1.The accuracy of frozen section of uterine lesions in the practice of gynecologic surgery. A retrospective assessment study in a government tertiary training hospital
Jimmy A. Billod ; Efren J. Domingo ; Nelson T. Geraldino
Philippine Journal of Obstetrics and Gynecology 2018;42(3):16-24
Objective:
This study aimed to determine the accuracy, sensitivity and specificity of frozen section (FS) in the diagnosis of uterine neoplasm in a tertiary government training hospital.
Methodology:
This is a retrospective validation study from 2004-2015 involving cases of uterine lesions from gynecologic surgeries. All histopathologic results of frozen and paraffin sections were retrieved and reviewed. Chi square test with 2x2 Fischer Exact test adjustment was used to check for associations. Accuracy indices of FS tool were estimated such as sensitivity, specificity, likelihood ratios, negative and positive predictive values, and overall accuracy. A p-value of < 0.05 alpha is considered significant.
Results:
A total of 143 uterine specimens were submitted for frozen section analysis. The utilization rate of FS is 1% per year. The FS results were correlated with the final histopathologic diagnosis with 96% agreement rate. Utilizing a median number of 3 sections per specimen provides an overall accuracy rate of 97%. The accuracy rate of FS is equal between combined benign-premalignant and malignant cases at 96%. The accuracy rate is not statistically affected by the procedure by which the specimen was taken, as well as the source and gross morphology of the specimen. Moreover, a minimum of 11 sections per specimen is needed to obtain an accuracy rate of 99-100%. The accuracy rate particularly for endometrial lesions is between 94 and 100%.
Conclusion
Accuracy rates of frozen section on uterine lesions are high regardless of the sampling procedure and source of the specimen. Increasing the number of sections during FS parallels that of the final histopathologic diagnosis. FS for uterine lesions is a vital and cost-effective intraoperative decision tool to maximize care of patients.
Frozen Sections
2.The accuracy of frozen section in the diagnosis of ovarian tumors.
Da Rin KI ; Ki Min KIM ; Cheol Hong KIM ; Moon Kyoung CHO ; So Jeong PARK ; Seok Mo KIM ; Ho Sun CHOI
Korean Journal of Gynecologic Oncology 2007;18(3):235-239
OBJECTIVE: As frozen sections play the role of determining the method or scope of operation for ovarian tumors, the present study examined the accuracy, limitations and clinical utility of frozen sections. METHODS: Among 1583 cases of ovarian tumor surgery conducted during the period from January 1999 to September 2005, 372 for which frozen sections were sent to the Department of Pathology were analyzed through comparison between their frozen section diagnosis and final histopathological diagnosis. RESULTS: Among the ovarian tumor cases, the accuracy of frozen section diagnosis was 91.1% and its sensitive to final diagnosis was highest as 96.0% for benign tumors, and 85.7% for malignant tumors, and as low as 62.9% for borderline?tumors (p<0.01). The positive predictive value was 87.1% for malignant tumors, 68.8% for borderline tumors, and 94.6% for benign tumors. Among the 33 cases for which frozen section did not agree with final diagnosis, 15 cases were false positive and 18 cases were false negative. Among them, 14 cases were mucinous tumors (15.4%, 14/91), showing difficulty in diagnosis compared to non-mucinous tumors (6.8%, 19/281) (p=0.018). CONCLUSION: Despite its limitations, frozen section is a very useful method of high accuracy in diagnosing ovarian tumors. Thus, gynecologists and pathologists need to make efforts to understand the limitations and problems of frozen section, which is not highly sensitive to borderline tumors and mucinous tumors, and to make accurate diagnosis.
Diagnosis*
;
Frozen Sections*
;
Mucins
;
Pathology
3.Imprint Cytological Diagnosis of Colonic Adenocarcinoma Metastatic to Liver
Shashikant Adlekha ; Tandra Chadha ; Prasad Krishnan ; B Sumangala ;
Malaysian Journal of Medical Sciences 2013;20(4):88-90
The liver is a common visceral site for metastatic tumours. Radiological features of the liver, fine needle aspiration cytology (FNAC) and histopathological evaluation (HPE) of liver nodules have a significant role in pre-operative diagnosis of liver lesions. In an intraoperative setting, frozen section biopsy plays a major diagnostic modality but the role of imprint cytology of liver nodules is also appealing. Imprint cytology is a valuable and precise tool in diagnosing the lesions for a rapid intraoperative diagnosis. This study presents a case of colorectal cancer liver metastasis diagnosed by imprint cytology intraoperatively.
Frozen Sections
;
Adenocarcinoma
;
Liver
;
secondary
4.A case of simple cyst of the testis in an infant: ultrasonography and testicular preservation.
Korean Journal of Urology 1992;33(6):1124-1127
We report a very rare case of simple intra-testicular cyst, a 1.7 x l.2 cm sized round lesion fulfilling the criteria of a simple cyst on ultrasound in a 4-month-old male infant in whom the lesion was confirmed as a simple intra-testicular cyst on frozen section and subsequently underwent excision with successful preservation or the testis.
Frozen Sections
;
Humans
;
Infant*
;
Male
;
Testis*
;
Ultrasonography*
5.Intraductal Papillary Mucinous Neoplasm of the Pancreas: The Role of Intraductal Ultrasonography in Selection of Resection Method of Pancreas.
Seung Hoon BAEK ; Young Deok CHO ; Jae Young JANG ; Young Koog CHEON ; Young Seok KIM ; Jong Ho MOON ; Yun Soo KIM ; Moon Sung LEE ; Kyung Yul HUR ; Chan Sup SHIM ; Boo Sung KIM
Korean Journal of Gastrointestinal Endoscopy 2005;31(2):90-96
BACKGROUND/AIMS: The treatment of choice of intraductal papillary mucinous neoplasm (IPMN) is partial pancreatic resection with complete excision of this potentially malignant lesion, thus preserving sufficient pancreatic tissue to ensure endocrine and exocrine functions. This strategy, however, requires a reliable preoperative assessment of the highly variable extension of IPMN. We performed this study to determine the role of intraductal ultrasonography (IDUS) in predicting the extension of IPMN and selecting the resection methods of pancreas. METHODS: A preoperative assessment of IPMN by IDUS was performed in 12 patients who underwent a surgical resection of IPMN. According to the preoperative localization of IPMN by IDUS, various types of limited pancreatic resections were planned. The histologic examination of the frozen section of the pancreatic cut surface was performed in all patient. In the cases of tumor involvement as cut surface margin, a modification of the planned pancreatic resection was done. RESULTS: Technical success was achieved in all 12 cases (100%). There were positive tumor margin of cut surfaces in 2 patients. Of 10 cases whose frozen tissue evaluation of the pancreatic cut surface had been negative at first, one patieat has turned out to be margin positive in permanent section examination, finally. Overall accuracy of IDUS in predicting the continuous extension of IPMN was 75%. CONCLUSIONS: IDUS is a reliable diagnostic modality to guide the resection extent of the pancreas in patients with IPMN.
Frozen Sections
;
Humans
;
Mucins*
;
Pancreas*
;
Ultrasonography*
6.The Accuracy of Frozen section Diagnosis of ovarian Tumors.
Kyung Taek LIM ; Tae Jin KIM ; Hwan Uk JUNG ; Ki heon LEE ; Chong Taik PARK ; In Sou PARK ; Jae Uk SHIM
Korean Journal of Gynecologic Oncology and Colposcopy 1997;8(2):151-155
We compared all frozen section examination of ovarian tumors during a 5 year period in our institute with permanent section diagnosis from paraffin sections. In this period, 604 ovarian tumors had frozen section examination. Final histologic diagnosis was divided into benign, low malignant potential and malignant. Sensitivity of frozen section diagnosis for malignant was 80 %, low malignant potential 73,1%, and benign 99.8%. Predictive value for malignancy was 98.5%, for low malignant potential 76.6%, and for benign disease 96.2%. Diagnostic problems occurred in huge tumors and low malignat potential mucinous tumors. Analysis of the 32 false negative(miss or under diagnosis) revealed that a sampling error was involved almostly. The cases of discrepancy between frozen section diagnosis and permanent section diagnosis, were 26/34 in mucinous tumors and 33/34 in huge size of tumors(more than 10cm). Although surgeons and pathologist are aware of the limitations of frozen section diagnosis of ovarian tumors, peroperative histologic examination can be worthwhile and prevent under or over treatment of ovarian malignancies.
Diagnosis*
;
Frozen Sections*
;
Mucins
;
Paraffin
;
Selection Bias
7.A Case of Hemorrhagic Infarct of Testis.
Choong Sung CHUN ; Yong Kyu JO ; Moon Soo YOON ; Sung Yung CHUNG
Korean Journal of Urology 1972;13(4):297-300
We have experienced an unusual case of hemorrhagic infarct in the right testis at the age of 59 years. The spermatic cord showed normal appearance and no torsion was noted. Orchiectomy was performed as frozen section revealed hemorrhagic infarction of the testis. Herein, hemorrhagic infarction of testis, a rare clinical entity, was reported with review of literatures.
Frozen Sections
;
Infarction
;
Orchiectomy
;
Spermatic Cord
;
Testis*
8.One Case of Epidermoid Cyst.
Kyu Baik LEE ; Hyung Soo KIM ; Byoung Uck SOH ; Young Sun KIM ; Jung Ran KIM ; Jae Hyung YOU
Korean Journal of Urology 1986;27(2):368-370
We experienced one case of epidermoid cyst. This tumor occurs usually in early adult life. So simple excision and testicular preservation are desirable when frozen section reveals the presence of an unequivocally benign lesion.
Adult
;
Epidermal Cyst*
;
Frozen Sections
;
Humans
;
Testis
10.Acute Phase of Sero-negative Rheumatoid Arthritis Misdiagnosed as Pyogenic Arthritis: A Case Report.
Cheol Hee PARK ; Joo Hyun LEE ; Tae Jin KIM ; Dong HURR ; Young Soo CHUN ; Kee Hyung RHYU ; Yoon Je CHO
Hip & Pelvis 2012;24(4):328-332
In cases of sero-negative rheumatoid arthritis (RA), no abnormal findings are observed on blood tests and its clinical course is favorable, compared to sero-positive RA. In the acute phase of sero-negative RA, infiltration of neutrophils may be the only pathologic finding on frozen section biopsy. Thus, it might be misdiagnosed as pyogenic arthritis. We report on a case of acute sero-negative RA misdiagnosed as pyogenic arthritis during hip surgery with review of the literature.
Arthritis
;
Arthritis, Rheumatoid
;
Biopsy
;
Frozen Sections
;
Hematologic Tests
;
Hip
;
Neutrophils