Are en face frozen sections accurate for diagnosing margin status in melanocytic lesions?

Abstract:

:To assess the diagnostic accuracy of margin evaluation of melanocytic lesions using en face frozen sections compared with standard paraffin-embedded sections, we studied 2 sets of lesions in which en face frozen sections were used for analysis of surgical margins (13 from malignant melanomas [MMs] and 10 from nonmelanocytic lesions [NMLs]). Routine permanent sections were cut after routine processing. The slides were mixed and coded randomly. Fifteen dermatopathologists examined the cases separately. Margin status was categorized as positive, negative, or indeterminate. Kappa statistics were calculated per dermatopathologist and per case. One case from each group was excluded because epidermis was not available in the routine sections. Of 330 evaluations (22 cases, 15 dermatopathologists), there were 132 diagnostic discrepancies (40.0%): 66 each for MM and NML (mean per case for both diagnoses, 6). In 9 instances (6.8%), the change was from positive (frozen) to negative (permanent) and in 43 (32.6%), from negative (frozen) to positive (permanent). There was poor agreement between frozen and permanent sections (kappa range per dermatopathologist, -0.1282 to 0.6615). If permanent histology is considered the "gold standard" for histologic evaluation, en face frozen sections are not suitable for accurate surgical margin assessment of melanocytic lesions.

journal_name

Am J Clin Pathol

authors

Prieto VG,Argenyi ZB,Barnhill RL,Duray PH,Elenitsas R,From L,Guitart J,Horenstein MG,Ming ME,Piepkorn MW,Rabkin MS,Reed JA,Selim MA,Trotter MJ,Johnson MM,Shea CR

doi

10.1309/J1Q0-V35E-UTMV-R193

subject

Has Abstract

pub_date

2003-08-01 00:00:00

pages

203-8

issue

2

eissn

0002-9173

issn

1943-7722

journal_volume

120

pub_type

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