Saturday, July 8, 2017

Challenges of Frozen Section in Thoracic Pathology: Lepidic Lesions, Limited Resections, and Margins

Alain C. BorczukMD
From the Department of Pathology, Weill Cornell Medicine, New York, New York.
Reprints: Alain C. Borczuk, MD, Department of Pathology, Weill Cornell Medicine, 1300 York Ave, ST10-1000A, New York, NY 10065 (email: ).
The author has no relevant financial interest in the products or companies described in this article.
Presented in part at the 3rd Princeton Integrated Pathology Symposium; May 14, 2016; Plainsboro, New Jersey.
Context.— The use of frozen section in thoracic pathology includes assessment of peripheral lung lesions with lepidic pattern, with greater emphasis on evaluating lung-sparing resections and margin assessment.
Objective.— To review pitfalls of frozen section in thoracic pathology; in this setting, reduction of false-positive and false-negative diagnosis in lesion identification and margin assessment is critical.
Data Sources.— PubMed search of frozen section lung pathology yielded specific references related to the use of frozen section in the identification of lepidic lesions and the clinical recommendation for margin distance.
Conclusions.— Frozen section diagnosis is overall accurate in assessment of lepidic lesions. Pitfalls include rare benign mimickers and more common reactive lesions. Standard approaches to gross assessment and margin measurement require further research with increasing use of lung-sparing resections.

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