Agreement between frozen section and histopathology to detect malignancy in adnexal masses according to size and morphology by ultrasound.

Objective: Management of suspect adnexal masses involves surgery to define the best treatment. Diagnostic choices include a two-stage procedure for histopathology examination (HPE) or intraoperative histological analysis - intraoperative frozen section (IFS) and formalin-fixed and paraffin-soaked tissues (FFPE). Preoperative assessment with ultrasound may also be useful to predict malignancy. We aimed at determining the accuracy of IFS to evaluate adnexal masses stratified by size and morphology having HPE as the diagnostic gold standard. Methods: A retrospective chart review of 302 patients undergoing IFS of adnexal masses at Hospital de Clínicas de Porto Alegre, between January2005 and September2011 was performed. Data were collected regarding sonographic size (≤10cm or >10cm), characteristics of the lesion, and diagnosis established in IFS and HPE. Eight groups were studied: unilocular lesions; septated/cystic lesions; heterogeneous (solid/cystic) lesions; and solid lesions, divided in two main groups according to the size of lesion, ≤10cm or >10cm. Kappa agreement between IFS and HPE was calculated for each group. Results: Overall agreement between IFS and HPE was 96.1% for benign tumors, 96.1% for malignant tumors, and 73.3% for borderline tumors. Considering the combination of tumor size and morphology, 100% agreement between IFS and HPE was recorded for unilocular and septated tumors ≤10cm and for solid tumors. Conclusion: Stratification of adnexal masses according to size and morphology is a good method for preoperative assessment. We should wait for final HPE for staging decision, regardless of IFS results, in heterogeneous adnexal tumors of any size, solid tumors ≤10cm, and all non-solid tumors >10cm.

Agreement between frozen section and histopathology to detect malignancy in adnexal masses according to size and morphology by ultrasound

Abstract Objective Management of suspect adnexal masses involves surgery to define the best treatment. Diagnostic choices include a two-stage procedure for histopathology examination (HPE) or intraoperative histological analysis - intraoperative frozen section (IFS) and formalin-fixed and paraffin-soaked tissues (FFPE). Preoperative assessment with ultrasound may also be useful to predict malignancy. We aimed at determining the accuracy of IFS to evaluate adnexal masses stratified by size and morphology having HPE as the diagnostic gold standard. Methods A retrospective chart review of 302 patients undergoing IFS of adnexal masses at Hospital de Clínicas de Porto Alegre, between January2005 and September2011 was performed. Data were collected regarding sonographic size (≤10cm or >10cm), characteristics of the lesion, and diagnosis established in IFS and HPE. Eight groups were studied: unilocular lesions; septated/cystic lesions; heterogeneous (solid/cystic) lesions; and solid lesions, divided in two main groups according to the size of lesion, ≤10cm or >10cm. Kappa agreement between IFS and HPE was calculated for each group. Results Overall agreement between IFS and HPE was 96.1% for benign tumors, 96.1% for malignant tumors, and 73.3% for borderline tumors. Considering the combination of tumor size and morphology, 100% agreement between IFS and HPE was recorded for unilocular and septated tumors ≤10cm and for solid tumors. Conclusion Stratification of adnexal masses according to size and morphology is a good method for preoperative assessment. We should wait for final HPE for staging decision, regardless of IFS results, in heterogeneous adnexal tumors of any size, solid tumors ≤10cm, and all non-solid tumors >10cm.

Frozen sections compared with paraffin-embedded sections: a retrospective veterinary autopsy study

Histologic examination of tissues collected at autopsy are typically prepared using conventional methods (formalin fixed, paraffin‐embedded tissue). In this study, twenty-five tissue specimens from twelve animals were collected at autopsy and examined using the frozen section technique. Of the 25 specimens examined, an accurate and specific diagnosis was obtained in 21 specimens; the pathologic process was correctly identified, but a specific diagnosis was not obtained in 1 specimen; the diagnosis was missed in 2 specimens, and in 1 specimen the diagnosis was deferred. Of the two incorrect diagnoses, one was due to a sampling error and one was due to an interpretation error. Overall, the use of postmortem frozen sections allowed for complete agreement with conventional methods in 21 specimens (84%) and the results from this study support the use of frozen section examination of tissue samples collected postmortem.(AU)

Frozen sections compared with paraffin-embedded sections: a retrospective veterinary autopsy study

Histologic examination of tissues collected at autopsy are typically prepared using conventional methods (formalin fixed, paraffin‐embedded tissue). In this study, twenty-five tissue specimens from twelve animals were collected at autopsy and examined using the frozen section technique. Of the 25 specimens examined, an accurate and specific diagnosis was obtained in 21 specimens; the pathologic process was correctly identified, but a specific diagnosis was not obtained in 1 specimen; the diagnosis was missed in 2 specimens, and in 1 specimen the diagnosis was deferred. Of the two incorrect diagnoses, one was due to a sampling error and one was due to an interpretation error. Overall, the use of postmortem frozen sections allowed for complete agreement with conventional methods in 21 specimens (84%) and the results from this study support the use of frozen section examination of tissue samples collected postmortem.