Efficacy of Frozen Section in Rapid Diagnosis of Central Nervous System Neoplasms: An Experience in A Tertiary Health Care Center in Eastern Odisha.

Objective: The primary goal of the intraoperative Frozen Section biopsy in a clinically suspected Central Nervous System (CNS) neoplasm is to evaluate the submitted tissue for rapid diagnosis, which helps in proper management during open craniotomy. In this study, the accuracy of frozen section in the diagnosis of CNS neoplasms and discrepancies in diagnosis were analyzed. Material & Methods: Ninety cases of CNS neoplasms were examined over a period of one year. All the cases were open biopsies performed at Neurosurgery Department &intra-operative frozen section (by cryostat) was performed & reported in the Histopathology section of a referral center in Eastern Odisha. The diagnoses given on FS were compared with the final diagnosis given on permanent paraffin embedded tissue sections. Results: In all cases, cryostat sections were prepared and a provisional diagnosis was given. Final histopathological diagnosis was given by studying the Hematoxylin & Eosin (H&E) section. Out of these 90 cases, 81 cases (90.0 %) were concordant, 9 cases (10.0 %) were discrepant. The discrepancies occur in mainly differentiating astrocytomas from oligodendrogliomas & schwannoma from meningioma along with few over-grading of glioma cases. Conclusion: Our results showed a reasonably high percentage of accuracy in the intraoperative diagnosis of CNS lesions. However, freezing artifact, obscuring cytological detail, heterogenous features of gliomas and lack of proper clinical inputs were the major causes for discrepancies. [ABSTRACT FROM AUTHOR]