By Syed K. Mohsin
The Frozen part Library sequence offers concise, easy, website particular handbooks which are good illustrated and spotlight the pitfalls, artifacts and differential prognosis concerns that come up within the moved quickly frozen part situation.
Frozen part Library: Breast offers a simple reference and notebook concerning the nuances of correctly dealing with breast specimens in a manner that meets the more and more complicated atmosphere of breast pathology. the professionals and cons of frozen part as opposed to use of contact imprint in addition to comparable caliber insurance requisites are addressed. different much less universal makes use of of intraoperative assessment, comparable to analysis and margin overview are defined. the amount contains urged instructions for assessment and documentation of particular gross pathologic positive aspects, along with radiological imaging. thoughts and protocols for such examinations are illustrated. the quantity closes with an summary of the newly released directions for dealing with quite a few breast specimens, that are meant for use for evaluation of predictive factors.
Syed okay. Mohsin, M.D. is the top of Breast Pathology and scientific Director, Immunohistochemistry, Riverside Methodist clinic, Columbus, OH
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Extra info for Frozen Section Library: Breast
7 Close margin for invasive tumor on frozen section. The invasive tumor has a relatively circumscribed edge and it is within 1 mm of the inked margin. It appears that there is rim of benign tissue at the margin. 8 Indeterminate margin on frozen section. There is marked cautery artifact with crushed cells, which cannot be reliably interpreted. There is a small intact focus of DCIS. On close examination, it appears that DCIS is very close to the margin and there is a piece of cauterized epithelium on the left.
25 Normal breast epithelium on touch imprint of surgical margin. High power view of normal breast epithelial component (seen in Fig. 22), sometimes seen on touch imprints of negative margins. 4 List of studies evaluating the usefulness of touch imprint method of surgical margin assessment. Authors No. Sensitivity (%) Specificity (%) Klimberg et al. D’Halluin et al. Cox et al. Saarela et al. a 428 400 114 55 12 100 89 100 38 8 100 92 97 – 98 a Invasive lobular carcinoma only of median follow-up.
22 Typical features of touch imprint from a negative margin. Intermediate power view of an alcohol-fixed touch imprint. Besides clear background and small amount of fat, there is a small group of epithelial cells. They are arranged in monolayer and have uniform nuclei, typical of benign breast ductal epithelium. The interpretation is negative margin. 23 Evaluation of epithelial structures from touch imprints. High power view of the epithelial group seen in Fig. 24. Note the flat sheet-like arrangement, uniform nuclear size, and slightly branched architecture of normal ductal epithelium.