What is intraoperative frozen section?
A frozen section examination is a specific type of biopsy procedure that allows a surgeon to establish a rapid diagnosis of a suspicious mass during surgery. The technical name for this procedure is cryosection.
What is frozen section in histopathology?
The frozen section refers to the process where there is rapid tissue section cooled with a cryostat to provide an immediate report of the tissue sample. The cryostat freezes the tissue allowing it to be cut for a microscopic section. The conversion of water into ice acts as the embedding media for cutting the tissue.
How is a frozen section performed?
During an operation, tissue is transferred to the frozen tissue lab directly from the operating room. There, it is placed on a freezing microtome machine where the bottom of the sample is frozen within seconds.
How is a frozen section sent to the lab?
The pathologist freezes the tissue in a cryostat machine, cuts it with a microtome, and then stains it with various dyes so that it can be examined under the microscope. The procedure usually takes only minutes.
How accurate is frozen section biopsy?
Most centers reported an accuracy rate of frozen sections 92% to 98% depending on type of cases studied. A large center like Mayo clinic Rochester, USA reported an overall accuracy of 97.8% on reviewing 24,880 frozen cases in a year.
How accurate is frozen section?
Frozen section was accurate in 92.7% of all cases and inaccurate in 7.3%. The sensitivity for malignant tumors was 92.5% tumors (95% confidence intervals 87.7% to 97.2%), the sensitivity for borderline tumors was 44.8% (95% confidence interval 26.4% to 63.2%).
What are the common used of frozen section?
The frozen section is mainly used for rapid diagnosis of the lesion for intraoperative management, to know the extent of the lesion, to do enzyme immunocytochemistry and immunofluorescence study and also to stain lipid and certain carbohydrate in the tissue.
What are the limitations of the frozen section?
Well, what are these limitations? The Manual of Surgical pathology (2) in a section titled” Frozen Sections Are Not Permanent Sections” points to four reasons. These are: sampling error, ice crystal artifacts, lack of special studies, and lack of consultation.
Can frozen biopsy be wrong?
What are the indications of frozen section biopsy?
Indications for frozen sections usually include (1) margins of orbital exenteration for basal cell carcinoma or squamous cell carcinoma, and occasionally for lacrimal gland tumors (ie, adenoid cystic carcinoma); (2) identification of lymphoproliferative lesions for triaging of fresh specimen for flow cytometry to …
How accurate is the frozen section?
What is the utility of frozen section histopathology?
Utility of intraoperative frozen section histopathology in the diagnosis of periprosthetic joint infection: a systematic review and meta-analysis Intraoperative frozen sections of periprosthetic tissues performed well in predicting a diagnosis of culture-positive periprosthetic joint infection but had moderate accuracy in ruling out this diagnosis.
When to use an intra-operative frozen section?
Intra-operative frozen section plays an important role in the management of surgical patients and yet it must be used prudently to avoid the indiscriminate usage of this important technique.
Which is the modern technique of frozen section?
The modern technique of frozen section The development of a cryomicrotome or popularly known as cryostat in 1959, has revolutionized the FS technique. The cryostat is a refrigerated box containing a rotary microtome. The temperature inside the cryostat is about −20° to −30° Celsius.
What are the artifacts of a frozen section?
Frozen section introduces histologic artifacts: (a) alteration of architectural features makes benign lesions such as sclerosing adenosis more closely mimic invasive carcinoma; (b) artifactual clefting / spaces around tumor cells simulates lymphovascular invasion ( Arch Pathol Lab Med 2005;129:1565 )