Chandra is the accomplished surgeon in our motley crew of 3. He is quite knowledgeable and I was fortunate enough to hear these wise words from him today.
"Why would you want to do a Frozen Section on a Thyroid perioperatively? It is futile. What you are trying to distinguish with a frozen section is papillary from follicular. The only way you can say that it is papillary is by looking at Orphan Annie eyed nuclei (OAN). But OAN is a histological artifact which is formed due to paraffin accumulation while fixing the slide. Since there is no paraffin involved in the making of the frozen section, you cannot diagnose papillary carcinoma from follicular.
"What about follicular? Well, whether benign or malignant, the frozen section will show follicular cells only. What you need to identify it as carcinoma is evidence of tissue invasion which, again cannot be judged on frozen section. Hence, that is out too."
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