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PubMed1991

Evaluating cervical cone biopsy specimens with frozen sections at hysterectomy.

Frozen section evaluations of cervical cone biopsy specimens were performed at the time of hysterectomy to exclude invasive cervical cancer. During a two-year period we prospectively evaluated 43 cone biopsy specimens. We found all the diagnoses made with frozen sections to be accurate when compared with prospective permanent sections, and all patients received appropriate therapy. Thirty-eight cases showed no evidence of invasion. Two patients had invasive squamous cell cervical cancer, one had invasive cervical adenocarcinoma extending to the endometrial cavity, and two had microinvasion. All invasive cancers were diagnosed correctly with frozen sections and confirmed with permanent sections. When hysterectomy immediately followed conization, no complications occurred, and no significant increase in blood loss was noted. We found frozen section evaluation of a cone biopsy specimen at the time of hysterectomy to be a reliable procedure that saves time, eliminates the risk of additional anesthesia and decreases patients' costs.

Adult↗
PubMed1990

Renal biopsy frozen section: a fluorescent study of hematoxylin and eosin-stained sections.

When frozen sections of kidney are stained with hematoxylin and eosin (H&E) and viewed by standard fluorescence microscopy, crisp detail of nephron and vascular basement membranes is revealed. We studied by H&E fluorescence, control kidneys, and 85 renal biopsies which span a broad range of renal disease. We found that H&E fluorescence provides useful initial orientation by revealing the presence of cortex or medulla and number of glomeruli and vessels. It also reveals major structural alterations of nephron and vascular basement membranes (sclerosis, disruption, atrophy) and heavy deposition of abnormal material (fibrin, immune deposits, paraprotein). When coupled with direct immunofluorescence, a much greater understanding of the disease process is possible, prior to review of permanent sections.

Benzopyrans↗
PubMed1981

Frozen section.

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Frozen Sections↗
PubMed2003

How accurate is frozen section for skin cancers?

Frozen section analysis has been used to increase the likelihood of complete excision of skin cancers and to minimize the risk for recurrence. The question of its accuracy has been addressed in many studies and this article adds data to the discussion. A retrospective study was performed of 60 consecutive cases in which frozen section diagnoses were compared with permanent sections. It was found that in 85% of the cases the frozen sections were accurate compared with the permanent sections, but in 13% of the total cases the margins were less than 1 mm. These results concur with the literature. The surgery and pathological examinations were performed in a community hospital in which there was no dermatopathologist. The authors review the limitations of frozen section diagnosis in skin cancers and show that frozen section may be necessary in select cases but not in most skin cancers.

Adult↗
PubMed1999

Image sampling in static telepathology for frozen section diagnosis.

BACKGROUND: A frozen section diagnostic service is often not directly available in small rural or mountain hospitals. In these cases, it could be possible to provide frozen section diagnosis through telepathology systems. Telepathology is based on two main methods: static and dynamic. The former is less expensive, but involves the crucial problem of image sampling. AIMS: To characterise the differences in image sampling for static telepathology when undertaken by pathologists with different experience. METHODS: As a test field, a previously studied telepathology method based on multimedia email was adopted. Using this method, three pathologists with different levels of experience sampled images from 155 routine frozen sections and sent them to a distant pathology institute, where diagnoses were made on digital images. After the telepathology diagnoses, the glass slides of both the frozen sections and the definitive sections were sent to the remote pathologists for review. RESULTS: Four of 155 transmissions were considered inadequate by the remote pathologist. In the remaining 151 cases, the telepathology diagnosis agreed with the gold standard in 146 (96.7%). There was no significant divergence between the three pathologists in their sampling of the images. Each case comprised five images on average, acquired in four minutes. The overall time for transmission was about 19 minutes. CONCLUSIONS: The results suggest that in routine frozen section diagnosis an inexperienced pathologist can sample images sufficiently well to permit remote diagnosis. However, as expected, the internet is too unreliable for such a time dependent task. An improvement in the system would involve integrated real time features, so that there could be interaction between the two pathologists.

Frozen Sections↗
PubMed1993

An ultrathin frozen section is suitable for demonstrating cytochrome c oxidase activity at electron microscopic level.

Cytochrome c oxidase activity in rat liver was demonstrated in 40 microns sections and ultrathin frozen sections (100-200 nm in thickness), using the diaminobenzidine method. Electron microscopic observations showed strong activity in 81.9 +/- 13.1% of mitochondria along the edge, and 29.9 +/- 21.2% in the center of 40 microns sections. On the other hand, all mitochondria possessed strong activity in ultrathin frozen sections under the same experimental condition. In the ultrathin frozen section, the mitochondrial membranes, as well as the plasma membrane, were broken. The present study indicates that the ultrathin frozen section is suitable for demonstrating cytochrome c oxidase activity at electron microscopic level.

Animals↗
PubMed1993

Frozen section diagnosis in ophthalmic pathology.

Frozen section diagnosis is extensively used in various branches of pathology, but its application in ophthalmic pathology was recognised only in the 1970s. We studied 10 sections of ocular and adenexal lesions by frozen section diagnosis, which included orbital lesions (4 cases), lid lesions (3 cases), and intraocular tissue (1 case). The time taken for processing ranged between 10 to 15 minutes. Diagnoses based on frozen section evaluation included lymphoma, mesenchymal chondrosarcoma, solar keratosis, compound naevus, silicone oil globules in cataractous lens, neurofibromatosis, pseudotumour, retinoblastoma, and chronic blepharitis. Although further histopathologic examination correlated well with the frozen section (100%) observations, the diagnosis was deferred in the case of naevus and reactive lymphoid hyperplasia. Our study shows that frozen section diagnosis in ophthalmic surgery is quite reliable and is particularly useful in ocular adenexal lesions.

Eye Diseases↗
PubMed1999

[Utility of the paraffin-embedded section method on the detection of estrogen receptor from breast cancer tissues--comparison of the paraffin-embedded section method (6F11 and 1D5) with frozen section (H222) and dextran-coated charcoal (DCC) ones].

From March 1988 to December 1990, we detected estrogen receptor (ER) from breast cancer tissues with the dextran-coated charcoal (DCC) method. From September 1990 to March 1998, we repeated the above with the frozen section method (cloneH222; DAINABOT). With the paraffin-embedded section method using two antibodies of anti-ER (clone6F11; NOVOCASTRA and clone 1D5; MBL), we examined the ER of the same 185 primary breast cancer tissues. We had already detected these tissues with the frozen section method, and we also applied the same procedure for the 43 primary breast cancer tissues which had already been detected with the DCC method. We compared these data. The positive rates of ER with DCC, H222, 6F11 and 1D5 were 49%, 53%, 53% and 52% respectively, which were within the reported range. The accuracy between H222 and 6F11 which was calculated as the percentage that were in positive and negative concordance by the two methods, was 88%. The accuracies between H222 and 1D5, between 6F11 and 1D5, between DCC and 6F11, between DCC and 1D5 were respectively 89%, 96%, 79%, and 77%. Although the accuracy between DCC and the paraffin-embedded section was not necessarily high, we obtained a higher concordance between the frozen and paraffin-embedded sections. The highest concordance existed between 6F11 and 1D5. The 30% of negative cases with DCC were positive with paraffin-embedded section. Among these methods of ER detection from breast cancer tissues, the paraffin-embedded section method seemed to be the most useful.

Breast Neoplasms↗
PubMed1995

Frozen section of diagnosis of breast lesions.

Frozen section diagnosis rendered in 549 consecutive breast biopsies performed in 5 years in a single pathology laboratory was correlated with the final pathological diagnosis. There were no false positive reports among the 220 (40.1%) biopsies interpreted as benign lesions in paraffin sections. Among 329 (59.9%) malignant biopsies on paraffin sections, 3 cases were interpreted as benign lesions on frozen sections. Three false negatives included 2 ductal carcinoma in situ and one infiltrating ductal carcinoma associated with papillomatosis. The tumors were small and confined to the breast without any evidence of metastasis. There was a very good correspondence between the frozen section diagnosis and the paraffin section diagnosis (K = 0.98). The sensitivity of frozen section diagnosis was 99.1% and the clinical diagnostic specificity was 100%. Our results suggest that frozen section diagnosis is a highly reliable procedure, but small lesions (less than 1 cm in diameter, or non-palpable) should not be subjected to frozen section examination to avoid unnecessary loss of neoplastic tissue during the frozen section. The careful investigation of paraffin-embedded tissue is recommended for small breast lesions in breast conserving lumpectomy.

Breast Diseases↗
PubMed2005

Frozen section of lung specimens.

CONTEXT: Frozen section of lung tissue is performed to guide the surgeon in subsequent therapy. DESIGN: Practical experience in frozen section of the lung was reviewed in the medical literature and from the records of several academic hospitals. RESULTS: Most frozen sections of the lung are performed for evaluation of a solitary nodule, a mass, or the surgical margins of a resection. Frozen section may also be used to assess the adequacy of a lung wedge biopsy taken for later diagnosis of a condition. CONCLUSION: The pathologic evaluation of intraoperative pulmonary lesions is indicated for the differential diagnosis of pulmonary nodules and masses, both neoplastic and nonneoplastic, surgical resection margins, and mediastinal lymph nodes. The most worrisome pitfalls involve differentiating benign reactive atypia from malignancy on frozen section.

Diagnosis, Differential↗
PubMed2000

Requirements for obtaining unbiased estimates of neuronal numbers in frozen sections.

The use of frozen sectioning is a convenient and rapid means of observing the results obtained using fluorescent retrograde tracers. Quantitation of these results using the biased stereological methods currently available can be associated with large errors. A recently developed stereological tool, the optical dissector, provides unbiased and efficient results, however, the requirements for its use in frozen sections has not previously been established. In this study, a comparison was made of neuron numbers, estimated using the optical dissector method, in the motoneuron pool retrogradely labelled from the rat sciatic nerve with either Fast Blue or Tetramethylrhodamine dextran (fluoro-ruby) in methacrylate embedded and frozen spinal cord specimens. Despite over 50% shrinkage in the frozen sections, compared with virtually no shrinkage in the methacrylate sections, no significant difference in labelled motoneuron numbers was observed, provided this shrinkage was taken into account. Correction for section shrinkage is therefore essential in order to use the optical dissector with confidence to count fluorescent labelled neurons in frozen tissue.

Amidines↗
PubMed2002

Measurement of the repeat period of myelin sheath using ultrathin frozen sections.

The myelin sheath of peripheral nerves was observed by transmission electron microscopy (TEM) using plastic-embedded sections and ultrathin frozen sections. Repeat distances of myelin sheaths were measured in high-powered electron micrographs. The ultrathin frozen sections showed a longer repeat distance than the plastic-embedded sections. The ultrathin frozen sections were thought to contain fewer artefacts, as they had not been subject to dehydration and embedding. It is known that broken myelin sheaths are often observed under conventional TEM. It is thought that these procedures cause contraction and partial destruction of the myelin sheath.

Animals↗
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↗
PubMedDate not supplied

Frozen section diagnosis in ophthalmic surgery.

Frozen section diagnosis can afford the opportunity for histopathological examination of excised tissues in the operating room. Because frozen section techniques have traditionally been little used in ophthalmic surgery, many pathologists are not familiar with eye tissues. However, with cooperation and understanding between the ophthalmologist and the pathologist, frozen section diagnosis may be able to identify the tissue, the pathologic process and the extent of the lesion within 10-15 minutes. In this review, applications and problems of frozen section diagnosis in various types of ocular surgery are discussed.

Anterior Chamber↗
PubMed2005

The impact of size of the adnexal mass on the accuracy of frozen section diagnosis.

OBJECTIVE: We recently showed that frozen section diagnosis has an almost perfect specificity for the diagnosis of malignancy in an adnexal mass, whereas the sensitivity was, though good, not perfect. The aim of the present study was to examine whether the accuracy of frozen section diagnosis is affected by the size of the adnexal masses. METHODS: We included women that underwent frozen section diagnosis for adnexal mass surgery. For each patient we recorded serum CA125 level, menopausal status, tumour size, and histologic classification both at frozen section diagnosis and at definite histological examination. We calculated sensitivity and specificity of frozen section diagnoses, both in tumours below and above 10 cm diameter. RESULTS: We included 257 patients, of whom 142 had a benign tumour, 28 had a borderline tumour and 87 had a malignant tumour at definitive histological assessment. In case frozen section diagnosis showed malignancy, this was always confirmed at final histological assessment. In women with a tumour <10 cm, there was only 1 false negative diagnosis in 50 women with a benign frozen section diagnosis, whereas there were 11 false negative diagnoses in 97 women in women with a tumour > or = 10 cm. The corresponding likelihood ratios of a benign diagnosis for presence of malignancy were .15 for tumours > or = 10 cm and 0.03 for tumours <10 cm, respectively. CONCLUSION: The accuracy of frozen section diagnosis is dependent on tumour size. In adnexal masses > or = 10 cm, a benign result of the frozen section diagnosis is less reliable than in women with a tumour <10 in cm.

Adnexa Uteri↗
PubMed1995

Remote frozen section service in Norway.

Remote frozen section service has been in regular use in northern Norway since 1990. Two local hospitals are equipped with a motorized video microscope remote controlled from the workstation at the University Hospital. The video images are transmitted via a two ways audio and video telenetwork. This dynamic telepathology system utilizes a videocodec for image compression and a transfer rate of 384 Kbit/s. The video images of surgical specimens and frozen sections are displayed on monitors at both the sender and receiver site. From 1990 until 1. July 1994 tissue from 100 patients have been examined. Breasts and thyroid tissues accounts for 74 of cases. Correct benign versus-malignant diagnosis has been given obtained in 89 cases. One false positive, three false negative and seven deferred diagnosis regarding malignancy have occurred. The false positive diagnosis had no major consequences for the patient. Two of the deferred diagnosis turned out to be malignant. The average time taken for examination of each frozen section was 12 minutes (range, 3 to 45 min). Our concept of remote frozen section service can be recommended for hospitals without a local service in surgical pathology.

Breast Neoplasms↗
PubMed1981

Radical prostatectomy with pelvic lymphadenectomy: observations on the accuracy of staging with lymph node frozen sections.

The accuracy of intraoperative frozen section examination of excised lymph nodes was analyzed in 40 consecutive patients with clinical stages A2, B1 and B2 adenocarcinoma of the prostate who underwent pelvic lymphadenectomy immediately before anticipated radical prostatectomy. Lymph node metastases were observed with frozen sections and verified with paraffin sections in 5 cases (13 per cent). Among the 35 patients with negative frozen sections lymph node metastases were found with paraffin sections in 3 cases (9 per cent). Despite the potential for false negative findings we believe that intraoperative frozen sections constitute a practical method of pathologic staging prior to radical prostatectomy.

Adenocarcinoma↗