Reasons for the inconsistency between frozen sections of cervical lymph nodes and postoperative pathology in thyroid cancer
Objective To explore and analyze the reasons why frozen section(FS)is inconsistent with paraffin section(PS)in cervical lymph node surgery of thyroid cancer to improve the coincidence rate between them.Methods After collecting clinical data,5 patients with FS inconsistent with paraffin section were screened out,and the sections were re-read under the microscope.Taking paraffin section as the gold standard,the reasons of FS inconsistent with paraffin section were ana-lyzed.Results Of the 30 patients,18 were delayed in diagnosis,10 were false negative and 2 were false positive.Postoper-ative pathological thyroid papillary carcinoma metastasized in 19 cases,medullary thyroid carcinoma was detected in 1 case,and benign without metastasis in 10 cases.Among the 18 cases of delayed diagnosis,8 cases were pathological papillary thyroid carcinoma metastasis,5 cases were ectopic thyroid,3 cases were not found tumor,and 2 cases were found in psam-moma bodies.10 cases were false negative,including 2 cases of missing samples,2 cases of FS were not cut out,and 6 cases were not recognized under microscope.Postoperative pathological types included 8 cases of papillary thyroid carcino-ma,1 case of medullary thyroid carcinoma and 1 case of ectopic thymic lymph node thyroid carcinoma.The quality of FS section of 30 patients included 14 cases of grade C and 12 cases of grade B;Of the 20 patients,19 cases had metastases less than 2 mm,and 1 case was more than 2 mm;The tumor was located in the subcapsular sinus of lymph nodes in 12 cases and not in the subcapsular sinus in 8 cases.Conclusion The reasons for the inconsistency between FS and paraffin sections are diverse and run through the entire process of FS and section review,including insufficient sampling and missed diagnosis,failure to cut deep lesions in the section,poor section quality,minimal metastasis,missed diagnosis under endo-scope,or insufficient atypia,making it difficult to identify.
Frozen sectionParaffin productionLymph nodesPapillary thyroid carcinomaThyroid cancer
万方数据
维普
