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At least 289 records · Page 16Linked to original sources
PubMed1983

Evaluation of frozen section in parotid gland surgery.

One hundred eight patients underwent primary parotid gland resections at Stanford University Medical Center between 1977 and 1980. Sixty-nine percent of the patients received intraoperative frozen-section diagnosis. Of these, 81% were benign and 19% were malignant. Four patients who received frozen-section diagnosis benefited by further surgery during the initial procedure. Two of four patients who did not receive frozen-section diagnosis could have benefited by further surgery. False-negative results (a malignant tumor called benign on frozen-section diagnosis) occurred in 5%. False-positive results (a benign lesion called malignant on frozen-section diagnosis) did not occur and no unnecessary surgery was performed.

False Negative Reactions↗
PubMed1984

Tumors of the salivary glands. Comparison of frozen-section diagnosis with final pathologic diagnosis.

Of the 256 cases of salivary gland tumors subjected to frozen-section diagnosis, the error rate in diagnosis for malignant disease was one of four cases, and in benign disease, it was one of ten cases. Six of the 52 malignant tumors were erroneously labeled as benign, while four of the 204 benign tumors were diagnosed as malignant neoplasms. The occurrence of concurrent benign and malignant disease, nonneoplastic alterations of salivary gland tissue, and sampling errors militated against total reliance on frozen-section diagnosis in the management of salivary gland neoplasms.

Child↗
PubMed1986

Salivary gland tumors. Fine-needle aspiration vs frozen-section diagnosis.

We examined the relative accuracy of fine-needle aspiration biopsy (FNAB) and frozen section (FS) in the diagnosis of salivary gland tumors; FNAB completely and accurately diagnosed 35 (88%) of 40 cases, including ten (100%) of ten nonneoplastic lesions, 20 (87%) of 23 benign, and five (71%) of seven malignant tumors. No complications were encountered with this procedure. These results compare favorably with previously published reports. Twenty-one of 40 tumors diagnosed by FNAB and FS at surgery. Sixteen (76%) of 21 of these were correctly diagnosed by FNAB, and 15 (71%) of 21 by FS. Cystic lesions gave the most diagnostic difficulties both on FNAB and FS. Worldwide, FNAB has been demonstrated to be a cost-effective, accurate, and safe procedure. Furthermore, the use of FNAB allows for better preoperative management and overall treatment planning.

Adenocarcinoma↗
PubMed2000

Lymphatic mapping and focused analysis of sentinel lymph nodes upstage gastrointestinal neoplasms.

BACKGROUND: Lymph node analysis is essential for staging gastrointestinal (GI) neoplasms. Intraoperative lymphatic mapping and sentinel lymphadenectomy were originally described for melanoma but have not yet been investigated for most GI neoplasms. HYPOTHESES: (1) Lymphatic mapping and sentinel lymphadenectomy is feasible in GI neoplasms, (2) the sentinel node (SN) status reflects the regional node status, and (3) focused analysis of the SN improves staging accuracy. DESIGN: Prospective patient series. PATIENTS AND METHODS: Lymphatic mapping was performed in 65 patients with GI neoplasms by injecting 0.5 to 1 mL of isosulfan blue dye around the periphery of the neoplasm. Blue-stained SNs were analyzed by hematoxylin-eosin staining, multiple sectioning, and cytokeratin immunohistochemistry. RESULTS: Lymphatic mapping identified at least 1 SN in 62 patients (95%). Of the 36 cases with nodal metastasis, 32 (89%) had at least 1 positive SN and 15 (42%) had nodal metastasis only in the SN. In 11 cases, tumor deposits were identified by multiple sectioning (n = 2) or immunohistochemistry (n = 9) only. In 5 cases (8%), lymphatic mapping identified aberrant lymphatic drainage that altered the extent of the lymphadenectomy. CONCLUSIONS: Lymphatic mapping and sentinel lymphadenectomy are feasible in GI neoplasms and identify aberrant lymphatic drainage. The SN status accurately reflects the regional node status. Focused analysis of the SN increases the detection of micrometastases and may improve selection of patients for adjuvant treatment.

Adult↗
PubMed1975

Lobular carcinoma of the breast in situ. Are we too radical in its treatment?

Twenty-four patients (average age, 46 years) with 29 instances of lobular carcinoma in situ of the breast have been treated from 1952 to 1971 at the Henry Ford Hospital (incidence, 1%). Six patients had bilateral lesions, one synchronous and 5 metachronous. The initial complaint in 23 of 24 patients was a mass in the breast. Diagnosis was based on permanent histologic section as mammorgraphy and frozen section analysis were inconclusive. Treatment consisted of radical mastectomy in six, modified radical mastectomy in five, and simple mastectomy in 20. All lymph nodes recovered showed no metastatic disease. All patients are alive and well with no evidence of disease. Based on our experience, we recommend a simple mastectomy for treatment of lobular carcinoma in situ with contraleteral bipsy examination in those instances when clinical or roentgenographic evidence suggests a pathologic process.

Adult↗
PubMed1985

Reliability and sensitivity of frozen-section pancreatic biopsy.

A collaborative Veterans Administration and University of California, Davis Medical Center group of 586 patients with histologically proved pancreatic carcinoma was reviewed. During laparotomy, 159 patients underwent 251 frozen-section pancreatic biopsies with subsequent permanent section examination of the same tissue block. All 112 positive frozen-section diagnoses were corroborated on permanent sectioning. The 47 patients with false-negative biopsy specimens were equally divided between sampling and interpretation error. We conclude that in this group of 159 pancreatic cancer patients, 30% failed to be correctly diagnosed by intraoperative frozen-section biopsy. This failure was due to patient sampling and interpretation error in equal proportion. Interpretation error rates were not influenced by the type or number of biopsies. Patient sampling error is apparently reduced by repeated biopsy, and specimen sampling error occurred less frequently with wedge biopsy.

Biopsy↗
PubMed1989

Guidelines for practical utilization of intraoperative frozen sections.

We reviewed 4057 intraoperative frozen sections from 1980 through 1984 to assess the accuracy, strengths, and weaknesses of this technique. Breast, lymph node, and skin comprised half of the sites evaluated. Frozen-section and final diagnoses agreed in 91.5% and disagreed in 6.8% of the cases; 1.7% of the cases were deferred. False-negative frozen-section diagnoses were due to pathologist sampling or judgment errors and surgeon sampling errors. There were eight (0.15%) false-positive diagnoses, none of which altered patient treatment. We recommend that lymph nodes for lymphoproliferative disorders and breast tissue for which a malignant diagnosis will not result in an immediate mastectomy not be submitted for frozen-section diagnosis. Appropriate studies of these tissues can be carried out without an intraoperative diagnosis; such a policy will increase the cost-effectiveness of frozen sections without compromising patient care.

False Negative Reactions↗
PubMed1997

Comparative utility of diagnostic bone-marrow components: a 10-year study.

Ten years of cumulative experience represented by 4,902 consecutive diagnostic bone-marrow examinations at a tertiary care and referral center were reviewed to assess the value of specific components. While it has been shown previously that the information obtained from each component is generally complementary, the inclusion of some or all components may vary between institutions. The components studied included aspirate smears, clot sections, biopsy cores, and touch imprints of biopsy and clot sections. Three clinical presentations accounted for the majority of cases: staging for carcinoma or lymphoma, cytopenias, and acute leukemia. We conclude that bilateral aspirates with biopsies are required for diagnosis in staging of neoplasms and that a unilateral aspirate with biopsy is sufficient to assess patients with cytopenia or leukemia. Only rarely were touch imprints of biopsy cores necessary to establish a diagnosis; however, their early availability prior to examining sections of the clot and core did provide immediate information, when positive, in the staging of patients with carcinoma. In a small percentage of staging and leukemia cases the diagnosis rested with the clot section alone. The findings in this study address common assumptions associated with routine diagnostic hematology and oncology procedures, and are important to both clinicians and pathologists concerned with accuracy, quality assurance, turnaround time, and cost containment.

Biopsy↗
PubMed1996

Qualitative and quantitative analysis of glycine- and GABA-immunoreactive nerve terminals on motoneuron cell bodies in the cat spinal cord: a postembedding electron microscopic study.

The distribution of glycine- and gamma-aminobutyric acid (GABA)-like immunoreactivity (LI) in nerve terminals on the cell soma of motoneurons in the aldehyde-fixed cat L7 spinal cord was examined using postembedding immunogold histochemistry in serial ultrathin sections. Quantitative examination of 405 terminals on eight neurons of alpha-motoneuron size in the L7 motor nuclei from one animal was performed. A majority of the terminals (69%) were immunoreactive to glycine and/or GABA. These terminals contained flat or oval synaptic vesicles, thus classifying them as F type or as C type in one case. In no case was a type-F terminal unlabeled for both glycine and GABA. Most of the immunolabeled terminals were immunoreactive to glycine only (62.5%), whereas 35.4% contained both glycine- and GABA-LI. A very small number of immunolabeled terminals (2%) were immunoreactive to GABA only. In those terminals, where glycine- and GABA-LI coexisted, the gold particle density for each amino acid was only half of that seen in boutons containing only one of the two amino acids. The involvement of glycine and GABA in postsynaptic inhibition of spinal alpha-motoneurons is discussed, with particular reference to the possibility that these two inhibitory amino acids may be coreleased from a significant proportion of the nerve terminals impinging on the cell bodies.

Animals↗
PubMed1996

Total number of neurons in the neostriatal, pallidal, subthalamic, and substantia nigral nuclei of the rat basal ganglia: a stereological study using the cavalieri and optical disector methods.

The total number of neurons within six subdivisions of the rat basal ganglia was estimated using unbiased stereological counting methods and systematic random sampling techniques. Six young adult rats were perfuse-fixed, their right cerebral hemispheres were embedded in glycolmethacrylate, and a complete set of serial 40-mu m sections was cut through each hemisphere. After a random start, a systematic subset (e.g., every tenth) of these sections was used to estimate the total volume of each subdivision using Cavalieri's method. The same set of sampled sections was used to estimate the number of neurons in a known subvolume (i.e., the Nv) by the optical disector method. The product of the total volume and the Nv by these methods yields an unbiased estimate of the total number of neurons. It was found that the right basal ganglia consisted, on average, of 2.79 million neostriatal or caudate-putamen neurons (with a coefficient of variation of 0.07), 46,000 external globus pallidus neurons (0.11), 3,200 entopeduncular/internal globus pallidus neurons (0.10), 13,600 subthalamic neurons (0.10), 7,200 substantial nigra pars compacta neurons (0.15), and 26,300 substantia nigra pars reticulata neurons (0.07).

Animals↗