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Is there a Role for Frozen Section Evaluation of Parotid Masses After Preoperative Cytology or Biopsy Diagnosis?
Pastorello, R G; Rodriguez, E F; McCormick, B A; Calsavara, V F; Chen, L C; Zarka, M A; Schmitt, A C.
Afiliação
  • Pastorello RG; Sirio Libanes Hospital, Sao Paulo, SP, Brazil.
  • Rodriguez EF; The Johns Hopkins Hospital, Baltimore, MD, USA.
  • McCormick BA; Department of Laboratory Medicine & Pathology, Mayo Clinic Arizona, 13400 E Shea Boulevard, Scottsdale, AZ, 85259, USA.
  • Calsavara VF; AC Camargo Cancer Center, Sao Paulo, SP, Brazil.
  • Chen LC; Department of Laboratory Medicine & Pathology, Mayo Clinic Arizona, 13400 E Shea Boulevard, Scottsdale, AZ, 85259, USA.
  • Zarka MA; Department of Laboratory Medicine & Pathology, Mayo Clinic Arizona, 13400 E Shea Boulevard, Scottsdale, AZ, 85259, USA.
  • Schmitt AC; Department of Laboratory Medicine & Pathology, Mayo Clinic Arizona, 13400 E Shea Boulevard, Scottsdale, AZ, 85259, USA. ceolinschmitt.alessandra@mayo.edu.
Head Neck Pathol ; 15(3): 859-865, 2021 Sep.
Article em En | MEDLINE | ID: mdl-33616853
Fine-needle aspiration (FNA) biopsy reliably diagnoses parotid gland lesions preoperatively, whereas intraoperative frozen section (FS) has the additional benefit of assessing surgical margins and refining diagnoses; however, the role of FS in the setting of prior FNA diagnosis is not well established. Our aim was to determine whether FS should still be performed after a prior FNA/ CNB diagnosis. Parotid gland resections from January 2009 to January 2020 were identified; however, only patients who had both FNA and FS constituted our study population. For the purpose of statistical analysis, FNA diagnoses were classified into non-diagnostic (ND), non-neoplastic (NN), benign neoplasm (BN), indeterminate, and malignant. FS diagnoses were classified into benign, indeterminate, or malignant. Resections were dichotomized into benign and malignant and regarded as the gold standard to subsequently calculate diagnostic accuracy of FNA and FS. A total of 167 parotid gland resections were identified, but only 76 patients (45.5%) had both FNA and FS. In 35 cases deemed as benign preoperatively, three (8.6%) were reclassified as malignant on FS. Out of 18 lesions reported as malignant on FNA, four (22.2%) were interpreted as benign on FS, with three of these benign lesions confirmed on permanent slides. In addition, in patients with both FNA and FS, compared to FNA, FS was able to provide a definitive diagnosis in all five ND cases and in 61.1% (11/18) of indeterminate tumors. Intraoperative assessment provided a relative increase of 33.3% in specificity and 38.5% in positive predictive value when compared to preoperative FNA. The addition of FS to FNA was helpful to further refine the diagnoses of parotid gland lesions, which may provide better guidance for surgical intervention.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Parotídeas / Biópsia por Agulha Fina / Secções Congeladas Tipo de estudo: Diagnostic_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Head Neck Pathol Assunto da revista: NEOPLASIAS / PATOLOGIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Parotídeas / Biópsia por Agulha Fina / Secções Congeladas Tipo de estudo: Diagnostic_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Head Neck Pathol Assunto da revista: NEOPLASIAS / PATOLOGIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos