Intraoperative Consultation in Ovarian Pathology

Akrivos, Nikolaos; Thomakos, Nikolaos; Sotiropoulou, Maria; Rodolakis, Alexandros; Antsaklis, Aris

doi:10.1159/000318865

Cited by 11 publications

(8 citation statements)

References 124 publications

(52 reference statements)

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“…In most institutes pathologists have been studying in particular sections. We sometimes see the disadvantages of this The possible reasons for discordance between FS and PS in BL mucinous tumors are associated with characteristics of these tumors, such as larger sizes, and presence of benign, BL and malignant components in the same tumor, in contrast to serous tumors (12). The samples should be taken from the thickest and solid areas of the cystic neoplasms.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative frozen section in ovarian neoplasms; a tertiary center experience

Acikalin

Torun²,

Bağır³

et al. 2014

TJPATH

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Objective: Frozen section is an accurate diagnostic tool with some unavoidable pitfalls in gynecologic tumors. We aimed to evaluate the diagnostic value of frozen section, and to detect the factors causing erroneous diagnosis in ovarian tumors. Material and Method:Frozen section and paraffin section reports of 282 patients with ovarian neoplasms diagnosed between July 2006 and January 2013 in our institute were re-analyzed. Results were grouped into benign, borderline (for epithelial tumors) and malignant categories and compared between frozen section and paraffin section diagnosis, statistically. Results:Overall diagnostic accuracy of frozen section was 96.5%. Sensitivity of frozen section for benign, borderline and malignant tumors were 97.5%, 95.8%, and 95.6% and the related specificities were 97.5%, 97.6%, and 100%, respectively. We found the lowest positive predictive value in borderline group (79.3%), all of them with mucinous type epithelium. Second frequent discordant tumor type was immature teratoma. Conclusion:Apart from the limitations of frozen section, pathologists should be aware of the pitfalls of technique and tumor types and tend to sample from the solid areas particularly in mucinous tumors and teratomas to avoid inappropriate surgery. Bulgular:Frozen incelemenin genel tanısal doğruluk oranı %96,5 idi. Benign, borderline ve malign tümörler için frozen incelemenin duyarlığı sırasıyla %97,5, %95,8 ve %95,6 idi. Özgüllük ise aynı sırayla, %97,5, %97,6 ve %100 idi. En düşük pozitif prediktif değer borderline grubunda saptandı (%79,3) ve hataya neden olan tüm olgular müsinöz tip epitelyal tümörler idi. Tanı uyumsuzluğu bulunan ikinci tümör grubu ise immatür teratom idi. Sonuç:Frozen incelemenin kısıtlılıkları yanısıra, patoloğun frozen incelemenin teknik veya tümör tipi ile ilgili tuzaklarını bilmesi, özel-likle müsinöz tümörler ve teratom olgularında solid görünen alanlardan örneklenmesi yetersiz veya gereksiz operasyon yapılmasını önlemek adına yararlı olacaktır.

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Section: Discussionmentioning

confidence: 99%

Intraoperative frozen section in ovarian neoplasms; a tertiary center experience

Acikalin

Torun²,

Bağır³

et al. 2014

TJPATH

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“…[4][5][6] Ovarian specimens are very commonly submitted for intra-operative consultation in order to confirm the presence of malignancy. 7 Borderline mucinous tumours comprised the single largest source of error in frozen section. 8,9 Among the several cytological techniques applied to ovarian specimens, scrape cytology is often considered the most suitable.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic utility of imprint cytology of ovarian neoplasm: A cyto-histological comparison

Ivan¹,

Chacko²,

Thomas³

2020

ACHR

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Background: Intra-operative cytology (IOC) is a method of intra-operative pathological evaluation of cytology smears. The most important indication for IOC is to establish or confirm diagnosis rapidly. Other advantages of IOC are its simple, inexpensive, excellent preservation of cellular details, with no loss of tissues as occurs with cryostat sections and adequacy of surgical margins. Frozen sections are well established method for providing rapid and accurate intra-operative diagnosis. Objective: To evaluate the diagnostic utility of imprint cytology and assess the accuracy of imprint cytology with histopathological diagnosis obtained from ovarian neoplasm. Materials and Methods: Imprint smears were prepared immediately from all the ovariotomy specimens. The specimens were sent for histopathology along with prepared smears to categorize as benign, borderline and malignant. Sensitivity, specificity and accuracy were assessed. Results : Among the 99 specimens studied, 80 were benign, 9 borderline and 10 malignancy according to histopathology. We found that sensitivity, specificity, for benign lesions were 100%, 42.1% and for malignant lesions were 80%, 91.9% respectively. The overall accuracy was 89%. Conclusion : Imprint smear of ovarian neoplasm gives a rapid diagnosis with 89% accuracy against histopathology with added advantages. Imprint cytology is an adjunct to frozen section for providing an intra-operative diagnosis; however, in resource poor settings, it can be used as a stand-alone method for aiding intra-operative decision making.

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“…When it is difficult to select the appropriate surgical procedure based on the preoperative evaluation, intraoperative frozen section analysis is important. The accuracy of the intraoperative frozen section procedure for ovarian tumors is 91-97%, but in borderline cases it is lower, i.e., 65-84% [1][2][3][4] . ImThis retrospective study was approved by the Institutional Review Board of Tohoku University Hospital.…”

Section: Introductionmentioning

confidence: 99%

Is Imprint Cytology Useful to Diagnose Malignancy for Brenner Tumors? A Case Series at a Single Institute

Minato

Tokunaga²,

Okamoto³

et al. 2017

Acta Cytologica

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Background: The aim of this study was to investigate cytological features of Brenner tumors according to tumor grade using imprint cytology. Case: Between 2004 and 2015, intraoperative imprint cytology was performed on 8 patients with Brenner tumors suspected to be malignant neoplasmas on gross examination because of their large size and solid part. These consisted of 1 benign, 3 borderline, and 4 malignant tumors. In patients with benign and borderline tumors, naked nucleus-like stromal cells and tumor cells in a sheet-like arrangement were observed against a clear background. The nuclei were round to oval-shaped with finely granular chromatin patterns and small nucleoli. Papillary cell clusters and high nucleus-to-cytoplasm ratios were only observed in 1 borderline case. In cases with malignancy, the background was necrotic. The tumor cells occurred in large papillary clusters. The nuclei showed a high degree of nuclear atypia. Nuclear grooves were present in 6 of our 8 cases and they were scant in the malignant cases. Conclusion: Imprint cytology of Brenner tumors provided no characteristic findings to enable a definitive distinction of benign versus borderline tumors, but it enabled discrimination between malignant and other tumors. Imprint cytology can facilitate intraoperative diagnosis and aid in selecting the appropriate surgical procedure.

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Intraoperative Consultation in Ovarian Pathology

Cited by 11 publications

References 124 publications

Intraoperative frozen section in ovarian neoplasms; a tertiary center experience

Intraoperative frozen section in ovarian neoplasms; a tertiary center experience

Diagnostic utility of imprint cytology of ovarian neoplasm: A cyto-histological comparison

Is Imprint Cytology Useful to Diagnose Malignancy for Brenner Tumors? A Case Series at a Single Institute

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