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Fixation artefact in an intra-operative frozen section: a potential cause of misinterpretation.

Thomson AM, Wallace WA - J Cardiothorac Surg (2007)

Bottom Line: The intra-operative histological assessment of fresh tissue can provide valuable diagnostic information and guide surgical management, however, even a limited exposure to standard fixation agents can potentially compromise analysis.Defined handling strategies should exist to facilitate the receipt of all specimens, in their optimal state, by the laboratory.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Pathology, College of Medicine and Veterinary Medicine, The University of Edinburgh and Department of Pathology, Royal Infirmary of Edinburgh, Edinburgh. Andrew.Thomson@luht.scot.nhs.uk

ABSTRACT
The intra-operative histological assessment of fresh tissue can provide valuable diagnostic information and guide surgical management, however, even a limited exposure to standard fixation agents can potentially compromise analysis. Defined handling strategies should exist to facilitate the receipt of all specimens, in their optimal state, by the laboratory.

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Related in: MedlinePlus

(1A): Representative cryostat section of the first biopsy (exposed, prior to freezing, to 10% neutral buffered formalin) stained with haematoxylin and eosin (magnification ×400); (1B) Representative cryostat section of the second biopsy (which had not been exposed to fixative prior to freezing) stained with haematoxylin and eosin (magnification ×400); (1C) Formal paraffin section of the first biopsy stained with haematoxylin and eosin (magnification ×200).
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Figure 1: (1A): Representative cryostat section of the first biopsy (exposed, prior to freezing, to 10% neutral buffered formalin) stained with haematoxylin and eosin (magnification ×400); (1B) Representative cryostat section of the second biopsy (which had not been exposed to fixative prior to freezing) stained with haematoxylin and eosin (magnification ×400); (1C) Formal paraffin section of the first biopsy stained with haematoxylin and eosin (magnification ×200).

Mentions: The initial histology (Figure 1A) suggested a range of possible diagnoses from: a mesenchymal lesion to adipose tissue associated with a cluster of atypical epithelial cells; in contrast, cryostat analysis of a second fresh biopsy, submitted without fixation, showed features typical of squamous carcinoma (Figure 1B). This diagnosis was confirmed by the formal paraffin sections from the original specimen in which, clusters of atypical cells containing large, pleomorphic nuclei, a prominent nucleolus and eosinophilic cytoplasm were readily identified (Figure 1C). Upon review of the original sections (Figure 1A), it was clear that artefactual 'ballooning' of the neoplastic cells had occurred probably as a consequence of partial fixation and subsequent freezing of the specimen.


Fixation artefact in an intra-operative frozen section: a potential cause of misinterpretation.

Thomson AM, Wallace WA - J Cardiothorac Surg (2007)

(1A): Representative cryostat section of the first biopsy (exposed, prior to freezing, to 10% neutral buffered formalin) stained with haematoxylin and eosin (magnification ×400); (1B) Representative cryostat section of the second biopsy (which had not been exposed to fixative prior to freezing) stained with haematoxylin and eosin (magnification ×400); (1C) Formal paraffin section of the first biopsy stained with haematoxylin and eosin (magnification ×200).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2117000&req=5

Figure 1: (1A): Representative cryostat section of the first biopsy (exposed, prior to freezing, to 10% neutral buffered formalin) stained with haematoxylin and eosin (magnification ×400); (1B) Representative cryostat section of the second biopsy (which had not been exposed to fixative prior to freezing) stained with haematoxylin and eosin (magnification ×400); (1C) Formal paraffin section of the first biopsy stained with haematoxylin and eosin (magnification ×200).
Mentions: The initial histology (Figure 1A) suggested a range of possible diagnoses from: a mesenchymal lesion to adipose tissue associated with a cluster of atypical epithelial cells; in contrast, cryostat analysis of a second fresh biopsy, submitted without fixation, showed features typical of squamous carcinoma (Figure 1B). This diagnosis was confirmed by the formal paraffin sections from the original specimen in which, clusters of atypical cells containing large, pleomorphic nuclei, a prominent nucleolus and eosinophilic cytoplasm were readily identified (Figure 1C). Upon review of the original sections (Figure 1A), it was clear that artefactual 'ballooning' of the neoplastic cells had occurred probably as a consequence of partial fixation and subsequent freezing of the specimen.

Bottom Line: The intra-operative histological assessment of fresh tissue can provide valuable diagnostic information and guide surgical management, however, even a limited exposure to standard fixation agents can potentially compromise analysis.Defined handling strategies should exist to facilitate the receipt of all specimens, in their optimal state, by the laboratory.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Pathology, College of Medicine and Veterinary Medicine, The University of Edinburgh and Department of Pathology, Royal Infirmary of Edinburgh, Edinburgh. Andrew.Thomson@luht.scot.nhs.uk

ABSTRACT
The intra-operative histological assessment of fresh tissue can provide valuable diagnostic information and guide surgical management, however, even a limited exposure to standard fixation agents can potentially compromise analysis. Defined handling strategies should exist to facilitate the receipt of all specimens, in their optimal state, by the laboratory.

Show MeSH
Related in: MedlinePlus