Cytological Evaluation of Two Methods of Effusion Cell Block Preparations

  • Deepa Siddappa Masur S.Nijalingappa . medical college. bagalkot
  • Shilpa Somashekhar Biradar
Keywords: Serous effusions, Conventional smear, Cellblock, Plasma thrombin method, formalin cell block


Background:  Cell Block (CB)  procedures  have  now  become  an  established  part  of cytological  diagnostics  because  of  its  pivotal  role  in  diagnosis  and  ancillary  studies. Hence  the  present  study  was  undertaken  to  emphasize  the  role  of  CB  technique  over Conventional Smear (CS)  in  serous  effusions  and  to  compare  the  Plasma-Thrombin (PT) block  to  Formalin  Method  block (FM)  in  assessment  of  morphological  preservation  and  cellularity.Aim:  To  obtain  simple , cost  effective  and  ideal  CB  preparation  where  in  maximal number  of  cells  are  displayed  within  a  small  areaMethods:  The sample  was  divided  into  three  Parts(A,B,C). After centrifugation  of  all three  parts  of  sample  at  3000rpm  for  15min – Part A  sediment  was  used  to  prepare two  CS  for  Papanicolaou (PAP)  and  May Grunwald Giemsa(MGG)  stains.  Part B sediment  was  subjected  for 1hr  and  24hr  fixation  in  1:1 solution of  5ml  ethylalcohol and  10%  formalin. To  the  Part C  sediment  2drops  of  finger  prick  plain  blood  was added,  mixed  well  and   allowed  to  clot. The  sediment  of  Part B  and  the  clot  of  Part C were  then  processed  for  paraffin  embedding.Result: 110  fresh  effusion  samples  were  evaluated  for  cellularity retention  of architectural  patterns  and  volume  of  background.  FM  block’s  were  inconclusive  in  12 cases  due  to  low  cellularity. PT  block’s  were  all  evaluable  with  best  preservation  of architecture  and  pale  background.Conclusion: The CB  technique  revealed  better  architectural  patterns  and  increased  the sensitivity of  cytodiagnosis. PT block’s  had  sufficient  to  abundant  cellularity  with evenly distributed  cells  in  small  area.  PT preparation   is  simple  and  cost  effective.  DOI: 10.21276/APALM.1432

Author Biography

Deepa Siddappa Masur, S.Nijalingappa . medical college. bagalkot
department of pathology, assistant professor


1. Wojcik EM, Selvagi SM, Comparison of smears and cellblocks in the fine needle aspiration diagnosis of recurrent gynecological malignancies. ActaCytol 1991; 35(6): 773-776.
2. Ceelen GH: The cytologic diagnosis of ascitic fluid. ActaCytol 1964;8:175-183.
3. De. Girolami E. Applications of plasma thrombin cell block in diagnostic cytology. Part II. Digestive and Respiratory Tracts, Breast and Effusions. Annu Pathol 1997,12: 91-110.
4. Leung SW, Bedard YC. Methods in Pathology. Simple mini block technique for cytology. Mod pathol 1993;6(5):630-632.
5. Shidham VB, Atkinson BF. Cytopathologic diagnosis of serous fluids. Elsevier WB Saunders, 2006; 1-55.
6. Koss LG: Diagnostic Cytology and Its Histopathologic Bases. Fifth edition. Philadelphia, Lippincott Williams and Wilkins. Pennysylvia. USA. 2006 Pg 919-1018
7. Jing X, Li QK, Bedrossian U, Michael CW. Morphologic and Immunohistochemical performances of effusion cell blocks prepared using 3 different methods. Am J Clin Pathol 2013;139:177-82.
8. Foot NC. Identification of types and primary sites of metastatic tumors from exfoliated cells in serous fluids. Am J Pathol 1954; 30(4): 661-677.
9. Yang GC, Wan LS, Papellas J, Waisman J. Compact cell blocks, Use for body Fluid, Fine needle aspirations and Endometrial brush biopsies. Acta Cytol 1998; 42: 703-706.
10. Mair S, Dunbar F, Becker PJ, DuPlesis W. Fine needle cytology: Is aspiration suction necessary? A study of 100 masses in various sites. Acta cytol 1989;33:809-813.
11. Krogerus LA, Anderson LC, A simple method for the preparation of paraffin embedded cell blocks from fine needle aspirates, effusions and brushings. Acta Cytol 1998; 32(4): 585-587.
12. Thapar M, Mishra RK, Sharma A, Goyal V. Critical analysis of cell block versus smear examination in effusions. Journal of cytology 2009; 26(2):60-64.
13. Dekker A, Bupp PA. Cytology of serous effusions. An investigation into the usefulness of cellblocks versus smears. Am J Clin Pathol 1978; 70(6): 855-860.
14. Nigro K, Tynski Z, Wasman J, Abdul-Karim F, Wang N. Comparison of cell block preparation methods for nongynaecologic thinprep specimens. Diag Cytopathol 2007; 35(10): 640-643.
15. Karnachow PN, Bouin RE. ”Cell-block” technique for fine neddle aspiration biopsy. J Clin Pathol 1982;35:688.
16. Burt AD, Smillie D, Cowan MD, Adams FG: Fine neddle aspiration cytology: Experience with a cell block technique (letters). J Clin Pathol 1986; 39: 114-115.
17. Kulkarni Mb, Desai SB, Ajit D, Chinoy RF. Utility of the thromboplastin-plasma cell-block technique for fine needle aspiration and serous effusions. Diag cytopathol 2009; 37(2):86-90.
18. Mahazouni P, Sharifani M. Direct smear vs cell Block (plasma-thrombin clot) method: diagnostic value in serosal cavities fluid cytology. Diag cytopathol 1999; 27 (2):77-80
19. 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: 142-144
20. Bhatia P, Dey P, Uppal R, Shifa R, Srinivasan R, Nijhawan R. Cell blocks from scraping of cytology smear – comparison with conventional cell block. Acta cytological 2007; 52(3): 329-333.
21. Crapanzano JP, Heymann JJ, Monaco S, Nassar A, Saqi A. The state of cell block variation and satisfaction in the era of molecular diagnostics and personalized medicine. CytoJournal 2014;11:7
22. Weihmann J, Weichert C, Petersen I, Gajda M. Evaluation of a cell block method in cytological diagnostics. Der Pathologe 2012;33:6 553-559.
23. Balassanian R, Ono JC, Wool GD, Olejnik-Nave J, Mah MM, Sweeney BJ, A superior technique for cell block preparation for fine needle aspiration. Mod Pathol 2013;26:83A.
24. Jain D, Mathur SR, Iyer V K. Cell blocks in cytopathology: a review of preparative methods, utility in diagnosis and role in ancillary studies. Cytopathology 2014; 25(6): 356-371.
Original Article