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Frozen Section Evaluation Does Not Alter Surgical Decisions in Thyroid Neoplasms With Inconclusive FNA Diagnosis: Presented at ASCP By Lexa W. Lee NEW ORLEANS, LA -- October 26, 2007 -- Intraoperative frozen sections (FS) of thyroid lesions are not useful for preoperative fine needle aspiration (FNA) diagnosis of thyroid neoplasms, according to findings presented here at the 2007 annual meeting of the American Society of Clinical Pathology (ASCP). Surgeons continue to disagree about whether a frozen section of thyroid lesions would alter the operative decision and justify a change in surgical management of these cases, said Purva Gopal, MD, Pathology Resident, University of Louisville, Louisville, Kentucky, United States. The study was done to determine the role of FS in thyroid lesions with inconclusive FNA diagnoses and their usefulness in intraoperative decision making. The investigators retrospectively reviewed the records of 38 patients with inconclusive diagnoses rendered by FNA between 2001 and 2006. From this sample, three categories were defined based on the FNA diagnosis: follicular neoplasm (50%), suspicious for malignancy (18.5%), and non-diagnostic (31.5%). Patients were hen also evaluated according to the availability of intraoperative FS. Results of both FNA and FS were then compared with the final pathological diagnosis. There were 28 patients in the FS group and 10 in the non-FS group. Specimens without histology followup were excluded. The FS were given one of three diagnoses: benign (18%), deferred (75%), malignant (7%). Among the FS patients, 28.5% showed thyroid carcinoma on permanent histology. Of these eight cases, six diagnoses were deferred on FS and two were diagnosed malignant on FS. In the 10 non-FS group, 50% showed thyroid carcinoma on permanent histology, three of them received a lobectomy, and two had total/subtotal thyroidectomy without neck dissection. Of the patients with non-diagnostic FNA, 87.5% had FS. Of these eight cases, seven had diagnoses deferred on FS and one was diagnosed to be benign on FS. FS did not alter the operative decision in any patient with preoperative inconclusive FNA diagnosis. Dr. Gopal said, "We concluded that intraoperative FS is not useful for a preoperative FNA diagnosis of neoplasm." [Presentation title: Clinical Utility of Frozen Section Evaluation in Patients Undergoing Surgery for Nodular Thyroid Disease with Inconclusive FNA Diagnosis. Poster 24] E-mail this page to a friend or colleague! To print, use this version