Frozen section discrepancy in the evaluation of nonneoplastic central nervous system samples

Annals of Diagnostic Pathology
Thomas P Plesec, Richard A Prayson

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

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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
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

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