Thyroid & parathyroid
Thyroid - general
Frozen section
Author: Shahid Islam, M.D., Ph.D.
Last author update: 1 March 2009
Last staff update: 17 April 2024
Copyright: 2003-2024, PathologyOutlines.com, Inc.
PubMed Search: frozen section thyroid
Cite this page: Islam S. Frozen section. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/thyroidfrozen.html. Accessed December 20th, 2024.
Definition / general
- Click here for the frozen section procedure topic
- Not indicated for most thyroid nodules due to low sensitivity; frequency has been decreasing (Virchows Arch 2008;453:433)
- Results may conflict with FNA (Arch Otolaryngol Head Neck Surg 2007;133:874), but see Thyroid 2007;17:557
- Well differentiated carcinomas often cannot be diagnosed on frozen section, regardless of experience of pathologist
- Intraoperative cytology may be useful to detect nuclear features of papillary carcinoma (Mod Pathol 2000;13:210)
- False negatives by frozen section:
- Minimally invasive follicular carcinoma:
- Sensitivity varies from 17 - 42% (Presse Med 2008;37:949)
- Need a mean 9 paraffin blocks to identify vascular invasion (Am J Clin Pathol 2001;115:370)
- Most diagnoses are "follicular lesion - diagnosis deferred to permanent sections"
- Minimally invasive follicular carcinoma:
- False positives by frozen section:
- Metastatic papillary carcinoma: apparent metastases may actually be Riedel thyroiditis, diffuse hyperplasia of ectopic thyroid tissue or sequestered thyroid tissue
- Freezing artifact may mimic nuclear features of papillary thyroid carcinoma or parathyroid neoplasms (43% of cases diagnosed as "suspicious for papillary carcinoma" are not papillary carcinoma at permanent section, Thyroid 2008;18:419)
- Post FNA alterations can mimic capsular or vascular invasion
Microscopic (histologic) images
AFIP images
Nuclear features
Images hosted on other servers:
Follicular variant of papillary carcinoma
Additional references
