The Best Post of January, 2008

An installment of my "best post" series:
The best neuropathologyblog post in January of 2008 presented frozen section room rules as described by Dr. Mark Cohen of Case Western in his seminar called "Neuropath@Nite – Staying Cool in the Frozen Room”. The seminar, presented at the annual College of American Pathologists meeting in October of 2007, was conducted in collaboration with Dr. Joe Parisi of the Mayo Clinic.

Here are Frozen Room Rules to live by:
1. You, and you alone, know if you need more tissue to make an intraoperative diagnosis.

2. When misdiagnosing a lesion, always strive to do the least amount of harm!

3. Lipid-laden macrophages are very strong evidence against the presence of a glioma.

4. Rule number 2 trumps rule number 3 (explained as: “It is easier to reoperate on a patient with a glioma initially misdiagnosed as a tumor-like demyelinating lesion, than replace resected demyelinated tissue initially misdiagnosed as gliomas.”)