Thyroid & parathyroid

Thyroid - general

Frozen section

Topic Completed: 1 March 2009

Minor changes: 29 December 2020

Copyright: 2003-2021,, Inc.

PubMed Search: frozen section thyroid

Shahid Islam, M.D., Ph.D.
Page views in 2020: 546
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Cite this page: Islam S. Frozen section. website. Accessed December 3rd, 2021.
Definition / general
  • Not indicated for most thyroid nodules due to low sensitivity; frequency has been decreasing (Virchows Arch 2008;453:433)
  • Results may conflict with FNA (Arch Otolaryngol Head Neck Surg 2007;133:874), but see Thyroid 2007;17:557
  • Well differentiated carcinomas often cannot be diagnosed on frozen section, regardless of experience of pathologist
  • Intraoperative cytology may be useful to detect nuclear features of papillary carcinoma (Mod Pathol 2000;13:210)

  • False negatives by frozen section:
    • Minimally invasive follicular carcinoma:

  • False positives by frozen section:
    • Metastatic papillary carcinoma: apparent metastases may actually be Riedel thyroiditis, diffuse hyperplasia of ectopic thyroid tissue or sequestered thyroid tissue
    • Freezing artifact may mimic nuclear features of papillary thyroid carcinoma or parathyroid neoplasms (43% of cases diagnosed as "suspicious for papillary carcinoma" are not papillary carcinoma at permanent section, Thyroid 2008;18:419)
    • Post FNA alterations can mimic capsular or vascular invasion
Microscopic (histologic) images

AFIP images

Nuclear features

Images hosted on other servers:

Follicular variant of papillary carcinoma

Additional references
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