Outpatient frozen sections by telepathology in a Veterans Administration Medical Center

A relatively simple telepathology system is described for evaluating the ma rgins of excision of cutaneous basal and squamous carcinomas. The system us es a microscope with a built-in television camera, but no eyepieces. The im age is projected onto an adjacent monitor and transmitted by T1 line at 768 KCbs to a remote, large screen monitor. The microscope is operated by the surgeon under the telephone direction of the pathologist at the remote site . In a series of 66 cases involving more than 400 individual tissue blocks, we have had only 2 cases with false-negative interpretations and 2 in whic h the block was not fully displayed on the frozen section. In 15 cases, 1 o r more surgical margins were positive, and the surgeon proceeded to excise additional tissue. Our success is attributed to dedicated involvement by th e surgeon, very high-quality frozen sections, and the experience of the pat hologist. Copyright (C) 2000 by W.B. Saunders Company.