Journal article
A Quantitative and Qualitative Assessment of Frozen Section Diagnosis Accuracy and Deferral Rate Across Organ Systems
American journal of clinical pathology, Vol.158(6), pp.692-701
12/01/2022
DOI: 10.1093/ajcp/aqac115
PMID: 36197800
Abstract
Objectives Monitoring of frozen section diagnostic performance provides an important quality improvement measure. Methods Surgical specimens involving a frozen section diagnosis over a 3-year period were retrospectively reviewed. Glass slides were reviewed on cases with discordance. Discordance and deferral rates were calculated. Results Of 3,675 frozen section diagnoses included, 96 (2.7%) were discordant with the final diagnosis. Additionally, 114 frozen section diagnoses (3.1%) were deferred. The organ-specific discordance rates were lowest in breast and genitourinary specimens and highest for pancreas, lymph node, and gynecologic specimens. Deferral rates were highest in musculoskeletal, breast, and hepatobiliary cases and lowest in thyroid, parathyroid, and neuropathology cases. Discordance was explained by block-sampling error (45%), specimen-sampling error (27%), or interpretation error (27%). Discordant frozen section diagnoses from gynecologic specimens were responsible for 81% of specimen-sampling errors; frozen section diagnoses of lymph nodes, head and neck, and pancreas were responsible for 54% of interpretation errors; 51% of block-sampling errors involved lymph node evaluation for metastatic carcinoma. Conclusions Careful gross evaluation and microscopic examination of multiple levels should minimize specimen-sampling error and block-sampling error, respectively. Periodic review of accuracy and deferral rates may help reduce errors and improve the overall performance of this essential procedure.
Details
- Title: Subtitle
- A Quantitative and Qualitative Assessment of Frozen Section Diagnosis Accuracy and Deferral Rate Across Organ Systems
- Creators
- Anas Mohamed - East Carolina UniversityMuhammad Masood Hassan - University of Mississippi Medical CenterWen Zhong - University of Pittsburgh Medical CenterAisha Kousar - Vidant Medical CenterKotaro Takeda - Vidant Medical CenterDeepak Donthi - The University of Texas Southwestern Medical CenterAreeba Rizvi - Vidant Medical CenterMarwan Majeed - Vidant Medical CenterAhmed Younes - Vidant Medical CenterAhlam Ali - Omar Al-Mukhtar UniversityAnn Sutton - Vidant Medical CenterGina Murray - Vidant Medical CenterAbdullah Thayyil - Vidant Medical CenterJohn Fallon - Vidant Medical CenterKim Geisinger - Joint Pathol Ctr, Silver Spring, MD USA
- Resource Type
- Journal article
- Publication Details
- American journal of clinical pathology, Vol.158(6), pp.692-701
- DOI
- 10.1093/ajcp/aqac115
- PMID
- 36197800
- NLM abbreviation
- Am J Clin Pathol
- ISSN
- 0002-9173
- eISSN
- 1943-7722
- Publisher
- Oxford Univ Press
- Number of pages
- 10
- Language
- English
- Date published
- 12/01/2022
- Academic Unit
- Pathology
- Record Identifier
- 9984845397702771
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