Pulmonary Sclerosing Pneumocytoma Remains a Diagnostic Challenge using Frozen Sections: A Clinicopathological Analysis of 59 Cases

Abstract

Aims

Using intraoperative frozen sections to diagnose pulmonary sclerosing pneumocytoma is always challenging. However, an accurate diagnosis is needed to guide surgical management and prevent unnecessary treatment. The aim of this study was to investigate the most frequently misdiagnosed histological patterns and evaluate the potential diagnostic pitfalls of using frozen sections.

Methods and results

We retrospectively reviewed 59 cases of sclerosing pneumocytoma that underwent an intraoperative frozen section examination. All original frozen section slides and permanent section slides were reviewed. The rate of accurate diagnosis using frozen sections was 44.1%, the deferral rate was 15.3%, and 10 cases (16.9%) were misdiagnosed as malignancy. A solid-predominant pattern is more frequently misdiagnosed than other growth patterns. We also summarized the five major diagnostic pitfalls, including hypercellularity, glandular spaces, desmoplasia-like sclerosis, cellular atypia and coagulative necrosis.

Conclusions

In addition to evaluating the tumour circumscription and identifying the various growth patterns, we propose that the key to avoiding a misdiagnosis is to recognize the dual-cell populations in a tumour, i.e., cuboidal surface cells and stromal round cells.

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from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2wKEgON