2015 Annual Meeting

SC59-Frozen Section Diagnostic Pitfalls and Pearls in Head and Neck Path

2015 Annual Meeting

Room CC 313, March 27 2015, 8:00am to 11:30am

Qihui (Jim) Zhai, Yash J. Patil

Educational Objective


Frozen section interpretation is a critical component of daily practice for most surgical pathologists. Diseases of the head and neck region can be difficult to diagnose due to the complex anatomy and the wide histological spectrum. Rendering an accurate intraoperative diagnosis is often challenging and stressful considering the time limitation, freezing artifacts, and the immediate resulting surgical impact. Evidence-based case-study format with an interactive approach and audience participation will be used. Twelve cases representing commonly encountered practical scenarios will be presented. A surgeon will begin each case with his perspectives, particularly key questions that will impact his decision on the immediate surgical treatment; followed by a pathologist who will discuss specimen handling, and diagnostic pitfalls and pearls. General surgical pathologists, pathologists with special interest in Head and Neck pathology, and pathologists in training will benefit most from this course. Still images, along with histories, will be posted on the USCAP website for review by pre-registrants prior to the meeting. A syllabus reviewing diagnostic features and differential diagnoses, and a comprehensive reference list will be available prior to the meeting. All course registrants will also receive web access to the PowerPoint presented at the USCAP Annual Meeting along with the text portion of the syllabus. Upon completion of this educational activity, participants should be able to:

  1. Interact effectively with a surgeon for optimal intraoperative management.
  2. Understand the limitations of head and neck frozen section diagnoses, and when to defer, as well as instances where a frozen section is contraindicated.
  3. Identify differential diagnoses of squamous mucosal lesions and evaluation of the resection margins
  4. .
  5. Separate squamous carcinoma from its mimickers.
  6. Define the classification of salivary gland tumors, using an algorithmic approach to analyze major diagnostic features such as the low power growth pattern, the number of tumor cell types, cytologic atypia, etc. Pleomorphic adenoma, oncocytoma, Warthin tumor, mucoepidermoid carcinoma, adenoid cystic carcinoma, polymorphous low-grade adenocarcinoma, salivary duct carcinoma, myoepithelial carcinoma, etc. will be discussed.
  7. Handle small blue cell tumors in the head and neck area.
  8. Distinguish a benign primary cystic lesion from a metastatic well-differentiated squamous carcinoma in a neck lymph node.
  9. Recognize head and neck presentations of intracranial lesions such as meningioma and ectopic CNS tissue.
  10. Understand frozen section diagnostic implications, pitfalls, and pearls in thyroid nodules and parathyroid glands.

Session Credits: CME = 3 / SAMs = N/A


SC Speaker
Speaker: Qihui "Jim" Zhai, MD, Mayo Clinic-Florida, Jacksonville, FL
Access to Handouts
SC Speaker
Speaker: Yash Patil, MD, University of Cincinnati, Cincinnati, OH


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