Examining the Pathological Diagnostic Impact of Frozen Sections in Breast Cancer

Objective:To analyze the diagnostic value of frozen section pathology in the diagnosis of breast cancer.Methods:A total of 50 patients with breast tumors treated between July 2021 and February 2023 were randomly selected as samples.Both paraffin section and frozen section diagnoses were conducted.The paraffin section results served as the gold standard for evaluating the value of frozen section examination.Results:Among the frozen section diagnoses,48 cases(96.00%)were confirmed,1 case was misdiagnosed(2.00%),and 1 case was delayed(2.00%).Among the confirmed patients,45 cases(90.00%)were entirely consistent,and 3 cases(6.00%)were basically consistent.The diagnostic rate of the frozen section was 96.00%,compared with 100.00%for the paraffin section(P>0.05).The diagnostic time of the frozen section(35.25±2.11 min)was significantly shorter than that for the paraffin section(6911.36±58.36 min;P<0.05).Conclusion:Frozen section diagnosis is rapid and demonstrates relatively high diagnostic accuracy.It can guide doctors in determining whether to pursue breast-conserving treatment and aid in selecting appropriate surgical methods.This is beneficial for preventing unnecessary medical interventions and reducing the need for secondary surgeries in breast cancer patients.

Parathyroid carcinoma located in the thyroid gland:A case report

BACKGROUND Parathyroid carcinoma(PC)is a difficult-to-diagnose rare disease with low incidence.Relatively accurate preoperative diagnosis is very important in choosing surgical methods and patient prognosis.CASE SUMMARY This study reported the clinical diagnosis and treatment of a rare patient with PC located in the thyroid gland and provided a case reference for the diagnosis and treatment of PC.A case of a 64-year-old male patient who presented to our hospital with systemic muscle and joint pain and palpitations is outlined.Subsequently,the patient was admitted to the Department of Nephrology for the treatment of“multiple myeloma nephropathy pending investigation”.The patient was diagnosed with“primary hyperparathyroidism and hypercalcemic crisis”using thyroid color ultrasound.CONCLUSION The intraoperative frozen section report considered the parathyroid tumor.Surgical tumor resection was promptly performed,and the diagnosis of PC was confirmed.

Retrospective Analysis of Diagnosis by Intraoperative Frozen Section and Routine Paraffin Embedded Tissue in 638 Thyroid Disease Patients

OBJECTIVE To summarize a common pathogenefic condition, the pathologic characteristics shown in frozen section and our experience utilizing 2 different common thyroid diseases （TD）. diagnostic methods in cases of METHODS Data from 638 cases with frozen sections from thyroid tissue were retrospectively analyzed. The intraoperative frozen sections of the patients and postoperative diagnostic results of routine paraffin sections were compared. RESULTS In the 683 patients, the gender ratio of females to males was 2.64 ： 1, and the ratio between the patients with nodular goiter （NG） and the patients with thyroid adenoma was 1.5 ： 1. The oldest age group of patients with thyroid cancer （TC） ranged from 40 to 49 years. Frozen section pathologic examination has been employed more and more in the diagnosis of thyroid diseases, and the detection rate of TC has increased year by year, i.e., the rate increased to 6.45%, 7.58%, 14.55% and 16.57%, respectively, in 2005, 2006, 2007 and 2008. Thyroid papillary carcinoma （TPC） was the most commonly seen malignant tumor of the thyroid （MTT）, which accounted for approximately 94.8% of MTTs and 11.44% of the total TDs. Micropapillary carcinoma accounted for 27.4% of TPC, and multifocal carcinomas accounted for 15.58% of TCs. Many of the TCs （19.48%） were complicated by benign diseases such as adenoma, NG and thyroiditis. The coincidence rate of diagnoses made by frozen section and paraffin embedding for thyroid disease was 98.59%. Calcification was rather common in NG and TPC, and there were significant differences in psammoma bodies （PMB） between the calcifications of TPC and NG （P 〈 0.01）. CONCLUSION TPC ranks first in the incidence of MTTs and accounts for 94.8% of all MTTs. About 1/4 of TPCs are micropapillary carcinoma, while 1/5 are accompanied by benign disease, such as adenorna, NG and thyroiditis. PMB are of importance and of significance in the diagnosis of TPC.

Histological examination of frozen sections for patients with acute cholecystitis during cholecystectomy

BACKGROUND： Unexpected gallbladder cancer may present with acute cholecystitis-like manifestat/ons. Some authors rec- ommended that frozen section analysis should be performed during laparoscopic cholecystectomy for all cases of acute cholecystitis. Others advocate selective use of frozen section analysis based on gross examination of the specimen by the surgeon. The aim of the present study was to evaluate whether surgeons could effectively identify suspected gallbladder with macroscopic examination alone. If not, is routine frozen sec- tion analysis worth advocating？

Clinical Diagnosis Technique of Goat Pox Disease

[Objective] The aim was to provide theoretical basis for effective prevention of goat pox disease.[Method] 5 cases of infected goats were diagnosed for goat pox with microbiology examination.The poxes on their skin,rumen,reticulum,omasum,abomasum and submandibular lymph nodes,bronchial lymph nodes,lung and spleen were macroscopically and microscopically observed with pathanatomical and histopathological technique.[Result] Poxes on skin mainly showed ashen hemisphere state and gave prominence to the surface of skin; some cases had hemorrhage in the poxes and showed dark purplish red.Poxes on gastric mucosa showed ashen.Cytoplasmic inclusion body could be all observed in epithelial cells of the poxes and macrphages of lymph node,lung and spleen.[Conclusion] Poxes on skin,lung and the surface of gastric mucosa as well as cytoplasmic inclusion body in the epithelial cells of pox and the macrphages of lymphoid organs were the especial pathochanges of goat pox,which could be taken as the proof of goat pox＇s clinic diagnisis.

Histological Characteristics of Hair Follicle Structure of Hezuo Swine from Gansu Province

The characteristics of skin hair follicle structure of Hezuo swine were in- vestigated using frozen section method and HE staining. Experimental results showed that the hair root, hair tip, outer sheath, inner sheath, hair follicle group, fi- brous sheath, outer epidermis, inner epidermis, sebaceous gland and other organiza- tional structures of hair follicles of Hezuo swine can be clearly observed. The hair follicle pore size varied extremely significantly （P〈0.01） among different parts, showing a downward trend of shoulder 〈 body side 〈 buttocks; the hair follicle density ranged from 5.59 to 7.26 hair follicles/mm^2. This study provides reference for the in-dustrial and medical applications.

Intra-operative frozen section diagnosis of breast lesions:a retrospective analysis of 13 243 Chinese patients

Background Although cytological methods for breast oncology have been used in recent decades, intra-operative frozen section has been playing a vital role in making therapeutic decisions. We analyzed a large series of frozen section diagnoses for Chinese cases of breast lesion within the last 15 years. The experience was expected to increase the diagnostic accuracy of cases with breast lesions. Methods The data from consecutive 13243 cases of breast lesions diagnosed with intra-operative frozen sections between 1988 to 2002 were compared with paraffin sections in a case by case manner. The causes of false negative and positive diagnoses as well as delayed diagnoses were analyzed. Results One hundred and seventeen cases （0.9%） were falsely diagnosed, with one false positive case and 116 false negative cases. The diagnosis of 47 cases （0.4%） was delayed. The proportion of several lesions had the features of the patients＇ ages. Six types （false invasion, peri-papUloma, adenoma of nipple duct, florid adenosis, sclerosing adenosis, and granulose cell tumor） of lesions may lead to false positive, and four types （morphological changes responding chemotherapy, well differentiated papillary carcinoma, invasive Iobular carcinoma, and tubular carcinoma） to a false negative. Gross and microscopic findings may be inconsistent in two types of lesions （radial scar and florid adenosis） microscopic and clinical findings in three types （ganulomatous mastitis mammary, duct ectasia, and fat necrosis）, and three types （abundant fat or sclerous tissues; borderline lesions and changes of post-chemotherapy） were likely wrongly classified. Conclusions Intra-operative frozen section can accurately identify breast lesions in many instances, leading to fewer errors on account of more diaanostic experience and understandina of diaanostic limitations.

Value of frozen section examination in diagnosis and treatment of high-grade cervical intraepithelial neoplasia

Background Invasive cancer of the cervix is considered a preventable disease because it has a long pre-invasive state, cervical cytology screening programs are currently available, and treatment of pre-invasive lesions is effective. We tested the accuracy of frozen section examination （FSE） of cone specimens to identify the endocervical margin and rule out invasion in patients with high-grade cervical intraepithelial neoplasia （CIN）. Methods For 320 consecutive patients with a preoperative biopsy result of CIN stage 2/3, cold-knife conization （CKC） was performed followed by FSE. The results from analyses of permanent paraffin sections （PS） were compared with the FSE findings. Results The accuracy of FSE was 87% （278/320）. For all of the seven patients with an invasive squamous cell carcinoma of the cervix identified by FSE, the diagnosis was confirmed by PS analysis. For one patient, the FSE result was cervicitis, whereas PS ananlysis showed microinvasive carcinoma. Appropriate surgery was performed for all patients based on the FSE and biopsy results. The FSE and PS results were not significantly different （P=-0.000）. Definitive examination of margin status using PS was concordant with FSE findings in all cases. Conclusions FSE is a rapid and reliable method for evaluating CKC specimens. It can identify frank invasion, permit adequate treatment in a one-stage procedure, and reliably detect clear resection margins. Since discrepancies do exist and may result in inappropriate treatment, further research is required to decrease these discrepancies and avoid missing even one case.

Does intraoperative frozen section really predict significant positive surgical margins after robot-assisted laparoscopic prostatectomy?A retrospective study

We investigated the relationship between positive surgical margin(PSM)-related factors and biochemical recurrence(BCR)and the ability of intraoperative frozen sections to predict significant PSM in patients with prostate cancer.The study included 271 patients who underwent robot-assisted laparoscopic prostatectomy with bilateral nerve sparing and maximal urethral preservation.Intraoperative frozen sections of the periurethra,dorsal vein,and bladder neck were analyzed.The ability of PSM-related factors to predict BCR and significant PSM was assessed by logistic regression.Of 271 patients,108(39.9%)had PSM and 163(60.1%)had negative margins.Pathologic Gleason score^8(18.9%vs 7.5%,P=0.015)and T stage≥T3a(51.9%vs 24.6%,P<0.001)were significantly more frequent in the PSM group.Multivariate analysis showed that Gleason pattern≥4(vs<4;hazard ratio:4.386;P=0.0004)was the only significant predictor of BCR in the PSM cohort.Periurethral frozen sections had a sensitivity of 83.3%and a specificity of 84.2%in detecting PSM with Gleason pattern≥4.Multivariate analysis showed that membranous urethra length(odds ratio[OR]:0.79,P=0.0376)and extracapsular extension of the apex(OR:4.58,P=0.0226)on magnetic resonance imaging(MRI)and positive periurethral tissue(OR:17.85,P<0.0001)were associated with PSM of the apex.PSM with Gleason pattern≥4 is significantly predictive of BCR.Intraoperative frozen sections of periurethral tissue can independently predict PSM,whereas sections of the bladder neck and dorsal vein could not.Pathologic examination of these samples may help predict significant PSM in patients undergoing robot-assisted laparoscopic prostatectomy with preservation of functional outcomes.

Retrospective evaluation of frozen section use for thyroid nodules with a prior fine needle aspiration diagnosis of Bethesda Ⅱ-Ⅵ: The Weill Cornell Medical College experience

Objective: To evaluate the Weill Cornell Medical CoLlege (WCMC)/New York Presbyterian Hospital (NYPH) experience with intraoperative frozen (IOF) section in the management of thyroid nodules with a fine needle aspiration (FNA) diagnosis of Bethesda Ⅱ-Ⅵ and to analyze the cost and pathology benefit it provides.Methods: The surgical and cytopathology files at WCMC/NYPH were searched within the time period of January 2008 to May 2013.A total of 435 thyroid specimens were identified for which both an FNA and subsequent IOF section was performed.The FNA was correlated with the locations of the resected nodule and the nodule frozen for intraoperative diagnosis.The results of the FNA were compared to the IOF section diagnosis and final diagnosis (FD).Results: Among 435 cases, the FNA diagnosis was Bethesda Ⅱ:149 cases, Bethesda Ⅲ:170 cases, Bethesda Ⅳ: 91 cases, Bethesda Ⅴ: 19 cases, and Bethesda Ⅵ: 6 cases.There were a total of 83 carcinomas identified on FD, which included 69 papillary thyroid carcinomas (PTCs), 12 follicular carcinomas, and 2 poorly differentiated carcinomas.The preoperative FNA diagnosis for these carcinomas was as follows: Bethesda Ⅱ, 11/149 (7.4％), Bethesda Ⅲ, 24/170 (14％), Bethesda Ⅳ, 26/91 (29％), Bethesda Ⅴ, 16/19 (84％), and Bethesda Ⅵ, 6/6 (100％).IOF section contributed to the diagnosis of malignancy in 16/429 (4％) cases: 1/149 (0.7％) Bethesda Ⅱ, 5/170 (3％) Bethesda Ⅲ, 2/91 (1.1％) Bethesda Ⅳ, and 8/19 (42％) Bethesda Ⅴ.The diagnosis of malignancy was confirmed in the 6 Bethesda Ⅵl cases by IOF section.There were no false positives on IOF section.IOF had a sensitivity and specificity of 26％ and 100％, respectively.Conclusion: The role of IOF section is limited in the evaluation of thyroid nodules.IOF section is most useful for nodules with an FNA diagnosis of Bethesda V lesions.The diagnosis of follicular variant of PTC remains difficult on frozen section.

Comparison between peritoneal tuberculosis and primary peritoneal carcinoma： a 16-year, single-center experience

Background Peritoneal tuberculosis and primary peritoneal carcinoma can both present as an abdominal mass and ascites with elevated serum CA125. The purpose of our study was to evaluate the clinical features of peritoneal tuberculosis, compare them with features of primary peritoneal carcinoma, and establish definitive diagnostic procedures. Methods We conducted a retrospective study in patients with peritoneal tuberculosis from January 1995 to October 2010 at Peking Union Medical College Hospital. During this time, the data of 38 patients with primary peritoneal carcinoma were reviewed. Results The median age was 34 years （range, 19-80 years）. The most common symptoms were abdominal distension （16/30, 53.3%） and an abdominal mass （12/30, 40.0%）. The serum CA125 level was elevated in 25 patients （83.3%）. The median level of cancer antigen CA125 was 392.5 U/ml （range, 0.6-850.0 U/ml）. Abdominal ultrasound revealed a pelvic mass in 25 patients and ascites in 20 patients. Diagnostic laparoscopy was performed in 15 patients （50.0%） and exploratory laparotomy was performed in 12 patients （40.0%）, and 3 patients （10.0%） who underwent laparoscopy converted to laparotomy because of severe adhesions. The intraoperative findings were adhesions, multiple white tubercles, and ascites. Frozen tissue sections were obtained in 17 patients, and 14 of whom showed chronic granulomatous reactions. Final pathological examinations confirmed the diagnosis. Conclusions Peritoneal tuberculosis should be considered as a differential diagnosis, especially for young women with an abdominal mass, ascites, and elevated serum CA125 levels. Laparoscopy is a useful diagnostic method for peritoneal tuberculosis, and intraoperative frozen sections are recommended when the diagnosis is in doubt.