Bladder, ureter & renal pelvis
General
Frozen section


Topic Completed: 1 March 2011

Minor changes: 11 June 2020

Copyright: 2002-2020, PathologyOutlines.com, Inc.

PubMed Search: Frozen sections of bladder tumors

Turki Al-Hussain, M.D.
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Cite this page: Al-Hussain T, Levy G. Frozen section. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/bladderfrozen.html. Accessed October 28th, 2020.
Definition / general
Indications
  • 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
  • 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 2011;29:451)
Microscopic (histologic) 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
Microscopic (histologic) images

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Transitional cell carcinoma in situ at margin

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