Rapid Frozen Section Diagnosis

Abstract

Three factors contributed to the emergence of frozen sections as a rapid diagnostic method in the final decades of the nineteenth century. First, anaesthesia and aseptic techniques enabled surgeons to perform longer and more ambitious operations. Second, improvements in the optics of microscopes due to innovations such as the Abbe condenser and achromatic lenses made it possible for histologists to decipher the images of relatively inferior sections. Third, tissue preparation techniques had been considerably refined. Thus it became possible for surgeons to exploit the full diagnostic potential of histopathology actually during the course of surgical operations. Before about 1870, histological sections were cut by hand using razor blades; then the microtome appeared in histology laboratories, enabling better quality sections to be cut more rapidly; and with facilities for freezing and maintaining the tissues in a frozen State while being cut, it was possible to cut good sections almost immediately the tissue had been received in the laboratory (Wright 1985). The sections could be fixed rapidly in formalin (first reported as a fixative in 1893) before staining.