Freezing artifacts in a lymph node with Hodgkin's disease

Histopathologists face various types of artifacts in day-to-day practice, which often hinders the actual diagnosis. A case is presented in which a staff member left a lymph node biopsy in the freezer compartment overnight. Histopathology of this biopsy revealed large vacuolated cells. A long list of differential diagnoses was entertained, ranging from metastatic deposits of a carcinoma to an inflammatory lesion. However, it was determined that the vacuolation was caused by freezing artifacts. A rebiopsy was performed, which confirmed a diagnosis of Hodgkin's disease. Artifacts can cause difficulty in diagnosis and a pathologist should be aware of them. The supporting staff should be trained on preserving specimens that are received after working hours.