Enhancing Cell Block Quality- A Comparative Study Of Formalin And Agar-Based Methods
Keywords:
Cellblock, formalin method, agar method
Abstract
Background: There are not many studies conducted in India to compare cell block preparation methods with reagents and materials that are readily available in all laboratories. This study aimed to standardize and compare two simple cell block techniques, which can be done in low resource settings too. In the study, 35 cases of thyroid, lymph node, and breast were collected for both FNA and cell block preparation for six months. Materials and Methods: There were separate passes given for both methods. A total of seventy cell blocks made using formalin and agar methods of preparation. Results: We compared both the methods on technical and morphological levels. The formalin method was overall easy to perform and was yielding good morphological results in 98% cases, the only drawback being cell loss during handling and processing. While in the agar method, there was almost no cell loss, but it was more technically difficult and yielded poorer morphological results. A scoring system was made for cellularity: no cells = 0, hypo-cellular = 1+, hypo-cellular with tissue fragments = 2+, cellular = 3+.18 A score of 2+ and 3+ was scored by 31/35 formalin blocks and 28/35 agar blocks. Conclusions: The sensitivity of both formalin and agar methods are almost comparable. However, the procedure of the formalin method is far more straightforward and user friendly. Moreover, it also provides a better architectural picture than the agar method.References
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12. Yang GC, Wan LS, Papellas J, Waisman J. Compact cell blocks: use for body fluids, fine needle aspirations and endometrial brush biopsies. Acta Cytol. 1998; 42:703-6.
13. Smedts F, Schrik M, Horn T, Hopman AH. Diagnostic value of processing cytologic aspirates of renal tumors in agar cell (tissue) blocks. Acta Cytol. 2010; 54:587-94.
14. Gorman BK, Kosarac O, Chakraborty S, Schwartz MR, Mody DR. Comparison of breast carcinoma prognostic/predictive biomarkers on cell blocks obtained by various methods: Cellient, formalin, and thrombin. Acta Cytol. 2012; 56:289–96.
15. Wagner DG, Russell DK, Benson JM, Schneider AE, Hoda RS, Bonfiglio TA. Cellient automated cell block versus traditional cell block preparation: a comparison of morphologic features and immunohistochemical staining. Diagn Cytopathol. 2011; 39:730–36.
16. Jing X, Li QK, Bedrossian U, and Michael CW. Morphologic and Immunocytochemical Performances of Effusion Cell Blocks Prepared Using 3 Different Methods. Am J Clin Pathol. 2013; 139:177-82.
17. Nigro K1, Tynski Z, Wasman J, Abdul-Karim F, Wang N. Comparison of cell block preparation methods for non-gynecologic ThinPrep specimens. Diagn Cytopathol. 2007; 35:640-3.
2. Deveci MS, Deveci G, LiVolsi VA, Baloch ZW. Fine-needle aspiration of follicular lesions of the thyroid. Diagnosis and follow- up. Cyto Journal. 2006; 3:9.
3. Sanchez N, Selvaggi SM. Utility of cell blocks in the diagnosis of thyroid aspirates. Diagn Cytopathol. 2006, 34:89-92.
4. Chen PK. Artifacts of cytology cell block in fine-needle aspiration biopsy of thyroid. Diagn Cytopathol. 2004, 31:362-3.
5. Shivakumarswamy U, Arakeri SU, Karigowdar MH, Yelikar B. Diagnostic utility of the cell block method versus the conventional smear study in pleural fluid cytology. J Cytol. 2012; 29:11–5.
6. Rowe LR, Marshall CJ, Bentz JS. Cell block preparation as an adjunctive diagnostic technique in ThinPrep monolayer preparations: a case report. Diagn Cytopathol. 2001; 24:142–4.
7. Akalin A, Lu D, Woda B, Moss L, Fischer A. Rapid cell blocks improve accuracy of breast FNAs beyond that provided by conventional cell blocks regardless of immediate adequacy evaluation. Diagn Cytopathol. 2008; 36:523–9.
8. Sethi S, Geng L, Shidham VB, Archuletta P, Bandyophadhyay S, Feng J, et al. Dual-color multiplex TTF-1 + napsin A and p63 + CK5 immunostaining for subcategorizing of poorly differentiated pulmonary non-small carcinomas into adenocarcinoma and squamous cell carcinoma in fine-needle aspiration specimens. Cyto Journal. 2012; 9:10.
9. Nathan NA, Narayan E, Smith MM, Horn MJ. Cellblock cytology: improved preparation and its efficacy in diagnostic cytology. Am J Clin Pathol. 2000; 114:599-6.
10. Kulkarni MB, Desai SB, Ajit D, Chinoy RF. Utility of the thromboplastin-plasma cellblock technique for fine-needle aspiration and serous effusions. Diagn Cytopathol. 2009; 37: 86-90.
11. Fetsch PA, Simsir A, Brosky K, Abati A. Comparison of three commonly used cytologic preparations in effusion immunocytochemistry. Diagn Cytopathol. 2002; 26:61-6.
12. Yang GC, Wan LS, Papellas J, Waisman J. Compact cell blocks: use for body fluids, fine needle aspirations and endometrial brush biopsies. Acta Cytol. 1998; 42:703-6.
13. Smedts F, Schrik M, Horn T, Hopman AH. Diagnostic value of processing cytologic aspirates of renal tumors in agar cell (tissue) blocks. Acta Cytol. 2010; 54:587-94.
14. Gorman BK, Kosarac O, Chakraborty S, Schwartz MR, Mody DR. Comparison of breast carcinoma prognostic/predictive biomarkers on cell blocks obtained by various methods: Cellient, formalin, and thrombin. Acta Cytol. 2012; 56:289–96.
15. Wagner DG, Russell DK, Benson JM, Schneider AE, Hoda RS, Bonfiglio TA. Cellient automated cell block versus traditional cell block preparation: a comparison of morphologic features and immunohistochemical staining. Diagn Cytopathol. 2011; 39:730–36.
16. Jing X, Li QK, Bedrossian U, and Michael CW. Morphologic and Immunocytochemical Performances of Effusion Cell Blocks Prepared Using 3 Different Methods. Am J Clin Pathol. 2013; 139:177-82.
17. Nigro K1, Tynski Z, Wasman J, Abdul-Karim F, Wang N. Comparison of cell block preparation methods for non-gynecologic ThinPrep specimens. Diagn Cytopathol. 2007; 35:640-3.
Published
2020-07-02
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