Frozen section examination of liver, gallbladder, and pancreas.
BACKGROUND
Frozen section of the liver is a comparatively frequent request that most often applies to a relatively limited number of situations. The only indication for frozen tissue examination of a gallbladder with any frequency is the presence of a polypoid mucosal lesion or a suspicious thickening of the gallbladder wall. A variety of intraoperative consultations may be applicable during surgery of the pancreas.


OBJECTIVE
To examine the indications and pitfalls regarding the gross examination and frozen section performance for liver, gallbladder, and pancreas.


METHODS
Author experience and review of the pertinent literature.


CONCLUSIONS
Although indications are relatively straightforward for frozen section of liver and gallbladder, handling of the pancreas specimens for frozen tissue examination is often a cause for a certain degree of anxiety. This situation is the result of a relative rarity of such specimens outside large tertiary referral medical centers coupled with a variety of confounding factors, including the presence of chronic pancreatitis with distortion of the normal structures and the frequent presence of variable degrees of dysplasia. The suboptimal preservation of the frozen tissue adds further angst to the scenario. In this article, the main issues are critically examined in light of the experience of the author and others.
Lechago
Juan
J
Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA. lechagoj@cshs.org
D005629:Frozen Sections; D005705:Gallbladder Diseases / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D007432:Intraoperative Period; D008107:Liver Diseases / Q000175:diagnosis* / Q000601:surgery; D010182:Pancreatic Diseases / Q000175:diagnosis* / Q000601:surgery; D010340:Pathology, Surgical / Q000379:methods*; D012017:Referral and Consultation