Frozen section of thyroid and parathyroid specimens

Arch Pathol Lab Med. 2005 Dec;129(12):1575-84. doi: 10.5858/2005-129-1575-FSOTAP.


Context: Preoperative fine-needle aspiration of thyroid lesions has greatly diminished the need for surgical evaluation. However, because thyroid nodules are common lesions, many still require surgical intervention and represent a substantial number of cases that the pathologist encounters in the frozen section laboratory.

Objective: Comprehensive reviews of frozen section indications, as well as gross, cytologic, and histologic features of the most common and diagnostically important thyroid and parathyroid lesions, are presented to provide a guideline for proper triage and management of these cases in the frozen section laboratory. The most common pitfalls are discussed in an attempt to avoid discordant diagnoses.

Data sources: Thyroid lobectomy, subtotal or total thyroidectomy, and parathyroid biopsy or parathyroidectomy cases are included in this review.

Conclusions: The frozen section evaluation of thyroid and parathyroid lesions remains a highly accurate procedure with a low false-positive rate. Gross inspection, complemented by cytologic and histologic review, provides the surgeon with the rapid, reliable, cost-effective information necessary for optimum patient care.

Publication types

  • Review

MeSH terms

  • Diagnosis, Differential
  • Diagnostic Errors / prevention & control
  • Frozen Sections*
  • Humans
  • Parathyroid Diseases / diagnosis*
  • Parathyroid Diseases / surgery
  • Parathyroid Glands / pathology*
  • Parathyroid Glands / surgery
  • Pathology, Surgical / methods*
  • Practice Guidelines as Topic
  • Reproducibility of Results
  • Thyroid Diseases / diagnosis*
  • Thyroid Diseases / surgery
  • Thyroid Gland / pathology*
  • Thyroid Gland / surgery