- Intraoperative Frozen Cytology of Central Nervous System Neoplasms: An Ancillary Tool for Frozen Diagnosis
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Myunghee Kang, Dong Hae Chung, Na Rae Kim, Hyun Yee Cho, Seung Yeon Ha, Sangho Lee, Jungsuk An, Jae Yeon Seok, Gie-Taek Yie, Chan Jong Yoo, Sang Gu Lee, Eun Young Kim, Woo Kyung Kim, Seong Son, Sun Jin Sym, Dong Bok Shin, Hee Young Hwang, Eung Yeop Kim, Kyu Chan Lee
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J Pathol Transl Med. 2019;53(2):104-111. Published online January 14, 2019
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DOI: https://doi.org/10.4132/jptm.2018.11.10
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- Background
Pathologic diagnosis of central nervous system (CNS) neoplasms is made by comparing light microscopic, immunohistochemical, and molecular cytogenetic findings with clinicoradiologic observations. Intraoperative frozen cytology smears can improve the diagnostic accuracy for CNS neoplasms. Here, we evaluate the diagnostic value of cytology in frozen diagnoses of CNS neoplasms.
Methods Cases were selected from patients undergoing both frozen cytology and frozen sections. Diagnostic accuracy was evaluated.
Results Four hundred and fifty-four cases were included in this retrospective single-center review study covering a span of 10 years. Five discrepant cases (1.1%) were found after excluding 53 deferred cases (31 cases of tentative diagnosis, 22 cases of inadequate frozen sampling). A total of 346 cases of complete concordance and 50 cases of partial concordance were classified as not discordant cases in the present study. Diagnostic accuracy of intraoperative frozen diagnosis was 87.2%, and the accuracy was 98.8% after excluding deferred cases. Discrepancies between frozen and permanent diagnoses (n = 5, 1.1%) were found in cases of nonrepresentative sampling (n = 2) and misinterpretation (n = 3). High concordance was observed more frequently in meningeal tumors (97/98, 99%), metastatic brain tumors (51/52, 98.1%), pituitary adenomas (86/89, 96.6%), schwannomas (45/47, 95.8%), high-grade astrocytic tumors (47/58, 81%), low grade astrocytic tumors (10/13, 76.9%), non-neoplastic lesions (23/36, 63.9%), in decreasing frequency.
Conclusions Using intraoperative cytology and frozen sections of CNS tumors is a highly accurate diagnostic ancillary method, providing subtyping of CNS neoplasms, especially in frequently encountered entities.
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Citations
Citations to this article as recorded by 
- Intraoperative Integrated Diagnostic System for Malignant Central Nervous System Tumors
Takahiro Hayashi, Kensuke Tateishi, Shinichiro Matsuyama, Hiromichi Iwashita, Yohei Miyake, Akito Oshima, Hirokuni Honma, Jo Sasame, Katsuhiro Takabayashi, Kyoka Sugino, Emi Hirata, Naoko Udaka, Yuko Matsushita, Ikuma Kato, Hiroaki Hayashi, Taishi Nakamur Clinical Cancer Research.2024; 30(1): 116. CrossRef - A multicenter proof-of-concept study on deep learning-based intraoperative discrimination of primary central nervous system lymphoma
Xinke Zhang, Zihan Zhao, Ruixuan Wang, Haohua Chen, Xueyi Zheng, Lili Liu, Lilong Lan, Peng Li, Shuyang Wu, Qinghua Cao, Rongzhen Luo, Wanming Hu, Shanshan lyu, Zhengyu Zhang, Dan Xie, Yaping Ye, Yu Wang, Muyan Cai Nature Communications.2024;[Epub] CrossRef - Advancements in Neurosurgical Intraoperative Histology
Ali A. Mohamed, Emma Sargent, Cooper Williams, Zev Karve, Karthik Nair, Brandon Lucke-Wold Tomography.2024; 10(5): 693. CrossRef - Unveiling the potential application of intraoperative brain smear for brain tumor diagnosis in low-middle-income countries: A comprehensive systematic review
Muhammad Shakir, Ahmed Altaf, Hawra Hussain, Syed Muhammad Aqeel Abidi, Zoey Petitt, Mahnoor Tariq, Ahmed Gilani, S. Ather Enam Surgical Neurology International.2023; 14: 325. CrossRef - A Comparative Study of Squash Smear Cytology Diagnosis and Radiological Diagnosis with Histopathology in Central Nervous System Lesions
B N Kumarguru, G Santhipriya, S Kranthi Kumar, R Ramesh Kumar, A S Ramaswamy, P Janakiraman Journal of Cytology.2022; 39(1): 1. CrossRef - Intraoperative squash cytology provides a qualitative intraoperative diagnosis for cases in which frozen section yields a diagnosis of equivocal brain tumour
Hirotaka Fujita, Takuma Tajiri, Tomohisa Machida, Nozomi Nomura, Suguru Toguchi, Hitoshi Itoh, Shinichiro Hiraiwa, Tomoko Sugiyama, Masaaki Imai, Shinri Oda, Masami Shimoda, Naoya Nakamura Cytopathology.2020; 31(2): 106. CrossRef - Intraoperative frozen cytology of intraosseous cystic meningioma in the sphenoid bone
Na Rae Kim, Gie-Taek Yie Journal of Pathology and Translational Medicine.2020; 54(6): 508. CrossRef - Use of 5-Aminolevulinic Acid for Confirmation of Lesional Biopsy Sample in Presumed High-Grade Glioma
Victoria L. Watson, Jeffrey W. Cozzens World Neurosurgery.2019; 132: 21. CrossRef
- Ectomesenchymal Chondromyxoid Tumor in the Anterior Tongue: Case Report of a Unique Tumor
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Min Gyoung Pak, Kyung Bin Kim, Nari Shin, Woo Kyung Kim, Dong Hoon Shin, Kyung Un Choi, Mee Young Sol
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Korean J Pathol. 2012;46(2):192-196. Published online April 25, 2012
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DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.2.192
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7,848
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Ectomesenchymal chondromyxoid tumor (ECMT) is a rare tumor, exclusively arising in the anterior tongue. Thirty-eight cases have been reported in the English literature. It usually presents as a sessile protrusion and shows round to spindle cells embedded in myxoid to chondroid stroma. Tumor cells are almost always positive for polyclonal glial fibrillary acidic protein (GFAP). We report our experience in the recent treatment of a case of ECMT, the third case in 3 years. The mass in the anterior tongue revealed characteristic morphologic features of ECMT and the expression of polyclonal GFAP. Although ECMT should be differentiated from other mesenchymal tumors including myoepithelioma, its clinical, morphological, and immunohistochemical features enable its diagnosis, especially when pathologists are aware of it.
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Citations
Citations to this article as recorded by 
- Ectomesenchymal chondromyxoid tumor of the oral cavity: a report of 5 new cases with comprehensive review of the literature and clinicohistopathologic features
Molly Housley Smith, Jack Moynihan Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology.2023; 135(3): 410. CrossRef - Chondroid choristoma of the tongue
Sumaiya Nezam, Roquaiya Nishat, Shabab Ahmed Khan, Jeevendra Nath Shukla National Journal of Maxillofacial Surgery.2022; 13(Suppl 1): S121. CrossRef - Ectomesenchymal chondromyxoid tumor: a comprehensive updated review of the literature and case report
Astrid Truschnegg, Stephan Acham, Lumnije Kqiku, Norbert Jakse, Alfred Beham International Journal of Oral Science.2018;[Epub] CrossRef - Clinical features of ectomesenchymal chondromyxoid tumors: A systematic review of the literature
Masanari G. Kato, Evren Erkul, Kendall S. Brewer, Emily E. Harruff, Shaun A. Nguyen, Terry A. Day Oral Oncology.2017; 67: 192. CrossRef - Cyclin D1 Expression in Ectomesenchymal Chondromyxoid Tumor of the Anterior Tongue
Jan Laco, Radovan Mottl, Walter Höbling, Stephan Ihrler, Petr Grossmann, Alena Skalova, Ales Ryska International Journal of Surgical Pathology.2016; 24(7): 586. CrossRef - Nodular lesion in the buccal mucosa
Bruna Jalfim Maraschin, Ana Carolina Amorim Pellicioli, Lélia Batista de Souza, Pantelis Varvaki Rados, Marco Antonio Trevizani Martins, Manoela Domingues Martins The Journal of the American Dental Association.2015; 146(3): 196. CrossRef
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