Frozen Section Pathology

This book provides guidance regarding the approach to common scenarios encountered in the frozen section laboratory while underscoring diagnostic pitfalls and providing the proper level of diagnostic information to ensure clear communication. Given the use of frozen section in molecular and research pathology, the text also serves as a guide for morphologic examination. Written by experts in the field, the book is organized according to organ system with additional chapters discussing the roles of digital pathology and molecular assays. Each chapter is extensively illustrated to highlight key points that facilitate interpretation and highlight areas for potential error. The goal of this book is to help trainees understand the need for mastery of this unique diagnostic tool, and to aid pathologists who cover frozen section convert practical information provided into diagnostic improvements. Frozen Section Pathology is a comprehensive and state-of-the-art review and serves as a valuable resource for the general surgical pathologist with frozen section responsibilities as well as surgeons who regularly utilize frozen section.

Intraoperative Frozen Sections presents diagnostic challenges involved in the evaluation in the pathology lab of specimens obtained during surgery through the case experience of expert pathologists. Sixty-three problems cover the wide range of problems encountered in intraoperative consultations. Each presentation provides the case information as presented to the consultant, the evaluation and analysis of the specimen, discussion of the results and teaching points observed in the case, and an overall comment providing additional context for the diagnostic problem that has been presented. This problem-oriented format makes the book a superb reference resource for the working diagnostician and an ideal teaching tool for the resident or fellow. Coverage includes pediatric specimens and there is a section describing recognition of artifacts. Each case presentation is supported by several high-quality color photomicrographs with detailed explanations of each image, including images of the permanent sections and immunostains where applicable. Features of Intraoperative Frozen Sections include: Cases outline expert approach to diagnostic problems and technical issues most likely to be encountered in frozen section analysis Coverage includes pediatric specimens and recognition of artifacts Special emphasis on difficult problems and avoiding diagnostic pitfalls Provides common differential diagnoses for specific lesions seen in frozen section analysis (e.g. mimics of renal neoplasia) Nearly 500 high-quality color photomicrographs and detailed discussions of diagnostic features of each image "

A Practical Guide to Frozen Section Technique offers an easy to learn approach to frozen section technique in the form of a highly illustrated handbook intended for onsite use in the laboratory. The book begins with a novel, clearly delineated, step by step approach to learning continuous motion brush technique. Emphasis is placed on recognizing and correcting artifacts during the preparation process. The book addresses all of the steps in the preparation of slides from cutting through cover-slipping. The author’s unique, original techniques for tissue embedding including face down embedding in steel well bars, frozen block cryoembedding and paper cryoembedding are detailed. Variables key to the quality of the preparation including block temperature, tissue properties and section thickness are detailed. The book also covers understanding the cryostat and basic maintenance and care.Sections covering techniques used in Mohs dermatologic surgery, and techniques used in basic animal and human research are discussed by noted experts in their field. A Practical Guide to Frozen Section Technique will be of great value to pathologists, pathology residents in training and also experimental pathology researchers that rely upon this methodology to perform tissue analysis in research.

Frozen sections are performed for the purpose of rapid diagnosis while a patient is undergoing surgery, usually under general anesthesia, as a basis for making immediate treatment decisions. Therefore, frozen section diagnosis is often a highly demanding situation for the pathologist who must render a diagnosis quickly and a crucial determination for the patient and surgeon. In addition to the need for rapid recall of differential diagnoses, there are many pitfalls and artifacts that add to the risk of frozen section diagnosis that are not present with permanent sections of fully processed tissues that can be examined in a more leisurely fashion. Most standard pathology textbooks, both general and subspecialty, largely ignore the topic of frozen section. Few textbooks have ever focused exclusively on frozen section diagnosis and those textbooks that have done so are now out-of-date and have limited numbers of black and white figures. None has emphasized the education of the surgeon in terms of frozen section benefits, limitations or proper utilization. The Frozen Section Library series will provide convenient, user-friendly handbooks for each organ system to expedite use in the hurried frozen section situation. These books will be small and light-weight, copiously color illustrated with images of actual frozen sections, highlighting pitfalls, artifacts and differential diagnosis. These books will also include perspectives for the surgeon and for communication with the surgeon and suggest ancillary procedures (for example, when to take tissue for microbiology cultures). Each 5 X 8 book is estimated to be about 200 to 250 pages in toto with 100 to 150 color figures each. As a handbook for practicing pathologists, these books will be indispensable aids to diagnosis and avoiding dangers in one of the most challenging situations that pathologists encounter. Problems, such as differentiation of benign processes from malignant neoplasms which may be more difficult on frozen section than permanent section and which have a serious impact on the surgeon’s immediate treatment decisions, will be emphasized. Rapid consideration of differential diagnoses and how to avoid traps caused by frozen section artifacts will be readily accessible to the users of the handbooks. A series of concise, easy-to-use, well-illustrated handbooks alleviates the often frustrating and time-consuming, sometimes futile, process of searching through bulky textbooks that are unlikely to illustrate or discuss pathologic diagnoses from the perspective of frozen sections in the first place. Tables and charts will provide guidance for differential diagnosis of various histologic patterns. The advantages of a series of organ-specific handbooks, in addition to the ease-of-use and manageable size, is that (1) it allows more comprehensive coverage of more diagnoses, both common and rare, than a single volume that tries to highlight a limited number of diagnoses for each organ and (2) it allows more detailed insight by permitting experienced authorities to emphasize the peculiarities of frozen section for each organ system. Although some differences in practice of frozen section exist between different institutions, such as differing policies regarding whether or not to perform frozen section on specific types of specimens, these differences are generally not significant and can be discussed ( an organ-specific handbook by an expert in that organ system permits more opportunity for this type of discussion). Touch preparations, which are used for some organs such as central nervous system or thyroid more often than others, will be appropriately emphasized and illustrated according to the need for each specific organ. This series will be highly valuable to practicing surgical pathologists, both community and academic, and to pathology residents and fellows. The perspectives provided will also be valuable to surgeons and especially to surgery residents and fellows who must answer questions about pathology and frozen section on their board examinations. These handbooks will be easily portable by the individual but it is envisioned that many departments will want to also keep a series readily available in the frozen section laboratory.

The Second Edition of Biopsy Interpretation: The Frozen Section, a volume in the Biopsy Interpretation Series, addresses the frozen section, which is one of several intraoperative consultative options. It illustrates the practical use of the frozen section in the management of clinical problems, especially tumors. The demands of patient care require knowledge of the assets and limitations of the frozen section, including the practical techniques of its execution, interpretation, and the communication of its results. Although the frozen section is the focus, the central idea behind this book is intraoperative consultation and patient management. This edition features updates to the organ system based chapters as well as a revised chapter on pediatric pathology. Two new chapters on hematopathology and a review of published literature have also been added. The goal of this book is to not only provide updated information on the practice of frozen section, but also to help explain the role the general surgical pathologist can play in the treatment of patients. Features: Histologic illustrations are actual frozen sections, with artifacts Updated and expanded text Emphasis is placed on the morphologic expertise of the surgical pathologist in standard hematoxylin and eosin sections and imprints

Frozen sections are performed for the purpose of rapid diagnosis while a patient is undergoing surgery, usually under general anesthesia, as a basis for making immediate treatment decisions. Therefore, frozen section diagnosis is often a highly demanding situation for the pathologist who must render a diagnosis quickly and a crucial determination for the patient and surgeon. In addition to the need for rapid recall of differential diagnoses, there are many pitfalls and artifacts that add to the risk of frozen section diagnosis that are not present with permanent sections of fully processed tissues that can be examined in a more leisurely fashion. Most standard pathology textbooks, both general and subspecialty, largely ignore the topic of frozen section. Few textbooks have ever focused exclusively on frozen section diagnosis and those textbooks that have done so are now out-of-date and have limited numbers of black and white figures. None has emphasized the education of the surgeon in terms of frozen section benefits, limitations or proper utilization. The Frozen Section Library series will provide convenient, user-friendly handbooks for each organ system to expedite use in the hurried frozen section situation. These books will be small and light-weight, copiously color illustrated with images of actual frozen sections, highlighting pitfalls, artifacts and differential diagnosis. These books will also include perspectives for the surgeon and for communication with the surgeon and suggest ancillary procedures (for example, when to take tissue for microbiology cultures). Each 5 X 8 book is estimated to be about 200 to 250 pages in toto with 100 to 150 color figures each. As a handbook for practicing pathologists, these books will be indispensable aids to diagnosis and avoiding dangers in one of the most challenging situations that pathologists encounter. Problems, such as differentiation of benign processes from malignant neoplasms which may be more difficult on frozen section than permanent section and which have a serious impact on the surgeon’s immediate treatment decisions, will be emphasized. Rapid consideration of differential diagnoses and how to avoid traps caused by frozen section artifacts will be readily accessible to the users of the handbooks. A series of concise, easy-to-use, well-illustrated handbooks alleviates the often frustrating and time-consuming, sometimes futile, process of searching through bulky textbooks that are unlikely to illustrate or discuss pathologic diagnoses from the perspective of frozen sections in the first place. Tables and charts will provide guidance for differential diagnosis of various histologic patterns. The advantages of a series of organ-specific handbooks, in addition to the ease-of-use and manageable size, is that (1) it allows more comprehensive coverage of more diagnoses, both common and rare, than a single volume that tries to highlight a limited number of diagnoses for each organ and (2) it allows more detailed insight by permitting experienced authorities to emphasize the peculiarities of frozen section for each organ system. Although some differences in practice of frozen section exist between different institutions, such as differing policies regarding whether or not to perform frozen section on specific types of specimens, these differences are generally not significant and can be discussed ( an organ-specific handbook by an expert in that organ system permits more opportunity for this type of discussion). Touch preparations, which are used for some organs such as central nervous system or thyroid more often than others, will be appropriately emphasized and illustrated according to the need for each specific organ. This series will be highly valuable to practicing surgical pathologists, both community and academic, and to pathology residents and fellows. The perspectives provided will also be valuable to surgeons and especially to surgery residents and fellows who must answer questions about pathology and frozen section on their board examinations. These handbooks will be easily portable by the individual but it is envisioned that many departments will want to also keep a series readily available in the frozen section laboratory.

The second edition of this well-received book provides detailed information on the basic and advanced laboratory techniques in histopathology and cytology. It offers clear guidance on the principles and techniques of routine and special laboratory techniques. It also covers advanced laboratory techniques such as immunocytochemistry, flow cytometry, liquid-based cytology, polymerase chain reactions, tissue microarray, molecular technology, etc. The book's second edition covers several important recent topics with many new chapters, such as liquid biopsy, artificial neural network, digital pathology, and next-generation sequencing. Each chapter elucidates basic principle, practical methods, troubleshooting, and clinical applications of the technique. It includes multiple colored line drawings, microphotographs, and tables to illustrate each technique. The book is a helpful guide to the post-graduate students and fellows in pathology, practicing pathologists, as well as laboratory technicians, and research students.

Frozen section of Neuropathology-related cases is performed while the patient is undergoing surgery. Intraoperative consultation is used to help guide intraoperative management of the case and to ensure that adequate and appropriate tissue has been obtained for purposes of making an accurate final diagnosis. Frozen section diagnosis is often a highly demanding situation for the pathologist, who must render a diagnosis quickly and provide sound guidance and advice. In addition to the need for rapid recall of differential diagnoses, there are many pitfalls and artifacts that add to the risk of frozen section diagnosis that are not present with permanent sections of fully processed tissue that can be examined in a more leisurely fashion. Most standard pathology textbooks focus primarily on permanent section material and largely ignore the topic of frozen section. The purpose of this volume is to add to the Frozen Section Library series and provide a convenient, user friendly handbook to assist in the evaluation of central nervous system related frozen sections. It provides a useful reference, organized around differential diagnoses, primarily by location in the central nervous system. The text will be illustrated with color pictures and include tables as appropriate. This text provides a valuable tool for the practicing surgical pathologist both in community and in academic centers as well as pathology residents and fellows in training when confronted with Neuropathology frozen section.