ABSTRACT
Background: Diagnostic accuracy of intra-operative frozen section (FS) depends largely on quality of tissue sections backed by good clinical communication and experience of reporting pathologist. Periodic audit of this consultation in surgical pathology help in assessing the efficiency of procedure and addressing the pitfalls. In this study authors have analysed the spectrum, indications and assessed the accuracy of FS consultation in their institution.Methods: A retrospective study of 212 consequent tissue specimens submitted for FS over two years in study centre was conducted. The FS and corresponding formalin fixed paraffin embedded (FFPE) tissue section with their final histopathological examination (HPE) reports were studied and analyzed. The results were classified in concordant, discordant and deferred categories. Accuracy rates and discordant frequencies were calculated and comparison with other similar studies was done. Reasons for inaccuracies were deduced.Results: A total of 212 tissue specimens for FS were reported over two years in this study institute, six of which showed discordant results. Most common site of FS in this study centre was from central nervous system (CNS) lesions (28.77%). Indications for intra-operative consultation were mainly for establishment of tumor diagnosis (66.51%) and status of margins (29.25%). The accuracy rate was found to be 97.17% with error rate of 2.83%. On analysis of discordant cases; the reason for inaccuracy was mainly due to interpretation error (83.33%).Conclusions: The audit of FS consultation established that accuracy rates of this study institution are comparable with most international quality control statistics for FS. The discordant cases were mostly false positive hence emphasising that a variable degree of reservation is required while interpreting and communicating the FS results. The closest possible diagnosis should be communicated on FS and definitive diagnosis should be deferred to HPE in case of doubt.
ABSTRACT
Background: The MRI in Multiple sclerosis(MS) reveals focal white matter lesions which can show dissemination in space or in time. Therefore, the aim of this study was to determine the incidence and distribution of the white matter lesions on MRI.Methods: In this retrospective observational study MRI findings of all cases of MS diagnosed on the basis of McDonald criteria were studied.Results: The white matter lesions were most commonly seen in Periventricular region 43(66.2%) cases, followed by Centrum semiovale36 (55.4%). Subcortical and Juxtacortical lesions were seen in 12 (18.4%) and 20 (30.7%) cases respectively. Optic nerve involvement was seen in 4(6.1%) cases. The spinal cord was affected in 30 (46.1%) cases. Black holes were seen in only 3 (4.6%) cases and contrast enhancement in the lesions was seen in 30 (46.1%) cases.Conclusion: By mapping out the distribution and incidence of lesions in MS on MRI this study will help in correctly identifying demyelinating lesions which can b confused with other hyperintense lesions on T2Wimaging.