THE IMPORTANCE OF INTRAOPERATIVE HISTOPATHOLOGICAL EXAMINATION IN TYPING OF MALIGNITIES IN CASES TO BE OPERATED DUE TO PRIMARY LUNG CARCINOMA
Project no. 21896 · Status: Kapanmış · 2020
Summary
It is necessary to determine the diagnosis and subsequent treatment of lesions in the lung that are detected radiologically and cannot be diagnosed histopathologically in the preoperative period. Since the treatment schemes of small cell lung carcinoma (SCLC), non-small cell lung carcinoma (NSCLC) and NSCLC subtypes are different, the diagnosis obtained with the Frozen Section (FS) shapes the surgical step of treatment. In our study, 64 patients who were operated with a preliminary diagnosis of primary lung carcinoma without a histopathological diagnosis between January 2020 and June 2021 were evaluated prospectively. It was aimed to evaluate the diagnostic efficiency and interpretation accuracy of FS. While the diagnosis of NSCLC was determined by FS in 47 (92.1%) of 51 lesions reported to be malignant, subtyping was only possible as adenocarcinoma in 13 patients (25.4%) and squamous cell carcinoma in 5 patients (9.8%). 1 lesion (1.9%) without NSCLC was reported as SCLC, and 1 lesion (1.9%) was reported as lymphoma. According to these data, primary lung malignancy subtype was determined in 20 (39%) of 51 malignant patients with FS, and the surgical step of the treatment was planned. In all patient groups, after the diagnosis with FS was reported, there was no patient who had different results with Paraffin Block (PB). When the data were evaluated, it was observed that FS was able to distinguish benign-malignant with a higher rate and accuracy, but its power to discriminate in malignant cases was not very high. Although it has been shown that FS is sometimes insufficient in subtype discrimination in primary lung malignancy, it makes the distinction with 100% accuracy and continues to provide valuable contributions to the surgical team during the operation. For this reason, advanced frozen pathology examinations are necessary to avoid extra surgery.