Frozen Section Library: Appendix, Colon, and Anus (Frozen Section Library (4))

Frozen sections are performed while a patient is undergoing surgery as a basis for making an immediate diagnosis that will impact treatment decisions. Frozen section diagnosis is often a highly demanding situation for the pathologist who must render a diagnosis quickly for the patient and surgeon.The Frozen Section Library Series will provide concise, user-friendly, site specific handbooks that are well-illustrated and highlight the pitfalls, artifacts, and differential diagnosis issues that arise in the hurried frozen section scenario. Nicole C. Panarelli, MD is affiliated with Weill Medical College of Cornell University, New York, NY and New York Presbyterian Hospital, New York, NY. Rhonda K. Yantiss, MD is Associate Professor of Pathology and Laboratory Medicine at Weill Medical College of Cornell University, New York, NY. Preface 5 Series Preface 6 Contents 8 1 Intraoperative Evaluation of Colorectal Specimens Containing Cancer 9 Introduction 9 Assessing Local Extent of Colorectal Carcinoma 10 Assessing Lymph Node Status 20 Evaluation of Resection Margins 20 Implications of Neoadjuvant Therapy 25 References 28 2 Intraoperative Evaluation for Extracolonic Disease in Colon Cancer Patients 29 Introduction 29 Liver Metastases 30 Gross Features 30 Microscopic Features 30 Differential Diagnosis 31 Peritoneal Disease 33 Differential Diagnosis 36 References 40 3 Metastases and Mimics of Colorectal Carcinoma 42 Introduction 42 Primary Colorectal Cancer Versus Secondary Malignancies of the Colon 43 Gross Features of Colorectal Carcinoma 43 Microscopic Features of Colorectal Carcinoma 44 Gross Features Suggestive of a Secondary Neoplasm 46 Microscopic Features Suggestive of a Secondary Neoplasm 48 Non-neoplastic Processes That Mimic Malignancy 53 Diverticular Disease Associated Colitis 57 Endometriosis 58 References 64 4 Non-epithelial Tumors of the Colorectum 65 Introduction 65 Mesenchymal Lesions 66 Gastrointestinal Stromal Tumor 66 Intra-abdominal Fibromatosis 67 Hematopoetic Neoplasms 72 References 81 5 Frozen Section Assessment of the Colorectum in the Pediatric Population 82 Introduction 82 Hirschsprungs Disease 83 Hypoganglionosis 85 Intestinal Neuronal Dysplasia 87 References 88 6 Frozen Section Evaluation of the Appendix 90 Introduction 90 Appendicitis 91 Appendiceal Mucinous Neoplasms 92 Non-mucinous Appendiceal Epithelial Neoplasms 106 Endocrine Neoplasms of the Appendix 107 References 116 7 Frozen Section Evaluation of Anal Disease 117 Introduction 117 Pagets Disease 118 Squamous Cell Carcinoma 122 References 127 Index 128 Frozen sections are performed while a patient is undergoing surgery as a basis for making an immediate diagnosis that will impact treatment decisions. Frozen section diagnosis is often a highly demanding situation for the pathologist who must render a diagnosis quickly for the patient and surgeon. The Frozen Section Library Series will provide concise, user-friendly, site specific handbooks that are well-illustrated and highlight the pitfalls, artifacts, and differential diagnosis issues that arise in the hurried frozen section scenario. Nicole C. Panarelli, MD is affiliated with Weill Medical College of Cornell University, New York, NY and New York Presbyterian Hospital, New York, NY. Rhonda K. Yantiss, MD is Associate Professor of Pathology and Laboratory Medicine at Weill Medical College of Cornell University, New York, NY Front Matter....Pages i-ix Intraoperative Evaluation of Colorectal Specimens Containing Cancer....Pages 1-20 Intraoperative Evaluation for Extracolonic Disease in Colon Cancer Patients....Pages 21-33 Metastases and Mimics of Colorectal Carcinoma....Pages 35-57 Non-epithelial Tumors of the Colorectum....Pages 59-75 Frozen Section Assessment of the Colorectum in the Pediatric Population....Pages 77-84 Frozen Section Evaluation of the Appendix....Pages 85-111 Frozen Section Evaluation of Anal Disease....Pages 113-123 Back Matter....Pages 125-136 As a handbook for practicing pathologists, this book will be an indispensable aid to diagnosis and avoiding dangers in one of the most challenging situations that pathologists encounter. Rapid consideration of differential diagnoses and how to avoid traps caused by frozen section artifacts will be readily accessible to the users of this handbook. Currently, there is no other up-to-date single-source reference specifically focused on frozen sections of the lower gastrointestinal tract.