Volume : IV, Issue : XI, November - 2015

Diagnostic accuracy of intraoperative frozen sections in central nervous system lesions at a Tertiary care centre, Ahmedabad, India.

Dr. Ritesh P. Gohil, Dr. K. N. Delwadia, Dr. Khyati K. Patel

Abstract :

 BACKGROUND AND AIMS: Intraoperative consultation of CNS lesions provides accurate diagnosis to neurosurgeons. Some lesions, however, may cause diagnostic difficulty. In this study accuracy of intraoperative consultations of CNS lesions and discrepancies in diagnosis were analysed. METHODS: All CNS cases from April, 2014 to October, 2015 in which intraoperative frozen section had been performed, and which were reported in the Section of Histopathology, Civil Hospital Ahmedabad were retrieved. The diagnosis given on FS were compared with the final diagnosis given on permanent paraffin sections (and additional material if received), as indicated in the frozen section and final pathology report. RESULTS: During the study period, 124 CNS cases were received for intraoperative consultation. In all cases, cryostat sections (FS) plus cytology smears were prepared. The ages of the patients ranged from 1 month to 78 years. 76 were males and 48 were females. Out of these 124 cases, 109(87.9%) cases were concordant,15 cases ( 12.1%)were discrepant. The diagnostic accuracy of frozen section was 87.9%. 3(20%)of 15 discrepancies involved errors in classification of spindle cell lesions, most commonly confusing schwannomas with fioblastic meningiomas. 4(26.6%) cases involved errors in differentiating astrocyomas from medulloblastoma and oligodendrogliomas. 2(14.4%) cases involved errors in differentiating reactive from neoplastic processes, most frequently gliosis versus glioma. 3(20%) discrepancies involved errors in the grading of tumors. The remaining 3 (20%) cases included an assortment of other discrepancies. CONCLUSIONS: Our results show a reasonably high percentage of accuracy in the intraoperative diagnosis of CNS lesions. However, there are limitations and some lesions pose a diagnostic challenge. There is a need to improve our own diagnostic skills and establish better communication with neurosurgeons.

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Article: Download PDF   DOI : 10.36106/ijsr  

Cite This Article:

Dr.Ritesh P. Gohil, Dr.K.N.Delwadia, Dr.Khyati K.Patel / Diagnostic accuracy of intraoperative frozen sections in central nervous system lesions at a Tertiary care centre, Ahmedabad, India. / International Journal of Scientific Research, Vol : 4, Issue : 11 November 2015

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