter G. Pavlidakey ◽  
Conway C. Huang ◽  
C. Blake Phillips
Keyword(s):  
Melanoma In Situ ◽  
Permanent Section ◽  
Margin Control
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