Abstract
Frozen section (FS) for intraoperative evaluation of central nervous system (CNS) lesions provides the neurosurgeon with a rapid preliminary pathologic diagnosis. Diagnosis of nonneoplastic lesions is particularly challenging in this venue. To highlight common diagnostic pitfalls, we sought to identify discrepancies between FS and final diagnoses among nonneoplastic CNS samples via a retrospective review of 303 FS cases encountered from 1997 to 2006. Thirty-nine (12.9%) discrepant diagnoses were identified, of which 27 were clinically suspected tumors. Final diagnoses in the discrepant group included the following: inflammatory lesions (n = 8, 20.5%), malformation of cortical development-cortical dysplasia (n = 5, 12.8%), gliosis (n = 5, 12.8%), vascular malformations (n = 5, 12.8%), demyelination/progressive multifocal leukoencephalopathy (n = 3, 7.7%), infarct (n = 3, 7.7%), hemorrhage/blood clot (n = 3, 7.7%), and no pathologic changes (n = 3, 7.7%). The remaining 4 (10.2%) discrepant cases involved one case each of amyloid angiopathy, nonspecific vasculopathy, vasculitis, and meningioangiomatosis. Nonneoplastic lesions are often more challenging than neoplastic lesions at FS, particularly because they are less commonly samp...Continue Reading
References
Jan 1, 1992·Cleveland Clinic Journal of Medicine·D M WhitingC F Lanzieri
May 1, 1985·The American Journal of Surgical Pathology·P C Burger
Mar 1, 1988·Journal of Neurology, Neurosurgery, and Psychiatry·H J ColbassaniY Takei
Jan 1, 1994·Stereotactic and Functional Neurosurgery·B PirotteM Levivier
Sep 1, 1993·Cleveland Clinic Journal of Medicine·H GomezM Magdinec
Jan 1, 1993·Annals of Neurology·J J Kepes
Oct 8, 1997·Neurosurgery·S P Javedan, R J Tamargo
May 6, 1998·Acta Cytologica·D Di StefanoA Vecchione
Oct 2, 1998·Acta Cytologica·A B ShahS N Bhagwati
Sep 2, 1999·Journal of Neurosurgery·K S FirlikL D Lunsford
May 29, 2000·Brain : a Journal of Neurology·S M Sisodiya
Jan 5, 2002·Journal of Neuro-oncology·D HeymanP Menei
Jan 17, 2002·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·E CapelloG L Mancardi
Jan 25, 2002·Postgraduate Medical Journal·R K Garg
Mar 23, 2005·Brain Pathology·Arie PerryDavid H Gutmann
Apr 13, 2005·Neuropathology : Official Journal of the Japanese Society of Neuropathology·Hiroshi NomuraToru Iwaki
Oct 31, 2006·Journal of Clinical Pathology·S Love
Nov 2, 2006·Archives of Pathology & Laboratory Medicine·Richard A Prayson, B K Kleinschmidt-DeMasters
Mar 8, 2007·Journal of the Neurological Sciences·Luís F MaiaHoward H Feldman
Oct 10, 2007·Archives of Pathology & Laboratory Medicine·Thomas P Plesec, Richard A Prayson
Nov 15, 2007·Current Neurology and Neuroscience Reports·Joseph R Berger
Feb 5, 2008·Lancet Neurology·Robert D Brown
Mar 12, 2008·The Neurologist·James W Schmidley
May 23, 2008·Neurosurgery·Heinke PulhornMichael D Jenkinson
Nov 18, 2009·Annals of Diagnostic Pathology·Thomas P Plesec, Richard A Prayson
Jul 17, 2012·Annals of Diagnostic Pathology·Richard A Prayson
Mar 25, 2016·Journal of Cytology
Citations
May 28, 2013·Canadian Journal of Surgery. Journal Canadien De Chirurgie·Etienne MaheAlice Lytwyn
Jul 17, 2012·Annals of Diagnostic Pathology·Richard A Prayson
Aug 16, 2014·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·George A AlexiouAthanasios P Kyritsis
Apr 16, 2015·PloS One·Joseph F GeorgesPeter Nakaji
Nov 18, 2009·Annals of Diagnostic Pathology·Thomas P Plesec, Richard A Prayson
Oct 14, 2011·Advances in Anatomic Pathology·Hilary Lynch Somerset, Bette Kay Kleinschmidt-DeMasters
Dec 21, 2018·Diagnostic Cytopathology·Priyanka MaitySandip Chatterjee
Jan 15, 2019·Journal of Pathology and Translational Medicine·Myunghee KangKyu Chan Lee
Sep 20, 2011·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Hamilton MatushitaManoel Jacobsen Teixeira