Intraoperative Evaluation of Pediatric Bone and Soft Tissue Lesions: Retrospective Analysis of 595 Frozen Sections With Emphasis on Discrepancy and Diagnostic Pitfalls.
Context.-- Frozen section (FS) evaluation of pediatric bone and soft tissue (BST) lesions is infrequently encountered and may pose considerable diagnostic challenges. Limited data exist about the accuracy and related diagnostic difficulties. Objective.-- To identify and analyze discrepancies between...
| Publicado en: | Archives of Pathology & Laboratory Medicine Vol. 149; no. 9; pp. 838 - 846 |
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| Autores principales: | , , , , |
| Formato: | diagnostic images pictorial research tables/charts Journal Article |
| Publicado: |
College of American Pathologists
Sep2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=187816949&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 187816949 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00039985 1FS jtl: Archives of Pathology & Laboratory Medicine issn: 00039985 maglogo: N pubinfo: dt: Sep2025 vid: 149 iid: 9 pid: 2550 pub: College of American Pathologists place: Northfield, Illinois artinfo: ui: 187816949 187816949 187816949 10.5858/arpa.2024-0329-OA 187816949 ppf: 838 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Intraoperative Evaluation of Pediatric Bone and Soft Tissue Lesions: Retrospective Analysis of 595 Frozen Sections With Emphasis on Discrepancy and Diagnostic Pitfalls. aug: au: Coiner, Benjamin L. Correa, Hernán Johnson, Joyce E. Liang, Jiancong Wang, Huiying affil: Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts sug: subj: Childhood Neoplasms Diagnosis Soft Tissue Neoplasms Diagnosis Bone Neoplasms Diagnosis Frozen Sections Diagnostic Errors Prevention and Control Childhood Neoplasms Surgery Soft Tissue Neoplasms Surgery Bone Neoplasms Surgery Intraoperative Care Clinical Competence Decision Making, Clinical Human Male Female Infant, Newborn Infant Child, Preschool Child Adolescence Young Adult Retrospective Design Record Review Sarcoma, Ewing's Hematologic Neoplasms Rhabdomyosarcoma Spindle Cells Pathology Fisher's Exact Test Mann-Whitney U Test Osteosarcoma Histiocytosis, Langerhans-Cell Seminars and Workshops Tertiary Health Care Hospitals, Pediatric Age Factors Sex Factors Infant, Newborn: birth-1 month Infant: 1-23 months Child, Preschool: 2-5 years Child: 6-12 years Adolescent: 13-18 years Male Female ab: Context.-- Frozen section (FS) evaluation of pediatric bone and soft tissue (BST) lesions is infrequently encountered and may pose considerable diagnostic challenges. Limited data exist about the accuracy and related diagnostic difficulties. Objective.-- To identify and analyze discrepancies between the FS diagnosis and final diagnosis in order to increase the awareness of common diagnostic pitfalls in FS evaluation of pediatric BST lesions. Design.-- We retrospectively reviewed 595 consecutive FSs of pediatric BST lesions from 373 patients and analyzed the accuracy and causes for interpretation errors. Results.-- Discrepant diagnoses were found in 23 of 595 FSs (3.9%). Discrepancy rates were slightly higher in benign soft tissue lesions and FSs requested for diagnosis/adequacy, although no statistically significant difference was observed. Pathologist misinterpretation contributed to discrepancy in 17 of 23 FSs (73.9%), which were classified into 6 patterns of error. For margin, 3 patterns were found: normal hematopoietic elements versus malignant cells in Ewing sarcoma bone marrow margin (n = 3), prominent sinonasal vasculature and stroma versus sinonasal tract angiofibroma (n = 3), and atrophic skeletal muscles versus malignant cells in rhabdomyosarcoma and Ewing sarcoma (n = 2). For diagnosis, another 3 patterns were identified: misclassification of benign bone tumors (n = 5), misclassification of benign spindle neoplasms (n = 2), and vascular malformation versus normal tissue (n = 2). Conclusions.-- FS is a valuable tool for guiding surgical management of pediatric BST lesions, which can be challenging entities and represent significant diagnostic pitfalls. Awareness of these FS pitfalls may help in further increasing diagnostic accuracy. pubtype: Academic Journal doctype: diagnostic images pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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