[2101] Frozen Section – Permanent Correlation: An Audit of 3950 Cases

Maureen Metcalfe, Xianyong Gui, Jeffery T Joseph, Alfredo Pinto, Travis Ogilvie, Zuhua Gao. University of Calgary and Calgary Laboratory Services, Calgary, AB, Canada

Background: The correlation of intra-operative frozen section diagnosis with the final diagnosis on permanent sections is an integral part of quality assurance in anatomical pathology laboratories.
Design: We reviewed the slides and reports of 3950 cases of frozen sections and corresponding permanent sections including those from Surgical Pathology, Neuropathology and Paediatric Pathology practices. The types of discrepancies were classified based on the criteria set by the Association of Directors of Anatomic and Surgical Pathology. Reasons for discrepancies were analyzed.
Results: Summary of Correlation data.

Results
 NeuropathPediatricsSurgpathTotal
Total reviewed22519035353950
Agreement212 (94.2%)141 (74.2%)3196 (90%)3549 (89.9%)
Deferred -appropriate3 (1.3%)36 (18.9%)106 (3.0%)145 (3.7%)
Deferred -inappropriate, minor1 (0.4%)04 (0.1)5 (0.1%)
Deferred -inappropriate, major2 (0.9%)002 (0.0%)
Discordance -minor4 (1.8%)0127 (3.6%)131 (3.3%)
Discordance major1 (0.4%)2 (1.0%)75 (2.1%)78 (2.0%)
Reasons    
Block sampling0051 (1.4%)51 (1.3%)
Specimen sampling4 (1.8%)021 (0.6%)25 (0.6%)
Technical inadequacy002 (0.0%)2 (0.0%)
Lack of Clinical data0000
Interpretation1 (0.4%)9 (4.7%)104 (2.9%)114 (2.9%)
Other1 (0.4%)001 (0.0%)
     



Conclusions: Specimen sampling errors were more common in Neuropath cases likely due to surgical difficulties in accessing the tumor tissue. Deferrals and interpretation errors were more common in paediatric cases, caused by high frequency of small round cell tumors and congenital disorders that was difficult to diagnose in the intraoperative setting. Lessons learned from detailed analysis of the data could help to reduce errors, reduce the number of deferrals and improve the accuracy of frozen section diagnosis.
Category: Quality Assurance

Monday, March 19, 2012 1:00 PM

Poster Session II # 245, Monday Afternoon

 

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