Frozen Section Library: Gynecologic Pathology Intraoperative by Donna M. Coffey;Ibrahim Ramzy

By Donna M. Coffey;Ibrahim Ramzy

Frozen sections are played whereas a sufferer is present process surgical procedure as a foundation for making a right away prognosis that would influence remedy judgements. Frozen part analysis is usually a hugely not easy scenario for the pathologist who needs to render a analysis fast, in keeping with cautious gross exam of specimens to choose optimum components for microscopic examination.

The Frozen part Library sequence will supply concise, basic, website particular handbooks which are good illustrated and spotlight the pitfalls, artifacts and differential analysis concerns that come up within the moved quickly frozen part scenario.

Donna M. Coffey, M.D., is Assistant Professor, division of Pathology and Laboratory drugs, The Methodist health center, Houston, Texas and Weill scientific university of Cornell collage, long island, New York.

Ibrahim Ramzy, M.D., is Professor of Pathology - Laboratory drugs & Obstetrics-Gynecology, college of California, Irvine, California and Adjunct Professor of Pathology, Baylor collage of medication, Houston, Texas.

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Sample text

Vaginal intraepithelial neoplasia may be also encountered following or in association with cervical squamous epithelial neoplasia (Fig. 3). 3 Vaginal intraepithelial neoplasia. This lesion was encountered partially lining an inclusion cyst. There is complete involvement of the entire thickness of the epithelium by a high-grade intraepithelial neoplastic change. The patient had a history of cervical cancer (H&E, medium power). 4 Radical vaginectomy for squamous cell carcinoma. This vaginal tumor developed 15 years following radiation therapy for squamous cell carcinoma of the cervix.

The differentiation from squamous cell neoplasia can be difficult in some cases. However, the presence of an occasional cell with clear cytoplasm points to Paget disease (H&E, medium power). (b) Paget disease with nests and cords of adenocarcinoma cells infiltrating deeply into the vulvar tissues (H&E, medium power). identified in approximately 20% of cases. The sites of origin of the invasive component include colon/rectum cervix, bladder, or urethra. Patients with only superficial Paget disease are treated with a more conservative surgery such as local excision or skinning vulvectomy, with evaluation of the margins by frozen section.

2 Vulvar intraepithelial malignancies. VIN III Paget disease Malignant melanoma Clinical and gross Maculopapular White or erythematous May be parakeratotic Eczema, ulcer or erythematous lesion Focal white keratosis May be amelanotic or arise in nevus Glandular and adnexa Sq cells NL Dermoepidermoid junction Some pigmented Neoplastic cells Squamous Full thickness Special stains PAS diastase-labile Flat, speckled or pigmented PAS diastase resistant PAS diastase resistant Mucicarmine+ S 100, Dopa oxidase+ Alcian blue+, GCDP-15+ Melan A+ CEA+ prior to definitive surgical resection.

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