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Frozen sections of bladder tumors

Reviewers: Turki Al-Hussain, M.D., Johns Hopkins Medical Centers; Gillian Levy, M.D., Yale Medical Center (see Reviewers page)
Revised: 13 May 2011, last major update March 2011
Copyright: (c) 2003-2011, PathologyOutlines.com, Inc.

Indications - general

● Frozen sections usually performed for ureteral margin evaluation for carcinoma in situ or invasive carcinoma
● Only 3% positive ureteral margins in one study, which suggests it should not be done routinely (Can Urol Assoc J 2010;4:28)
● More useful if carcinoma in situ present in bladder (J Urol 2006;176:2409)
● Frozen sectioning may be useful for evaluating lymph nodes (Urology 2007;69:83)


● Recommended to obtain cross section of distal ureter, not shaved margin
● Frozen section is highly sensitive for malignant ureteral margins, but reresection often does not convert positive margins to negative margins (World J Urol 2010 Jul 9 [Epub ahead of print])

Micro description

● Technical artifact from freezing may induce atypical features in urothelium
● Use stromal lymphocytes as a reference of nuclear size
● Variant invasive patterns, such as plasmacytoid, may mimic inflammatory cells

Micro images

Normal mucosa (A) may resemble carcinoma in situ (B) at ureteral margin

Transitional cell carcinoma in situ at margin

End of Bladder > Miscellaneous > Frozen sections of bladder tumors

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