Frozen Section

This is the case as a Intraoperative Consultation is performed when the surgical team is in need of the results as soon as possible in order to minimize the time in which the patient is under total anaesthesia.

The scientific team of MICRODIAGNOSTIKI guarantees an answer that is both clear in meaning as well as fast in delivery when performing a frozen section. The expected turnover time (TAT) is 15’ to 20’ minutes from the time the specimen is received.

A frozen section is considered one of the most crucial as well as tasking procedures, as the histopathologist has to provide a clear and correct answer in a very limited time frame to the surgeon, who is meanwhile still operating in the surgical theater.

The procedure, which is performed in order for the surgeon to get a preliminary diagnosis while the surgery is still ongoing, can, for instance, let the surgeon know whether a suspicious mass that he has come upon is noncancerous and thus allows for a more conservative approach or whether is shows cancerous growth and thus a total removal of the lymph node and the local fat tissue is necessary.

Για παράδειγμα η εξέταση αυτή δύναται να πληροφορήσει τον χειρούργο για το αν μια ύποπτη μάζα που εντοπίζεται είναι μη-καρκινική και άρα επιτρέπει συντηρητικότερη αντιμετώπιση ή αν, για παράδειγμα, ένας λεμφαδένας στη μασχάλη περιέχει καρκινικά κύτταρα, απαιτώντας να αφαιρεθεί όλος ο τοπικός λιπώδης ιστός και ο λεμφαδένας.

In brief, the most common reasons to perform a Frozen Section are:

• To check the cleanliness of the surgical excision margins
• To determine if the mass under examination is benign, malignant or caused by inflammation
• To check whether a malignant neoplasm is present alongside inflammatory distortions (e.g. ulcerous colitis with cancerous growths), which will alter the plan of the surgery
• To check for a metastasis to the lymph nodes
• To check the sentinel lymph node (the outcome of the biopsy will determine whether an extensive lymphnode cleansing is necessary or not)
• Palpable distortion of the breast tissues, for which the cytological examination was inconclusive
• In order to determine a type of tissue.

Having mentioned the above it is also useful to know that there exist a number of cases for which Frozen Section is not recommended or simply offers sub-optimal results. Some examples are found in the following cases:

• Benign yet problematic distortions of the breast (sclerosing adenosis, atypic huperplasia of the pores et al) have to be examined for a conclusive diagnosis only in permanent paraffin sections.
• Vascularized granulomatous tissue that may show atypical characteristics and imitate sarcomas or carcinomas
• Distortions caused by radiotherapy and which can imitate sarcomas
• Cases of hyperpigmented distortions caused by tissue exhaustion and on which parameters of prognostic value for melanoma (e.g. growth depth per Breslow) might be present. The same could be true for specimens stemming from the sentinel lymphnode in patients with melanoma.