Bladder - Frozen sections of bladder tumors

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Miscellaneous

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
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● 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)

Procedure
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● 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
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● 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
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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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