Frozen Section Library: Genitourinary Tract (eBook)
XII, 178 Seiten
Springer New York (Verlag)
978-1-4419-0691-5 (ISBN)
Frozen sections are performed for the purpose of rapid diagnosis while a patient is undergoing surgery, usually under general anesthesia, as a basis for making immediate treatment decisions. Therefore, frozen section diagnosis is often a highly demanding situation for the pathologist who must render a diagnosis quickly and a crucial determination for the patient and surgeon. In addition to the need for rapid recall of differential diagnoses, there are many pitfalls and artifacts that add to the risk of frozen section diagnosis that are not present with permanent sections of fully processed tissues that can be examined in a more leisurely fashion. Most standard pathology textbooks, both general and subspecialty, largely ignore the topic of frozen section. Few textbooks have ever focused exclusively on frozen section diagnosis and those textbooks that have done so are now out-of-date and have limited numbers of black and white figures. None has emphasized the education of the surgeon in terms of frozen section benefits, limitations or proper utilization.
The Frozen Section Library series will provide convenient, user-friendly handbooks for each organ system to expedite use in the hurried frozen section situation. These books will be small and light-weight, copiously color illustrated with images of actual frozen sections, highlighting pitfalls, artifacts and differential diagnosis. These books will also include perspectives for the surgeon and for communication with the surgeon and suggest ancillary procedures (for example, when to take tissue for microbiology cultures). Each 5 X 8 book is estimated to be about 200 to 250 pages in toto with 100 to 150 color figures each.
As a handbook for practicing pathologists, these books will be indispensable aids to diagnosis and avoiding dangers in one of the most challenging situations that pathologists encounter. Problems, such as differentiation of benign processes from malignant neoplasms which may be more difficult on frozen section than permanent section and which have a serious impact on the surgeon's immediate treatment decisions, will be emphasized. Rapid consideration of differential diagnoses and how to avoid traps caused by frozen section artifacts will be readily accessible to the users of the handbooks. A series of concise, easy-to-use, well-illustrated handbooks alleviates the often frustrating and time-consuming, sometimes futile, process of searching through bulky textbooks that are unlikely to illustrate or discuss pathologic diagnoses from the perspective of frozen
sections in the first place. Tables and charts will provide guidance for differential diagnosis of various histologic patterns.
The advantages of a series of organ-specific handbooks, in addition to the ease-of-use and manageable size, is that (1) it allows more comprehensive coverage of more diagnoses, both common and rare, than a single volume that tries to highlight a limited number of diagnoses for each organ and (2) it allows more detailed insight by permitting experienced authorities to emphasize the peculiarities of frozen section for each organ system. Although some differences in practice of frozen section exist between different institutions, such as differing policies regarding whether or not to perform frozen section on specific types of specimens, these differences are generally not significant and can be discussed ( an organ-specific handbook by an expert in that organ system permits more opportunity for this type of discussion). Touch preparations, which are used for some organs such as central nervous system or thyroid more often than others, will be appropriately emphasized and illustrated according to the need for each specific organ.
This series will be highly valuable to practicing surgical pathologists, both community and academic, and to pathology residents and fellows. The perspectives provided will also be valuable to surgeons and especially to surgery residents and fellows who must answer questions about pathology and frozen section on their board examinations. These handbooks will be easily portable by the individual but it is envisioned that many departments will want to also keep a series readily available in the frozen section laboratory.
Frozen sections are performed for the purpose of rapid diagnosis while a patient is undergoing surgery, usually under general anesthesia, as a basis for making immediate treatment decisions. Therefore, frozen section diagnosis is often a highly demanding situation for the pathologist who must render a diagnosis quickly and a crucial determination for the patient and surgeon. In addition to the need for rapid recall of differential diagnoses, there are many pitfalls and artifacts that add to the risk of frozen section diagnosis that are not present with permanent sections of fully processed tissues that can be examined in a more leisurely fashion. Most standard pathology textbooks, both general and subspecialty, largely ignore the topic of frozen section. Few textbooks have ever focused exclusively on frozen section diagnosis and those textbooks that have done so are now out-of-date and have limited numbers of black and white figures. None has emphasized the education of the surgeon in terms of frozen section benefits, limitations or proper utilization. The Frozen Section Library series will provide convenient, user-friendly handbooks for each organ system to expedite use in the hurried frozen section situation. These books will be small and light-weight, copiously color illustrated with images of actual frozen sections, highlighting pitfalls, artifacts and differential diagnosis. These books will also include perspectives for the surgeon and for communication with the surgeon and suggest ancillary procedures (for example, when to take tissue for microbiology cultures). Each 5 X 8 book is estimated to be about 200 to 250 pages in toto with 100 to 150 color figures each.As a handbook for practicing pathologists, these books will be indispensable aids to diagnosis and avoiding dangers in one of the most challenging situations that pathologists encounter. Problems, such as differentiation of benign processes from malignant neoplasms which may be more difficult on frozen section than permanent section and which have a serious impact on the surgeon's immediate treatment decisions, will be emphasized. Rapid consideration of differential diagnoses and how to avoid traps caused by frozen section artifacts will be readily accessible to the users of the handbooks. A series of concise, easy-to-use, well-illustrated handbooks alleviates the often frustrating and time-consuming, sometimes futile, process of searching through bulky textbooks that are unlikely to illustrate or discuss pathologic diagnoses from the perspective of frozen sections in the first place. Tables and charts will provide guidance for differential diagnosis of various histologic patterns.The advantages of a series of organ-specific handbooks, in addition to the ease-of-use and manageable size, is that (1) it allows more comprehensive coverage of more diagnoses, both common and rare, than a single volume that tries to highlight a limited number of diagnoses for each organ and (2) it allows more detailed insight by permitting experienced authorities to emphasize the peculiarities of frozen section for each organ system. Although some differences in practice of frozen section exist between different institutions, such as differing policies regarding whether or not to perform frozen section on specific types of specimens, these differences are generally not significant and can be discussed ( an organ-specific handbook by an expert in that organ system permits more opportunity for this type of discussion). Touch preparations, which are used for some organs such as central nervous system or thyroid more often than others, will be appropriately emphasized and illustrated according to the need for each specific organ. This series will be highly valuable to practicing surgical pathologists, both community and academic, and to pathology residents and fellows. The perspectives provided will also be valuable to surgeons and especially to surgery residents and fellows who must answer questions about pathology and frozen section on their board examinations. These handbooks will be easily portable by the individual but it is envisioned that many departments will want to also keep a series readily available in the frozen section laboratory.
Frozen Section Library: Genitourinary Tract 2
Series Preface 4
Preface 6
Contents 8
Contributors 9
Chapter 1 10
Kidney 10
REASONS FOR INTRAOPERATIVE PATHOLOGY CONSULTATION 10
GROSS CONSULTATION 10
Clinical Background 10
Interpretation 12
FROZEN SECTION TO ESTABLISH A DEFINITIVE DIAGNOSIS OF A RENAL MASS 12
Clinical Background 12
Specimen Handling 16
Interpretation 16
The Diagnosis of RCC and Its Histological Subtypes 16
Differential Diagnoses of Clear Cell RCC, XGP, and Malakoplakia 20
Oncocytoma and Chromophobe RCC 25
Angiomyolipoma 26
FROZEN SECTION FOR CLINICALLY SUSPECTED UROTHELIAL CARCINOMA AND URETER/BLADDER CUFF SURGICAL MARGIN 34
Clinical Background 34
Specimen Handling 35
1.4.3. Interpretations 37
FROZEN SECTION TO EVALUATE A CYSTIC RENAL MASS 39
Clinical Background 39
Specimen Handling 39
Interpretation 39
PARTIAL NEPHRECTOMY SPECIMENS 44
Clinical Background 44
Specimen Handling 48
Interpretation 49
MULTIPLE RENAL MASSES AND EXTRARENAL MASSES 52
Clinical Background 52
Interpretation 52
Satellite Tumor Nodules in RCC 52
Multiple Renal Masses of the Same Histological Type 53
Multiple Renal Masses of Different Histological Types 53
Renal Tumors in VHL Syndrome 53
Primary Renal Lymphoma 54
Lymph Nodes 56
Extrarenal Masses 57
NEEDLE BIOPSY OF NATIVE OR TRANSPLANTED KIDNEYS 58
Clinical Background 58
Specimen Handling 58
Interpretation 58
DONORS’ KIDNEYS 60
Clinical Background 60
Specimen Handling 61
Interpretation 61
Chapter 2 69
Urinary Bladder, Ureter, and Urethra 69
REASONS FOR INTRAOPERATIVE PATHOLOGY CONSULTATION 69
EVALUATION OF THE SURGICAL MARGINS DURING RADICAL CYSTECTOMY OR CYSTOPROSTATECTOMY 70
Clinical Background 70
Ureteral Margin 71
Urethral Margin 71
Perivesical Soft Tissue Margin 71
Specimen Handling 71
Interpretation 71
EVALUATION OF THE SURGICAL MARGINS DURING PARTIAL CYSTECTOMY 87
Clinical Background 87
Specimen Handling 87
Interpretation 89
EXTRAVESICAL OR BLADDER PERITONEAL NODULES OR MASSES 89
Clinical Background 89
Specimen Handling 90
Interpretation 90
FROZEN SECTION DIAGNOSIS OF BLADDER LESIONS 90
Clinical Background 90
Specimen Handling 90
Interpretation 90
FROZEN SECTION DIAGNOSIS OF BLADDER NECK TISSUE IN RADICAL PROSTATECTOMY FOR PROSTATE ADENOCARCINOMA 97
Clinical Background 97
Specimen Handling 97
Interpretation 97
EVALUATION OF THE LYMPH NODES DURING CYSTECTOMY 98
Clinical Background 98
Specimen Handling 98
Chapter 3 102
Penis 102
INDICATIONS FOR INTRAOPERATIVE PATHOLOGY CONSULTATION 102
EVALUATION OF THE SURGICAL MARGINS FOR PARTIAL OR TOTAL PENECTOMY SPECIMENS 102
Clinical Background 102
Specimen Handling 103
Interpretation 104
Evaluation of Lymph Nodes During Penectomy 120
Clinical Background 120
Specimen Handling 120
Interpretation 120
Chapter 4 122
Prostate 122
REASONS FOR INTRAOPERATIVE PATHOLOGY CONSULTATION 122
EVALUATION OF THE SURGICAL MARGINS 122
Clinical Background 122
Specimen Handling 123
Interpretation 124
EVALUATION OF PELVIC LYMPH NODES DURING RADICAL PROSTATECTOMY 132
Clinical Background 132
Specimen Handling 133
Interpretation 133
FROZEN SECTION DIAGNOSIS OF ADENOCARCINOMA IN PROSTATES FROM ORGAN DONORS 135
Clinical Background 135
Specimen Handling 137
Interpretation 137
FROZEN SECTION DIAGNOSIS OF ADENOCARCINOMA IN PROSTATIC TRANSURETHRAL RESECTION SPECIMENS, OR SIMPLE PROSTATECTOMY SPECIMENS 139
Clinical Background 139
Specimen Handling 140
Interpretation: Diagnosis of Well Differentiated Prostate Carcinoma 140
Diagnosis of High-Grade Prostatic Carcinoma 142
Chapter 5 143
Testis 143
REASONS FOR INTRAOPERATIVE CONSULTATION 143
GROSS CONSULTATION ON RADICAL ORCHIECTOMY SPECIMEN 143
Clinical Background 143
Specimen Handling 144
Interpretation 144
FROZEN SECTION CONSULTATION FOR A SPECIFIC DIAGNOSISPRIOR TO SURGERY FOR POSSIBLE TESTIS-SPARING OPERATION 145
Clinical Background 145
Specimen Handling 147
Interpretation 149
GROSS CONSULTATION/FROZEN SECTION OF LYMPH NODES IN RETROPERITONEAL NODAL DISSECTION 157
Clinical Background 157
Specimen Handling 159
Interpretation 159
FROZEN SECTION/TOUCH PREPARATION OF TESTICULAR BIOPSY IN THE CONTEXT OF MANAGEMENT OF INFERTILITY 159
Clinical Background 159
Specimen Handling 161
Interpretation 161
EXAMINATION OF THE VASAL FLUID DURING VASECTOMY REVERSAL 161
Clinical Background 161
Specimen Handling 161
5.6.3 Interpretation 165
References 166
Index 176
| Erscheint lt. Verlag | 3.10.2009 |
|---|---|
| Reihe/Serie | Frozen Section Library | Frozen Section Library |
| Mitarbeit |
Herausgeber (Serie): Philip T. Cagle |
| Zusatzinfo | XII, 178 p. 174 illus. in color. |
| Verlagsort | New York |
| Sprache | englisch |
| Themenwelt | Medizin / Pharmazie ► Medizinische Fachgebiete ► Urologie |
| Studium ► 2. Studienabschnitt (Klinik) ► Pathologie | |
| Schlagworte | Differential Diagnosis • kidney • Penis • Prostate • Surgery • Testis • tissue • urinary bladder |
| ISBN-10 | 1-4419-0691-6 / 1441906916 |
| ISBN-13 | 978-1-4419-0691-5 / 9781441906915 |
| Haben Sie eine Frage zum Produkt? |
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