Frozen sections of bladder tumors

Author: Turki Al-Hussain, M.D., Gillian Levy, M.D. (see Authors page)

Revised: 16 August 2016, last major update March 2011

Copyright: (c) 2002-2016,, Inc.

PubMed Search: Frozen sections of bladder tumors

Cite this page: Frozen sections of bladder tumors. website. Accessed November 18th, 2018.
Definition / 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 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