Block Preparation Research Articles

Fixation of Coal Fly Ash (CFA) in the Form of Construction Blocks with Variable Combinations of Lime and FGD Gypsum

Coal fly ash (CFA) is produced on very large scales in thermal energy plants. The recycling of coal fly ash (CFA) is essential decreasing its environmental impact. In this research, a FaL-G (coal fly ash (CFA), lime, and FGD gypsum) technology is used to reuse coal fly ash (CFA) in brick-type form. First, all of the small-grained FaL-G were dried in the oven at 60and#176;C for 24 h. Three different combinations of coal fly ash (CFA), FGD gypsum, and lime were tested for block preparation. The blocks were treated with five conditions for hardening and drying, i.e., i. Sunlight, ii. Shade (room temperature), iii. Oven, iv. Presence of moisture, and v. Freezer (-16and#176;C). After complete drying, the compressive strength and flexural strength tests were applied. Over all, the sunlight treated blocks showed strong compressive strength of 5.9 MPa and flexural strength of 7.19 MPa. The blocks made through FaL-G technology are very good raw materials for construction, i.e., partition walls and decoration, as these blocks have impressive texture and plain edges. It was the first time that the variable combinations of coal fly ash (CFA), gypsum, and lime were tested through different conditions and have achieved good strength. The literature showed that little work has been carried out through FaL-G, while additional materials have also been used. The main novelty of the current research work is development of an enhanced technique for preparing building materials, stabilizing coal fly ash (CFA), and reducing its environmental hazards

Cytological Diagnosis of Malignant Pleural Effusion Caused by Metastatic Squamous Cell Carcinoma: A Series of Four Cases

The majority of malignant pleural effusions are caused by adenocarcinomas, with the most common primary sites being the lung and breast in men and women, respectively. Metastatic squamous cell carcinoma in serous effusions is rare, accounting for less than 3% of all malignant effusions. The most common primary site of origin for metastatic squamous cell carcinoma involving serous effusions is the lung, followed by the head and neck, oesophagus, and cervix. Well-differentiated squamous cell carcinoma in pleural effusion, characterised by keratinised cells with hyperchromatic nuclei, tadpole cells, and fiber cells, is exceedingly rare. Poorly differentiated squamous cell carcinomas often present a diagnostic challenge and can be mistaken for poorly differentiated adenocarcinoma, malignant mesothelioma, or reactive mesothelial hyperplasia. Immunohistochemistry is often required for a definitive diagnosis. Making an accurate diagnosis is crucial for providing optimal treatment to the patient. In this series, four cases (56 years old male,69 years old male, 60 years old female and 81 years old male) of malignant pleural effusion caused by metastatic squamous cell carcinoma arising from the lung, oropharynx, cervix, and oesophagus were examined. While one of the cases involved a well-differentiated squamous cell carcinoma with characteristic cellular morphology that allowed for a straightforward diagnosis, the other three cases were poorly differentiated squamous cell carcinomas that required cell block preparation and immunohistochemistry for confirmation.

Urinary tract cytology showing variant morphology and divergent differentiation.

Urothelial carcinoma represents a diverse group of tumours with distinct histologic subtypes, each exhibiting unique cytomorphologic features, architectural growth patterns, and/or well-developed aberrant differentiation. In fact, there are more than 13 subtypes of urothelial carcinoma recognized in the 2022 WHO classification of tumours in the urinary tract. The identification of these subtypes is crucial for an accurate diagnosis of urothelial carcinoma, and many have important clinical implications. Variant/divergent features may coexist with conventional high-grade urothelial carcinoma (HGUC) or present with 100% variant morphology. In urinary tract cytology (UTC), urothelial carcinoma can display divergent differentiation, such as squamous, glandular, or small cell carcinoma differentiation. The use of cell block preparations and immunohistochemistry with available residual urine can enhance diagnostic accuracy. On the other hand, identifying urothelial carcinoma variants, including nested, micropapillary, and plasmacytoid subtypes, poses significant challenges in UTC. Many cases of these variants are only detected retrospectively after variant histology has been established from resection specimens. Moreover, some variants exhibit features inconsistent with the diagnostic criteria for HGUC according to the Paris System for Reporting Urinary Tract Cytology. Nevertheless, the rarity of pure variant morphology and the occurrence of some false negatives for these variant cases are essential to maintain the specificity of UTC overall. This review covers the histology, cytomorphology, and important clinical aspects observed in urothelial carcinoma exhibiting divergent differentiation and various urothelial carcinoma variants detected in UTC.

Efficacy of Robotic Bronchoscopy for Molecular Marker Analysis in Primary Lung Cancer

BackgroundMolecular testing has become a more frequent necessity in NSCLC management. Using next-generation sequencing, multiple targets for therapy can be identified with small amounts of nuclear material. The authors evaluated the performance of robotic-assisted bronchoscopy in acquiring tissue that meets pre-analytic criteria for PD-L1 immunohistochemistry and/or next-generation sequencing. Materials and MethodsPatients with a diagnosis of primary lung cancer identified through robotic bronchoscopy were retrospectively reviewed. Pathology reports were assessed for results of molecular testing and detection of programmed death-ligand 1 (PD-L1). An independent pathologist evaluated each specimen type (smears, cell block, tissue biopsy, and/or touch prep) to determine whether each tissue type would meet pre-analytic criteria for attempting next-generation sequencing and/or PD-L1 immunohistochemistry. ResultsSeventy-eight patients with primary lung were reviewed. By independent pathologic assessment of cytological smears, cell block, biopsy, and/or touch preparations, 72% of samples were found to be adequate for molecular and PD-L1 testing. Preanalytic adequacy (%) for next-generation sequencing (NGS) and PD-L1 staining was determined based on specimen type: cytological smear 48.6% for NGS; cell block 14.3% for NGS and 32.9% for PD-L1; biopsy 29.2% for NGS and 62.5% for PD-L1; and touch prep 61.4% for NGS. ConclusionRobotic-assisted bronchoscopy yielded samples that met preanalytic criteria for molecular testing in 72% of cases. These results support the use of robotic-assisted bronchoscopy for both the diagnosis and molecular testing of early-stage lung cancer.

Optimization of Tissue Handling and Processing in the Era of Precision Medicine: A Practical Recommendation from a Multidisciplinary Panel of Indian Experts

AbstractMolecular analysis of biospecimens is the key to diagnostic and therapeutic decisions in clinical practice. However, there is a lack of consolidated guidelines for biospecimen collection, tissue handling, and storage in India. Therefore, this study aims to generate expert recommendations for the optimization of tissue handling and processing practices in India in the era of precision medicine. This study aimed to evaluate the clinical gaps related to tissue handling for molecular analysis and develop expert recommendations to mitigate preanalytical issues associated with biospecimen processing. These expert recommendations will help in increasing the diagnostic yield and accuracy of biomarker testing in clinical practice. A virtual advisory board meeting was convened with 19 experts, including pathologists, molecular biologists, medical oncologists, surgical oncologists, interventional radiologists, and a senior histology technician from 10 hospitals in India, along with an accreditation officer for testing and calibration of laboratory procedures. The scientific coordinators developed specific questions to address the salient issues associated with the preanalytic phase of tissue specimen preparation. The experts discussed each question until a complete set of recommendations was obtained. The expert panel provided recommendations for tissue collection, processing, fixation, and block preparation to ensure high-quality biospecimens. As per the expert panel recommendations, tissue sampling can be performed from any easily accessible site, regardless of the primary or metastatic locations. In addition, the cold ischemia time should be <1 hour, 10% neutral-buffered formalin should be used as the fixative, isopropyl alcohol should be used as the dehydrating agent, the volume of tissue to fixative ratio should be 1:10, and all the paraffin blocks should be archived in dry, pest-free conditions at room temperature. The experts suggested that the formalin used for fixation should be freshly prepared and its pH should be checked daily; moreover, the pH and date of formalin preparation should be mentioned on the containers. The experts highlighted the need to educate multidisciplinary teams on the optimization of tissue handling practices and emphasized that a pathologist should always check the tissue for adequate quality and quantity for biomarker testing. The existing routine clinical procedures for collecting and handling biospecimens adversely affect their quality. The expert recommendations for preanalytical quality control would ensure high-quality biospecimens for molecular analysis and precision medicine.

Classification of Salivary Gland Lesions on Cell Block Preparations with a Panel of Immunohistochemical Markers - a Rapid, Reliable, and Minimally Invasive Diagnostic Modality

<p>Fine-needle aspiration cytology (FNAC) is used as a valuable method for examining suspected salivary gland lesions. It is a simple, costeffective, and minimally invasive procedure with high specificity and sensitivity. Due to the cellular heterogeneity and overlapping architectural features, it can be difficult to distinguish between non-neoplastic processes, benign lesions, and/or malignancies in salivary glands on routine stains. Cell block methods are currently replacing surgical biopsy-based diagnostic methods on the basis of utilizing aspirates from FNAC with a rapid and reliable potential for reaching a conclusive diagnosis. Ancillary investigations including a panel of immunohistochemical markers are frequently applied on cytology specimens in the era of precision diagnostics to offer a specific diagnosis and even prognostic information for optimal patient care.</p>

Evaluation of shaping performance and surface changes of two different minimally invasive shaping file systems used in resin blocks

Aims: This study aimed to compare the shaping ability of T-endo MIS and TruNatomy (TRN) file systems in J-shaped resin root canals and to investigate the deformation of the files after two acrylic block preparation and two sterilization cycles.
 Methods: Forty acrylic blocks were numbered, then four file groups (n=10) were established: T-endo MIS glider (15.04) + T-endo MIS Finisher (25.04) (first and second usage) and TRN Glider (17.02) + TRN Prime (26.04) (first and second usage). Preoperative and postoperative images after the root canal preparation of simulated acrylic blocks were taken for each sample, and superimposed. The amount of resin removed from both the inner and outer walls of the canal to the level of 3, 5, and 7 mm from the apical point was measured, and the amount of transportation was calculated. Additionally, the deformation of the files was examined under a scanning electron microscope before and after usage and sterilization process.
 Results: Tip deformation of TRN files increased with the number of uses (p=0.007). With the second use, the surface deformation of the MIS files increased (p=0.015). There was no difference in cutting-edge deformation in either file type according to the number of uses (p>0.05). There was no difference in transportation values between the MIS and TRN file systems at any level (p>0.05). The file systems did not show a significant difference in the amount of transportation between first and second use (p>0.05).
 Conclusion: When TRN (26.04) and MIS (25.04) NiTi rotary files were used twice on acrylic blocks, the amount of deformation did not differ. Both file types were similar in terms of transportation values.

Breast metastasis as the first presentation of an anorectal melanoma diagnosed on fine needle aspiration cytology: a case report

BackgroundPrimary anorectal melanoma is a rare and aggressive disease accounting for approximately 1–3% of all colorectal and anal cancers.Case reportWe present a unique case of anorectal melanoma where the primary presentation was the metastatic breast lump which led to the detection of the primary tumor. A 70-year-old elderly postmenopausal female presented with complaint of left breast lump. On fine needle aspiration cytology, May Grunwald-Giemsa and Papanicolaou stained smears examined were highly cellular and showed sheets, clusters and singly scattered highly pleomorphic plasmacytoid cells having high nucleus to cytoplasmic ratio and scant to moderate cytoplasm with enlarged eccentric round to ovoid nuclei. Immunocytochemistry performed on cell block preparation showed tumor cells strongly positive for HMB-45, S-100 and negative for ER, PR, Her2neu, chromogranin, synaptophysin and Pan-CK. A thorough work up of the patient to look for the site of primary malignancy was done and radiological findings reveled presence of an ill-defined soft tissue mass in the anal canal. Biopsy from the anal mass confirmed the diagnosis of anal melanoma with metastasis to breast.ConclusionThe present case was reported to emphasize the importance of atypical presentation where the breast lump was the primary presentation of an anal melanoma. Therefore, we should have a strong index of suspicion for metastatic tumors in case of a breast lump especially when there is unusual morphology or unexpected immunophenotype, particularly if the neoplasm is triple-negative, in patients with a previous history of other malignancies.

A Comprehensive Review of the Newest World Health Organization (WHO) Cytopathology Reporting Systems.

World Health Organization cytopathology reporting system systems have proposed for the pancreatobiliary tract, lung, lymph node, and soft tissue aligned with the updates in the World Health Organization classification of Tumor series. Among them, the pancreatobiliary tract and lung specimen reporting system have been published recently and are now a 7-tier and 5-tier category system, respectively, without any subcategorization. World Health Organization reporting systems also encourage the application of ancillary diagnostic tests like cell block preparation, immunocytochemistry, and rapid on-site evaluation for better categorization of specimens and further management, especially in indeterminate (atypical and suspicious for malignancy) and malignant cytology categories. In this brief review, we aim to provide a brief outline of both the systems and their clinical risk-based management strategies.

Gastric glomus tumor on EUS-FNA-based cytology: clinicopathologic and immunohistochemical features of 4 cases, including 1 case with associated MIR143HG-NOTCH2 fusion gene.

Gastric glomus tumor (GT) is a rare submucosal tumor for which the preoperative diagnosis can be challenging. We report the cytomorphologic and immunohistochemical features of 4 gastric GTs diagnosed by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) cytology. Files were searched to identify gastric GTs diagnosed by EUS-FNA between 2018 and 2021. A total of 4 cases of gastric GTs (3 men and 1 women; mean age, 60 years) were included. Three GTs were located in the gastric antrum and one in the gastric body. Their size ranged from 2 to 2.5 cm. Three patients presented with epigastric discomfort and one with chest wall discomfort. Rapid on-site evaluation was performed for 3 cases; the findings for all 3 were indeterminate. The smears were moderate to highly cellular and showed loose clusters of evenly distributed small- to medium-size bland tumor cells. The tumor cells had centrally located round to oval nuclei with inconspicuous nucleoli and scant to moderate amount of eosinophilic to clear cytoplasm. Examination of the cell blocks revealed branching small vessels surrounded by small- to medium-size cells. The neoplastic cells were positive for smooth muscle actin and synaptophysin and negative for AE1/AE3 and S-100. C-KIT and CD34 were variably positive. Ki-67 was <2% positive. In 1 case, the fusion panel-solid tumor (50 genes) revealed the MIR143HG-NOTCH2 fusion gene. Smears and cell block preparation revealed angiocentric sheets of uniform, small round to oval tumor cells with pale to eosinophilic cytoplasm, intermingled with endothelial cells. The differential diagnosis of gastric GTs on rapid on-site evaluation includes neuroendocrine tumors and epithelioid or spindled cell neoplasms. Immunohistochemical and molecular studies can be helpful in the preoperative diagnosis of gastric GT.

Ayak cerrahisinde kullanılan periferal sinir blok uygulamasında iki metodun karşılaştırılması: USG yardımlı ve anatomic landmark yardımlı.

Aim: Ankle peripheral nerve block is applied by two methods. These are peripheral block that is performed using USG-assisted and anatomical landmarks that do not require the use of Ultrasonography (USG). In our study, we aimed to compare these two methods applied in foot surgeries retrospectively. Methods :Peripheral block patients performed with the USG-guided (group 1) were 20, anatomical landmarks- guided (group 2) were 20. In both groups, 40 cc of anesthetic mixture was used (bupivacaine + lidocaine). The recorded information of the patients were as follows: Block application time (BAT), surgery readiness time (SRT), duration of surgery (DoS), duration of block anesthesia (DBA) and intraoperative-postoperative Visual Analogue Scale (VAS). The results of the VAS applied to the patients postoperatively were obtained. Patients were contacted by phone and asked if they were satisfied with the anesthesia. Results : The BAT and DBA values of the patients in Group 1 were high. SRT and VAS 6 values of the patients in group 2 were high. No significant difference was found between the groups in other parameters. No additional dose of anesthetic was needed in group 1 during the intraoperative period. In group 2, local additional dose was administered to 3 patients. Conclusion: Peripheral block preparation USG-guided takes a long time. However, it is more comfortable during surgery. The USG-guided peripheral nerve block is more advantageous when considering the possibility of prolonging the duration of surgery for any reason and early postoperative pain control after surgery.

Utility and performance of cell blocks in urine cytology: Experience at three teaching hospitals.

The use of cell block (CB) preparation is underused in urine cytology (UC) and varies among hospitals. In addition to confirming a diagnosis, CBs can be useful in cases of metastatic disease, diagnoses requiring immunohistochemical (IHC) staining, and for ancillary studies. The role of this study is to examine the performance of CBs for UC at three affiliated teaching hospitals. A retrospective review of UC cases with a CB was conducted at a county hospital, Veterans Affairs hospital, and tertiary university-based hospital. For each specimen, patient demographics, specimen type, volume, original diagnosis, and IHC stains were recorded. Each case was reviewed for diagnosis based on ThinPrep alone, diagnosis based on ThinPrep and CB, utility of CB for diagnosis, and CB cellularity. A total of 250 UC specimens with CB from 186 patients was identified. Bladder washes were the most common (72.1%). IHC stains were performed on 17.2% of cases. On blinded review, CB preparation was deemed useful in 61.2% of cases, with the highest rate for suspicious for high-grade urothelial carcinoma (SHGUC) cases (87.0%). The diagnosis based on ThinPrep review changed with incorporation of CB in 13.2% of cases, with the highest rate for SHGUC cases (43.5%). The results demonstrate that use of CB in UC confirms the final diagnosis in more than one-half of cases and changes the diagnosis in a subset of cases. Use of CB was most helpful in the SHGUC category. Further evaluation of the types of cases in which CB are prepared is warranted.

Cell block preparation as an adjunctive tool after fine-needle aspiration cytology for screening oral and maxillofacial diseases

To describe the use of cell block (CB) preparation from fine-needle aspiration cytology for diagnosing oral and maxillofacial diseases. We performed a retrospective analysis of 568 samples collected by our laboratory for CB preparation from fine-needle aspiration cytology of the oral and maxillofacial region between January 2001 and October 2021. We performed cytologic diagnoses and compared them with the available histopathologic diagnoses to calculate the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CB preparation for identifying malignant lesions. The most frequent diagnosis was pleomorphic adenoma (n=44, 7.7%), followed by metastatic squamous-cell carcinoma (n=28, 4.9%) and odontogenic keratocyst (n=26, 4.6%). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CB preparation, which revealed detailed morphologic and architectural patterns, were 70.0%, 100.0%, 100.0%, 62.5%, and 80.0%, respectively. Cell block preparation from fine-needle aspiration cytology of the oral and maxillofacial region may be a useful adjunctive diagnostic tool for diagnosing oral and maxillofacial diseases because it reveals morphologic and architectural patterns similar to those shown on histopathologic slides, leading to the better categorization of diseases.

ANALYSIS OF CELL BLOCK VERSUS CONVENTIONAL SMEAR STUDY IN FLUID CYTOLOGY

Background: The cytological examination of body uids is routinely accepted, simple and minimally invasive technique. Cell block preparation along with conventional smear increases sensitivity of detecting malignancies by preservation of tissue architecture and obtaining multiple sections for special stain and immunohistochemistry. To assess and compa Objectives: re the diagnostic yield of conventional smear (CS) and cell block (CB) techniques in uid cytology. A total of 62 body uid specimen were simult Materials And Methods: aneously processed and examined by conventional smear and cell block technique. The morphological details, cellularity, architecture, nuclear and cytoplasmic details were studied in both CS and CB techniques. Out of 62 uid samples a total of 47 smears and 58 c Results: ell blocks had adequate material. On smears a total of 11 cases were malignant, 3 were suspicious and 33 were benign. On cell block a total of 15 cases were malignant, none was suspicious and 43 were benign. CB technique is superior to CS technique as it plays a signicant role Conclusion: in resolving the gray zone while determining the nature of cells on effusion whether reactive, atypical or malignant. Also it provides diagnostic advantage by making residual material available for special stains and IHC

Clinicopathological Parameters Associated With Peritoneal Involvement in Epithelial Ovarian Tumors.

Introduction Ovarian tumors remain one of the leading malignancies of the female genital tract, with a high mortality rate due to their insidious onset and lack of detection at an earlier stage. These tumors metastasize by direct extension into the neighboring pelvic organs; hence, the detection of peritoneal metastasis is valuable for staging and prognostic purposes. Peritoneal wash cytological analysis is an effective predictor of the involvement of the ovarian surface and peritoneal dissemination even in subclinical involvement of the peritoneum. The study aims to determine the significance of peritoneal wash cytology as a prognostic parameter and correlate it with various clinicohistological features. Methods A retrospective study was conducted at the Department of Histopathology, Liaquat National Hospital, Karachi, Pakistan, between July 2017 and June 2022. During this period, all the cases of ovarian tumors (borderline and malignant) that underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy and omental and lymph node sampling were included in the study. After opening the abdominal cavity, the free fluid present was aspirated immediately, the peritoneum was lavaged with 50-100 mL of warm saline, and samples were collected and sent for cytological analysis. Four cytospin smear slides and cell block preparation were prepared. The findings of peritoneal cytology were correlated with various clinicohistological features. Results A total of 118 cases of ovarian tumors were included in the study. Serous carcinoma was the most common sub-type (50.8%), followed by endometrioid carcinoma (14.4%), and the mean age at diagnosis was found to be 49.9±14.9 years. The mean tumor size was 11.2 cm. The majority of the cases of ovarian carcinoma were of high grade (78.8%), with capsular invasion present in 61% of cases. Positive peritoneal cytology was noted in 58.5% of cases, with omental involvement in 52.5% of cases. Serous carcinoma showed the highest frequency of positive cytology (69.6%) and omental metastasis (74.2%). Apart from tumor type, positive peritoneal cytology showed a significantly positive correlation with age, tumor grade, and capsular invasion. Conclusion Based on our study findings, we conclude that peritoneal wash cytology is a sensitive indicator of the peritoneal spread of ovarian carcinoma, with a significant prognostic value. Serous carcinomas, especially high-grade with capsular invasion, were found to be predictors of peritoneal involvement of ovarian tumors. Although we found smaller tumors to be associated with peritoneal disease more compared to larger ones, this most likely is attributed to tumor histology, as larger tumors were most commonly mucinous compared to serous carcinomas.

Cytological, cell block and immunohistochemical analysis of spectrum of malignant pleural effusion with special reference to non-small cell lung carcinoma: A hospital based study of North East India

Malignant pleural effusions (MPE) can result from primary malignancies of the pleura or from underlying intrathoracic or extrathoracic malignancies that reach the pleural space by hematogenous, lymphatic, or contiguous spread. Conventional smear and cell block (CB) technique is one of the oldest methods for the evaluation of body cavity fluids. The principal advantage of cell block over conventional smears are an additional yield of malignant cells and obtaining multiple sections for ancillary tests such as immunohistochemistry (IHC). This study is a hospital-based cross-sectional study which was conducted for a period of 14 months from June 2021 to July 2022 in a tertiary care centre of North East India. Among 277 pleural effusion specimens 11.91% cases were positive for malignancy.Lung carcinoma was the most common cause of malignant pleural effusion. Non-small cell lung carcinoma comprised majority of lung carcinoma cases. Adenocarcinoma was the most common subtype of NSCLC with female preponderance. Cytological diagnosis had a Sensitivity of 76.19%, specificity of 100% andAccuracy of 96.5%. Immunohistochemistry of lung carcinoma in cell block preparation revealed 77.77% cases of adenocarcinoma of lung were positive for TTF-1(P&amp;#60;0.018). Immuno-expression of P63 and P40 showed positive expression in both the cases of squamous cell carcinoma. Conventional smear and cell block method with application of immunohistochemistry will help us in accurate diagnosis of primary site of the tumour aiding early treatment especially in resources restricted hospitals.

Reutilization of ferro-arsenic waste sludge for the development of concrete blocks through solidification: conservation of natural aggregates with policy suggestion

ABSTRACT In the present study, arsenic sludge and iron sludge extracted from a laboratory scale water treatment plant were aimed to reutilize for the development of concrete blocks. Three different grades (M15, M20 and M25) of concrete blocks were made by blending of arsenic sludge and improved iron sludge (50% sand and 40% iron sludge) in the range of density of 425 to 535 kg/m3 at an optimum ratio of 10:90 (arsenic: iron sludge) followed by mixing of designed quantity cement, coarse aggregates, water and additives. Concrete blocks developed based on this such combination exhibited 26 MPa, 32 MPa and 41 MPa compressive strengths, and 4.68 MPa, 5.92 MPa and 7.78 MPa tensile strengths for M15, M20 and M25, respectively. In comparison with the developed concrete blocks and the blocks made with 10% arsenic sludge and 90% fresh sand, the developed ones (employing 50% sand, 40% iron sludge and 10% arsenic sludge) showed more than 200% higher strength perseverance on average. Successful Toxicity Characteristic Leaching Procedure (TCLP) and compressive strength of the sludge-fixed concrete cubes classified it as a non-hazardous and completely safe to use value-added material. This process involves stabilization of arsenic-rich sludge generated from high-volume long-run laboratory-based arsenic-iron abatement set-up from contaminated water with successful fixation in solid matrix of concrete through complete substitution of natural fine aggregates (river sand) in cement mixture. Techno-economic assessment reveals such concrete block preparation at $0.09 each which is lesser than 1/2 of the present market price of same quality concrete block in India

The international system for reporting serous fluid cytopathology: The initial project survey.

An international panel in the field of body fluid cytology, supported by the International Academy of Cytology and the American Society of Cytopathology, conducted a survey to identify opinions and explore existing practice patterns regarding body fluid cytopathology. The study group, formed during the 2018 European Congress of Cytology in Madrid, generated a survey of 54 questions related to the practice and taxonomy of body fluid cytology. The survey was available online from 28 August 2018 until 10 December 2018. Participants were invited through the websites and listserves of the professional societies. The survey collected 593 international participant responses. Questions pertained to practice patterns and diagnostic language. Information was collected regarding credentials, work setting, work volume (4-10,000 samples) and years in practice (0-60 years). The responses revealed variations in diagnostic practice and sample management. Direct smears and ThinPrep® preparations are the most popular methods, followed by Cytospin® and SurePath®. Most (70%) respondents perform ancillary studies on their material, with over 50% preferring a cell block preparation. Approximately 32% indicated that they are capable of performing genetic studies on the samples. Nearly 78% of participants would accept a two-stage cytology report, with a preliminary assessment followed by a final diagnosis that accounts for ancillary studies to generate a more precise cytological interpretation. Approximately one-third (36%) never report adequacy on body fluid samples. Most (78%) report a general category result (negative, atypical, suspicious, or positive) and 22% provide a detailed surgical pathology type report. Most (73.6%) participants believe that both Papanicolaou stains and a modified Giemsa stain (eg Diff Quik) should be standard preparations for all serous fluid cytology. The results of the survey demonstrated strong support for the development of a unified system for reporting body fluid cytopathology among respondents.

Cell blocks in cytology: review of preparation methods, advantages, and limitations.

Cell blocks are cytologic preparations that are processed as paraffin embedded blocks in a manner comparable to formalin-fixed paraffin-embedded tissue in surgical pathology. In addition to serving as an adjunct to other cytologic preparations for morphologic diagnosis, cell blocks play an increasingly important role as they yield tissue sections that can be utilized for ancillary testing such as immunohistochemical stains and molecular studies. While essentially universally viewed as playing a pivotal role in cytopathology practice, there are various factors that limit their use in practice and contribute to dissatisfaction with cell block quality. Cell block preparation, as opposed to tissue processing in surgical pathology, is more variable with many different protocols in use today. This review explores the most commonly used cell block preparation techniques currently in use with review of the unique advantages and limitations each method presents. The goal of this work is to serve as a resource that can aid in making more informed decisions about which cell block protocol may work best for individual laboratories.

Claudin18.2 expression and clinicopathological features in cytology effusion specimens from gastric adenocarcinoma: Acomparative study with tissue specimens.

Zolbetuximab (IMAB362) is under investigation for treating advanced gastrointestinal tumors because it targets Claudin18.2 (CLDN18.2). CLDN18.2 is a promising molecule along with the presence of human epidermal growth factor receptor 2 in gastric cancer. This study evaluated cell block (CB) preparations of serous cavity effusions for the feasibility for CLDN18.2 protein expression and compared the results with those of biopsy or resection specimens. The association of CLDN18.2 expression in effusion samples and the clinicopathological features were also investigated. Cytological effusion specimens and matched surgical pathology biopsy or resection specimens of 43 gastric and gastroesophageal junctional cancer cases were stained for CLDN18.2 expression and quantified using immunohistochemistry based on the manufacturer's instructions. Positive staining was detected in 34 (79.1%) tissue and 27 (62.8%) effusion CB samples in this study. When "positivity" was defined as moderate-to-strong staining in ≥40% viable tumor cells, CLDN18.2 expression was observed in 24 (55.8%) tissue and 22 (51.2%) effusion CB samples. A cutoff of 40% for CLDN18.2 positivity was used to demonstrate high concordance (83.7%) between cytology CB and tissue specimens. The results showed that CLDN18.2 expression in effusion specimens correlated with tumor size (p=.021) but not with sex, age at diagnosis, primary tumor location, staging, Lauren phenotype, cytomorphologic features, or Epstein-Barr virus infection. Cytological effusions with or without CLDN18.2 expression did not significantly affect overall survival. This study's results show that serous body cavity effusions may be suitable for CLDN18.2 biomarker testing; however, discordant cases should be interpreted cautiously.