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Related Experiment Videos

Frozen section diagnosis and the thyroid.

B B Kraemer1

  • 1Department of Pathology, St John's Mercy Medical Center, St Louis, MO 63141-8221.

Seminars in Diagnostic Pathology
|May 1, 1987
PubMed
Summary

Frozen section diagnosis of thyroid lesions presents challenges, particularly for follicular and Hurthle cell neoplasms. Optically clear nuclei in frozen sections can aid in identifying papillary thyroid carcinoma when other features are absent.

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Area of Science:

  • Surgical Pathology
  • Endocrine Pathology
  • Cytopathology

Background:

  • Frozen section evaluation of thyroid lesions poses diagnostic complexities and controversies.
  • Follicular and Hurthle cell neoplasms lack standardized classification and management.
  • Papillary carcinoma identification can be difficult due to absent distinguishing features on frozen sections.

Purpose of the Study:

  • To address diagnostic problems and controversial aspects of thyroid frozen section diagnosis.
  • To outline potential diagnostic pitfalls in frozen section evaluation of thyroid lesions.
  • To investigate the utility of optically clear nuclei in frozen sections for diagnosing papillary thyroid carcinoma.

Main Methods:

  • Analysis of 300 thyroid frozen sections over a 5-year period.
  • Histologic examination of frozen section features in 40 papillary thyroid carcinomas.
  • Comparison of nuclear features between frozen and permanent sections.

Main Results:

  • Optically clear nuclei were identified in frozen sections from 15 cases of papillary thyroid carcinoma.
  • Thirty-eight of 40 cases showed optically clear nuclei in permanent sections.
  • The presence of optically clear nuclei in frozen sections can be a helpful diagnostic clue.

Conclusions:

  • Frozen section diagnosis of thyroid lesions requires careful consideration of differential diagnoses like thyroiditides and ectopias.
  • Optically clear nuclei are not exclusive to permanent sections and can be present in frozen sections.
  • Identifying optically clear nuclei in frozen sections may assist in diagnosing papillary thyroid carcinoma, especially when classic features are lacking.

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