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Frozen-section Analysis (frozen-section + analysis)

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Medical Sciences	100%

Selected Abstracts

Predictive value of frozen-section analysis in the histological assessment of steatosis before liver transplantation

LIVER TRANSPLANTATION, Issue 12 2009
Michelangelo Fiorentino
Histological quality assessment of donated livers is a key factor for extending the cadaveric donor pool for liver transplantation. We retrospectively compared frozen-section analysis with routine histological permanent slides and the outcomes of grafts in liver biopsies from 294 candidate donors. The , concordance coefficient of agreement between frozen-section analysis and routine histological analysis was very good for macrosteatosis (, = 0.934), microsteatosis (, = 0.828), and total steatosis (, = 0.814). The correlation between the mean amounts of macrosteatosis, microsteatosis, and total steatosis in frozen and permanent sections was also significant (P < 0.001, Spearman's test). Macrosteatosis and microsteatosis were overestimated to >30% in 4 of 32 cases (12.5%) and in 23 of 62 cases (37.1%), respectively. The only 2 histological parameters of frozen sections able to predict graft dysfunction within 7 days of transplantation were macrosteatosis and total steatosis (P = 0.018 and P = 0.015, respectively, Mann-Whitney test). None of the other histopathological features evaluated in frozen sections, including portal inflammation, lobular necrosis, myointimal thickening, biliocyte regression, cholestasis, hepatocellular polymorphism, lipofuscin storage, and fibrous septa, were significantly correlated with the graft outcome. The frozen-section histological evaluation of biopsies from cadaveric liver donors is an accurate, time-effective, and predictive method for the assessment of graft suitability. Liver Transpl 15:1821,1825, 2009. © 2010 AASLD. [source]

Evaluation of Selective Lymph Node Sampling in the Node-Negative Neck,

THE LARYNGOSCOPE, Issue 6 2002
Richard O. Wein MD
Abstract Objective To determine whether intraoperative selective lymph node sampling before neck dissection in the node-negative (N0) neck accurately reflects the disease content of the neck and can be used to assist in treatment selection. Study Design A prospective clinical study at a university medical center. Methods Over a 2-year period, 36 patients with head and neck squamous cell carcinoma scheduled to undergo 41 elective neck dissections were enrolled. At the initiation of the neck dissection, biopsy of the "most suspicious" lymph node within the tumor's primary nodal drainage basin was performed, and the specimen was measured and sent for frozen-section evaluation. The results of lymph node sampling were compared with the final histopathologic interpretation of the resected primary and neck dissection. Results Of the 41 N0 necks, 29% (12 of 41) were positive for occult metastases. Results of selective lymph node biopsy correlated with the results of neck dissection in 34 of 41 specimens (83%). The specificity and positive predictive value of node sampling were both 100%. The proportion of cases with a positive neck dissection with a positive sampled node (sensitivity) was 42% (5 of 12). Conclusion The results of selective lymph node biopsy with frozen-section analysis in the N0 neck, as defined in the current study, did not reflect a technique with adequate sensitivity to alter intraoperative treatment strategy. [source]

Incidence of Unsuspected Metastases in Lateral Cervical Cysts,

THE LARYNGOSCOPE, Issue 10 2000
Christine G. Gourin MD
Abstract Objective Solitary cystic squamous cell carcinoma metastases may be difficult to distinguish clinically from a benign cervical cyst. We sought to identify the incidence of solitary cystic squamous cell carcinoma metastasis in patients presenting with apparently benign cervical cysts. Study Design Retrospective review. Methods The records of all patients who presented with isolated lateral cervical cysts between 1983 and 1999 were reviewed. Patients with a clinically apparent primary malignancy, a history of head and neck cancer, a history of irradiation, or age less than 18 years were excluded from analysis, as were patients with a histological diagnosis of nonsquamous cell malignancy or those without a final histological diagnosis. Results One hundred twenty-one adult patients presented with an initial diagnosis of lateral cervical cyst. Metastatic squamous cell carcinoma was demonstrated histologically after surgical excision in 12 patients (9.9%). The incidence of malignancy was significantly greater in patients greater than 40 years of age (23.5%, P < .0001). Results of preoperative fine-needle aspiration (FNA) were negative for malignancy in five cases of metastatic squamous cell carcinoma. Panendoscopy with directed biopsies revealed an occult primary in the base of tongue in three patients, tonsil in one patient, and nasopharynx in one. No primary was found in six patients, despite repeated examinations and close follow-up. Conclusions Solitary cervical cysts in patients older than 40 years of age should be presumed to be carcinoma until proven otherwise. A negative FNA result may be misleading, because of hypocellularity of the cyst fluid. Excisional biopsy should be undertaken with provisions made for frozen-section analysis of the specimen and contingency panendoscopy with directed biopsies of Waldeyer's ring if frozen-section histological examination reveals malignancy. [source]