Applications of Frozen Section to Intraoperative Evaluations of Extranodal Tissues for Hematolymphoid Disorders and Diagnostic Pitfalls of Frozen Section to Intraoperative Evaluations of Lymph Nodes for Hematolymphoid Disorders

Abstract

Frozen sections of extranodal tissues that are highly suspected of a hematolymphoid disorder or malignancy are primarily limited to situations in which there is a markedly paucicellular specimen upon review of the touch preparation. Even in those situations, nodular sclerosing classical Hodgkin lymphoma and primary mediastinal large B-cell lymphoma may result in paucicellular touch preparations and should be considered in mediastinal tissue biopsies.

Frozen sectioning may result in tissue artifacts which may cause diagnostic pitfalls in evaluating lymph node specimens for involvement by a hematolymphoid disorder or malignancy. Diagnostic pitfalls may also result from limited sampling. Such resulting diagnostic pitfalls include, but are not limited to, the following diagnostic dilemmas: distinguishing reactive or benign lymphoid proliferations from malignant lymphoma, distinguishing thymoma from malignant lymphoma, distinguishing malignant lymphoma with necrosis from an infectious process, distinguishing a hematolymphoid disorder or malignancy from a nonhematolymphoid malignancy, and distinguishing non-Hodgkin lymphoma from classical Hodgkin lymphoma.