Predictable Tissue Shrinkage During Frozen Section Histopathologic Processing for Mohs Micrographic Surgery

Abstract

background. When confronted with a histologic specimen that is appreciably smaller than the same tissue specimen immediately after acquisition, the Mohs surgeon is faced with two possibilities, namely that the tissue has either shrunken during laboratory processing or that the histologic specimen is incomplete due to the introduction of technical errors during embedding, cutting, or staining of the skin specimen. Because the entire objective of Mohs micrographic surgery is to precisely examine the entire surgical margin of skin specimens, the surgeon must be able to determine that any size discrepancies introduced during laboratory processing are not related to incomplete surgical specimens. Although there are anecdotal suggestions that skin, like other human tissues, undergoes some degree of shrinkage during routine frozen section processing, the exact nature and magnitude of this phenomenon has not been previously investigated. objective. To quantify the degree of tissue shrinkage in Mohs micrographic surgical specimens processed with routine frozen sections and subsequent hematoxylin and eosin staining. methods. A total of 117 Mohs surgery patients (135 cutaneous tumors) were prospectively enrolled. The dimensions of initial stage surgical specimens were determined after removal

Effect of tissue shrinkage on histological tumour-free margin after excision of basal cell carcinoma

“…Shrinkage of tissue is well documented to occur after excision and processing in skin and other tissues. [1][2][3][4][8][9][10] The 14% reduction in total specimen diameter after excision and fixation seen in this study is similar to our previous findings. 1 Between margin measurement and histological examination there is a variety of factors that might influence specimen size including initial tissue tension due to local anatomical factors, inherent tissue contractility, fixation effect and histological processing.…”

Preoperative Ultrasonic Assessment of Thin Melanocytic Skin Lesions Using a 100-MHz Ultrasound Transducer: A Comparative Study

“…Hence, we suggest that the aforementioned factors significantly contribute to overestimation of TT using noninvasive imaging techniques such as HFUS. 17,18 In this study, the 95% limits of agreement, which showed discrepancies up to 71 mm for 20-MHz ultrasound and 30 mm for 100-MHz ultrasound, indicate a variable numerical agreement between HFUS and histology. In fact, 100-MHz ultrasound does agree better with histology than 20-MHz ultrasound.…”

Study of shrinkage of cutaneous surgical specimens

“…The assessment of discrepancies between surgical and histopathological measurements of specimens is important in order to avoid repeat surgery and unnecessary follow-ups, besides legal implications with respect to the surgical margins around malignant tumors. 2 Surgical specimens of various human tissues, including prostate, breast, brain, oral cavity, colorectal, lung and carotid artery, 3,4 are known to undergo shrinkage, which has been attributed to the retractile properties of the specimens themselves and the action of formalin. 1,4,5 However, there have been few studies on cutaneous surgical specimens, and inconsistent findings have been published on their amount of shrinkage and on the potential role of formalin fixation.…”

“…2 Surgical specimens of various human tissues, including prostate, breast, brain, oral cavity, colorectal, lung and carotid artery, 3,4 are known to undergo shrinkage, which has been attributed to the retractile properties of the specimens themselves and the action of formalin. 1,4,5 However, there have been few studies on cutaneous surgical specimens, and inconsistent findings have been published on their amount of shrinkage and on the potential role of formalin fixation. 1 -3,5-7 Results on the influence of factors such as sex, age, localization and diagnosis on the amount of shrinkage have also been controversial (Table 1).…”