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The Accuracy of Intraoperative Diagnoses Based on Examination of Frozen Sections A Prospective Comparison with Paraffin‐Embedded Sections
Author(s) -
WHITEHAIR JON G.,
GRIFFEY STEPHEN M.,
OLANDER HARVEY J.,
VASSEUR PHILIP B.,
NAYDAN DIANE
Publication year - 1993
Publication title -
veterinary surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.652
H-Index - 79
eISSN - 1532-950X
pISSN - 0161-3499
DOI - 10.1111/j.1532-950x.1993.tb00394.x
Subject(s) - medicine , frozen section procedure , medical diagnosis , radiology , lymph node , fixation (population genetics) , diagnostic accuracy , pathology , nuclear medicine , population , environmental health
The accuracy of diagnoses based on examination of frozen sections was determined by comparing the results to those obtained by examination of tissues prepared using conventional methods (formalin fixation, paraffin‐embedded tissue). One hundred ninety‐four specimens were examined using the frozen section technique; 37 were examined to confirm a tentative diagnosis or to document lymph node metastasis and the remainder were examined to diagnose an unknown pathologic process. Of the 194 specimens examined, an accurate, specific diagnosis was obtained in 161 (83%); in 19 (10%), the pathologic process was correctly identified, but a specific diagnosis was not obtained; and in 2 (1%) the diagnosis was deferred. The remaining 12 (6%) were incorrectly diagnosed by the frozen section technique. When the number of specimens in which a specific diagnosis was obtained was combined with the number of specimens in which the pathologic process was correctly identified, the overall accuracy rate of the frozen section technique was 93%. There was no difference in the accuracy of the frozen section technique based on the reason for submission of the sample, source of tissue submitted, or the type of pathologic process (i.e., inflammatory or neoplastic). Of the 12 incorrect diagnoses, 4 (33%) were because of sampling errors and 8 (67%) were caused by interpretation errors. The proposed indications for the use of intraoperative frozen sections are: 1) to determine the nature of a pathologic process for which a preoperative diagnosis has not been established, 2) to determine the extent of spread of neoplastic tissue to lymph nodes and other organs, 3) to evaluate resection margins of a neoplastic process, and 4) to clarify situations where a discrepancy exists between the preoperative cytologic or histologic diagnosis and intraoperative gross pathology.