Cell Block Technique Research Articles

Significance of Plasma Thromboplastin Cell Block Technique as an Adjunct to Fine Needle Aspiration Cytology in Diagnosis of Breast Lesions

Introduction: Despite the fact that Fine Needle Aspiration Cytology (FNAC) has been widely utilised in the preoperative diagnosis of breast lumps, the Conventional Smears (CS) have drawbacks, including difficulty in understanding the pattern or architecture of the lesion, determining invasiveness, Immunohistochemistry (IHC), false positives, and false negatives. Cytologists advise using Cell Blocks (CB) to increase the diagnostic precision of FNAC. In this study, the significance of using Plasma Thromboplastin Cell Block (PTCB) routinely as an addition to CS in FNAC of palpable breast lesions. Aim: To determine the significance of PTCB as an adjunct in addition to CS to diagnose breast lesions. Materials and Methods: The present prospective observational study was conducted in the Department of Pathology, Chettinad Hospital and Research Institute, Kelambakkam, Chennai, Tamil Nadu, India, between July 2021 and June 2022 on 30 samples of palpable breast lesions. From the fine needle aspirates, smears were prepared and stained with Leishman and Papanicolaou stains. The residual material in the hub was rinsed in saline. The plasma-thromboplastin method was used to prepare CB, and Haematoxylin and Eosin (H&E) sections were made. A point scoring system was used and findings were compared to histopathology. IHC markers namely Estrogen Receptor (ER), Progesterone Receptor (PR), Human Epidermal Growth Factor Receptor-2 (HER2), Proliferation marker Ki-67 was utilised wherever appropriate. The results were analysed using Statistical Package for the Social Sciences (SPSS) software version 21.0. Results: Out of total 30 subjects, majority (n=9, 30%) were in the age group of 41-50 years. The mean scores of CS {background (0.93±0.25), cellularity (1.7±0.55), morphology (1.7±0.47) and architecture (1.03±0.32)} and PTCB {background (1.77±0.43), cellularity (1.77±0.48), morphology (1.8±0.48) and architecture (1.5±0.57)} were compared using the point scoring system. Though the mean scores of all four parameters were higher in PTCB than in CS, the statistically significant difference was seen in background (p-value=0.001) and architecture categories (p-value=0.0001). The PTCB finding as a screening test for predicting histopathological diagnosis showed a sensitivity of 94.44%, specificity of 100%, Positive Predictive Value (PPV) of 100%, Negative Predictive Value (NPV) of 92.3%, and 96.67% accuracy. IHC staining was feasible in CB and findings were comparable to biopsy. Conclusion: The routine use of PTCB technique in FNAC of breast lesions, along with smears, will aid in IHC, reducing diagnostic pitfalls, thereby reducing misdiagnosis and invasive procedures, particularly in suspicious for malignancy cases, which can lead to inappropriate radical treatment causing physical and psychological stress to patients.

Advantages of the cell block technique over the FNAC and correlation with histopathology of most prevalent breast lesions in the community at the tertiary care center

Breast lumps are a common cause of concern in both young and older women throughout the world. Fine needle aspiration of breast lesions is an important and widely practiced method of providing a preoperative diagnosis in women presenting with a lump in the breast. Cell blocks that are made from the aspirates help in preserving the architecture, and the nuclear morphology and help in preserving the material for immunohistochemical studies. The present study aims to highlight the role of FNAC and cell block in the diagnosis of breast lesions. This was a two-year prospective study of 72 patients presenting with palpable breast lesions referred for FNAC to the Department of Pathology JJMMC, Davangere from 1st July 2015 to 30th June 2017. After a detailed history, general physical & local examination, informed consent was taken and FNAC was performed under aseptic precautions. A part of the aspirate was fixed, then processed as cell blocks, and stained with H&E. Wherever lumpectomy or radical surgery was performed the histopathology was correlated with cytomorphological findings.: The present study showed a diagnostic accuracy of 85.71% in the FNAC diagnosis. The sensitivity and specificity of FNAC in diagnosing breast lesions were found to be 82.60% and 87.23%. PPV and NPV were 76% and 91.11% respectively. When cell blocks were used the diagnostic accuracy increased to 88.57%. Diagnosis by using cell block showed a sensitivity of 79% specificity of 93.47%, PPV of 86.36%, and NPV of 89.58%.: From the results of our study, it can be concluded that the accuracy of diagnosing breast lesions preoperatively can be increased when FNAC is combined with the cell blocks from the aspirates. The cell blocks also help to preserve the aspirated material for future reference and immunohistochemistry can also be applied for a more accurate diagnosis.

A novel method for making cell blocks with higher cellular yield.

Cytopathology is an important part of pathology that is used to diagnose disease on the cellular level. The application of the cell block (CB) technique plays a vital role in cytological diagnosis, as blocks and slides can be further used for special stains, immunohistochemistry (IHC), and molecular pathological analysis. Several methods for making CBs have been reported, but their procedures and cellular yield are still deemed unsatisfactory. In this article, we used gellan gum (GG) as an adjuvant for CBs, which resulted in higher cellular yield with simpler procedures. CBs were prepared by using GG, copper sulfate, plasma/thrombin, or pregelatinized starch methods. The procedures of each of these four methods were then compared. CB sections were stained with hematoxylin and eosin (H&E), and the background and morphological features seen by H&E staining were compared. A preliminary IHC and fluorescence in situ hybridization (FISH) study was performed using cytology specimens from elevenand five cases, respectively. The expression of immunocomplex by IHC and the molecular signals detected by FISH were compared in CB sections made by the four methods and a section derived from the biopsy specimen block from the same patient. Feulgen staining, Alcian blue staining, and Masson trichrome staining were performed on the CB sections from 3 cases of pleural fluid. The cellular yield of CB sections from 83 cases according to the four methods was compared using NDP analysis software. The results demonstrated that sections derived from CBs made with GG had a clear background and good morphological features by H&E staining. The expression of immunocomplex by IHC and the molecular signals of FISH detection in the sections from CBs made by GG were accurately located just as those in biopsy sections from the same patient. The DNA, acidic mucus, and fibrin could be clearly identified through special stains in the CB sections. The procedures involved in the GG method were easily controllable and the coagulated gel increased the ease by which the CB was embedded and sectioned. Specifically, sections from CBs made by the GG method contained higher cellular yield because cells could be concentrated on the bottom of the gel after centrifugation. This novel method for making CBs is a practical, simple method that can result in higher cellular yield. This method is therefore worth promoting in clinical applications.

Diagnostic utility of cytospin in comparison to cell block in peritoneal and pleural fluid cytology

Background: Fluid cytology plays an important role in delineating benign from malignant effusions, tumor staging, and also in diagnosing recurrences. Various methods are used in cytology for the preparation of smears. As the accurate diagnosis of the fluids aids in clinical decisions, the method of preparation of cytology smears, it is very important. Cytospin preparation of smears is one of the methods which provide higher cellular yield with better preservation of cellular morphology and is less time consuming. On the other hand, cell block method gives superior architectural details and provides options for immunocytochemistry. Aims and Objectives: The aim of this study was to assess the diagnostic utility of cytospin in comparison to cell block method in peritoneal and pleural fluid cytology. The study is done to determine the sensitivity, specificity, predictive values, and diagnostic accuracy of cytospin preparations with cell block method which is considered as the gold standard. Materials and Methods: This was a diagnostic test evaluation study done at the Department of Pathology, Government Medical College, Kottayam. The sample size was 240 which included all pleural and peritoneal fluids received in our cytology laboratory during the study period. Cytospin prepared smears of peritoneal and pleural fluids were compared with the tissue sections prepared by cell block method, to evaluate the diagnostic utility of cytospin. Tissue sections prepared from the cell blocks of effusions were considered as the gold standard for comparison. Results: A diagnostic test evaluation of cytospin preparation was done with cell block preparations. The sensitivity of cytopsin preparations in pleural and peritoneal fluid cytology is 94%. The specificity of cytopsin preparations in pleural and peritoneal fluid cytology is 100%. The positive predictive value of cytopsin preparations in pleural and peritoneal fluid cytology is 100% and the negative predictive value of cytopsin preparations in pleural and peritoneal fluid cytology is 96.8%. Hence, accuracy of the test is 97.9%. Conclusion: There is only minimal statistical difference between the results obtained by the cytospin and cell block methods. Cytospin method is less time consuming along with the advantage of higher cellular yield. Hence, the incorporation of cytospin along with the cell block technique is beneficial for augmenting the results of effusion cytology.

Evaluating cell block and cell smear technique in the body-cavity fluids cytology technique at Viet Tiep Hospital

Background/Purpose: To evaluate cell block (CB) and cell smear (CS) techniques in the diagnostic cytology of body-cavity fluids.
 Methods: The cross-sectional descriptive study was conducted based on the anatomical results of 106 patients of Viet Tiep Hospital
 Results: Most of the samples were pleural fluid, accounting for 73.6%, pink fluid was the main color (46.2%), and the amount of fluid taken from each specimen was mostly from 201 - 250 ml (53.8%). Through CB, staining H&E, and immunohistochemistry, we identified 49 cancer cases, most of which were adenocarcinomas accounting for 87.8%. On the cell block technique, all adenocarcinoma samples have large cell nuclei, increased nucleus/cytoplasmic ratio, over 90% have glandular structure, over 80% of chromatin is crude, the nucleus is clear and there is space around the tumor.
 Conclusion: Comparing the results of cytology between CB and CS techniques shows that CB has a higher diagnostic value.

Comparing cell block diagnostic results with histopathological results and some factors affecting the quality of cell blocks in the diagnosis of body cavity fluid cells at Viet Tiep Hospital

Background/Purpose: To contrast the results of cell block diagnosis with histopathological results and describe some factors that affect the quality of cell blocks.
 Methods: The cross-sectional descriptive study was conducted based on the anatomical results of 106 patients of Viet Tiep Hospital
 Results: The cell block technique had a sensitivity of 84.4% significantly higher than the sensitivity of the cell smear of 57.8%. The specificity of both tests is above 80%. Cellblock test results were less accurate in yellow fluid samples (13.3%). Blood fluid and pink fluid samples both have over 90% accuracy. The difference was statistically significant with p<0.05. Cellblock test results were less accurate in samples with a sample count of ≤150 ml (52.9%). Samples with a greater number of specimens were over 80% accurate. The difference was statistically significant with p<0.05. There was no difference in the accuracy of cell block test results between specimens at different sites, cancer types, cancer origins, age groups, and sex of the subjects studied.
 Conclusion: The cell block technique improves the number of malignant diagnoses compared to histopathology, and has higher sensitivity and lower specificity than the cell smear technique. Factors related to the accuracy of cell block test results include the color of the test fluid and the number of fluids. There was no difference in the accuracy of CB test results on different specimens, different cancer types, different cancer origins, different ages, and genders.

Utility of Cell Block with p53 Immunostain in Diagnosing Urothelial Carcinoma

Background: Urine cytology is an initial noninvasive screening test done in patients with suspected urothelial carcinoma. The objective of this study was to compare the sensitivity of conventional smear cytology with cell block technique for the diagnosis of malignant cells in urine and to assess the efficacy of p53 immuno-marker in the diagnosis and prognosis of urinary bladder cancer.
 Methodology: The study was carried out in the department of Histopathology, Pakistan Institute of Medical Sciences(PIMS), Islamabad. Cell blocks and cytology smears and were prepared from urine samples of 80 patients of urothelial carcinoma and p53 stain was applied. Data was analyzed using version 21. Sensitivity of conventional smear and cell block techniques were calculated for both low and high grade urothelial carcinomas.
 Results:The sensitivity of detecting atypical cells using conventional smear was 31% and 70.6% for low grade and high grade urothelial tumors respectively. The sensitivity increased to 41.4% and 84.3% for low and high grade urothelial carcinomas respectively with cell block technique. Positive p53 stain was seen in 13.8% of cases with low grade tumors and 66.7% cases with high grade tumors. Chi-square test was used to find the association of cytology findings with the histologic grade.
 Conclusion: Sensitivity of urine cell blocks is higher than the conventional smear method for detecting high grade lesions. It can be used as an efficient non-invasive technique and an adjunct tool for the determination of disease relapse and overall survival in patients.
 Keywords: Carcinoma, Cytology, P53 Protein, Urine

Use of Endoscopic Scraper and Cell Block Technique as a Replacement for Conventional Brush for Diagnosing Malignant Biliary Strictures.

Simple SummaryBrush cytology remains the primary method used worldwide for diagnosing malignant biliary strictures, despite its low sensitivity. Although the endoscopic scraper, the simplicity of which is comparable to that of a conventional brush, has been used mainly in Japan, it has yet to gain popularity on a global scale. The purpose of this study was to evaluate the diagnostic performance of the endoscopic scraper by comparing diagnostic yields and the number of collected cells using quantitative digital image analysis. Our study revealed that the endoscopic scraper and cell block method achieved higher sensitivity than the brush with the cell block method, and showed that the number of cells on the cell block sections obtained by the endoscopic scraper were significantly higher than those obtained using the brush. Given its ease of use and high sample acquisition capability, the endoscopic scraper could replace brush cytology for diagnosing malignant biliary strictures.Histological evidence is essential for diagnosing malignant biliary strictures. However, conventional brush cytology remains the primary method used worldwide, despite its low diagnostic sensitivity and accuracy, as it is technically easy, rapid, and cost-effective. The aim of this study was to evaluate the diagnostic performance of a recently introduced endoscopic scraper, the simplicity of which is comparable to that of a conventional brush, by comparing diagnostic yields and the number of collected cells. The sensitivity of the endoscopic scraper when using the cell block technique was significantly higher than when using brush cytology or a brush with the cell block technique (53.6% vs. 30.9%, p < 0.001; 53.6% vs. 31.6%, p = 0.024, respectively). Quantitative digital image analysis of cell block sections revealed that the median number of cells obtained with the endoscopic scraper was significantly higher than when using the brush (1917 vs. 1014 cells, p = 0.042). Furthermore, seven cases (8.3%; 7/84) were diagnosed by immunohistochemical analysis of the cell block section obtained from the endoscopic scraper. Given its simplicity and greater capacity for sample acquisition, use of the endoscopic scraper in conjunction with the cell block technique could replace brush cytology for the histological diagnosis of malignant biliary strictures.

A STUDY OF PLEURAL EFFUSION BY COMBINED APPROACH OF CONVENTIONAL SMEAR AND CELL BLOCK TECHNIQUE

BACKGROUND: Cytological examination of pleural uid is of paramount importance not only for diagnosis, staging, prognostication and management of malignancy also gives information about various inammatory and non-inammatory conditions. Conventional smear method has some disadvantages which can be overcome by cell block technique. To compare cytomorphological features ofAIMS AND OBJECTIVES: conventional smears versus cell block technique and also to evaluate the diagnostic efcacy of a combined approach of conventional smear study and cell block technique. 150 Sterile uid sample were processed in cytology section, Department of Pathology,MATERIAL AND METHOD: DECCAN COLLEGE OF MEDICAL SCIENCES, HYDERABAD. This study was conducted over a period of one and half years from January 2018 to June 2019. Each sample was divided into two equal parts one part was subjected to conventional smear method and other part was subjected to cell block technique. Statistical analysis was done using Microsoft Excel to calculate sensitivity and specicity of conventional cytosmears and cell block technique.RESULT: Sensitivity and additional yield for malignancy was 50% more by cell block method.

An Immunohistochemical Expression of CK5/6, CK7, and CK20 on Cell Blocks in Metastatic Cervical Lymphadenopathy

BackgroundThe neck is a common site of both primary and secondary malignancies. Many tumors from the head and neck (oral cavity, larynx, and pharynx), lung, and gastrointestinal tract metastasize to cervical lymph nodes. At most times, tumors are diagnosed by morphology, sometimes it is difficult to diagnose an unknown primary presenting as metastatic lymphadenopathy solely on the basis of morphology. Specific histological cell types can be confirmed by the use of immunohistochemistry.AimThe present study evaluated the utility of cell block over fine-needle aspiration cytology (FNAC) and immunohistochemical expression of CK5/6, CK7, and CK20 in metastatic cervical lymphadenopathy.Methods:This prospective study design was used on a total of 50 cases. FNAC smears and cell blocks were made in all the cases. All the cell blocks were compared with FNAC findings and further subjected to immunohistochemical (IHC) analysis. The necessary statistical analysis was done.Results and ConclusionOur study showed that the combined use of the cell block technique and FNAC was more useful and sensitive in diagnosing the metastatic cervical lymph nodes and the accuracy can be further improved by the use of IHC on the cell blocks. The combined use of CK5/6, CK7, and CK20 in metastatic cervical lymphadenopathy is helpful in diagnosing squamous cell carcinoma and adenocarcinoma with known/unknown primary sites.

Diagnostic Utility Of Fluid Cytology By Conventional Smear And Cell Block Method In Pleural Effusion

The cytological examinations of serous effusions have been well-accepted, and a positive diagnosis is often considered a definitive diagnosis. The study was planned to determine the diagnostic utility of fluid cytology by conventional smear and cell block method in pleural effusion. This was a hospital-based open cohort observational study conducted on patients diagnosed with pleural effusion. The study period was one year, and patients were recruited using a nonprobability sampling method. The fluid samples were subjected to the conventional smear examination, followed by cell block preparation. The overall morphologic details, cellularity, architecture, and nuclear and cytoplasmic details were studied and compared in conventional smear and cell block techniques. The samples were categorized as unsatisfactory, benign, suspicious for malignancy, or malignancy. The study was conducted on 113 pleural fluid samples. The study demonstrated that the cell block technique improved the cellular yield and established diagnosis in malignant effusions.

Diagnostic utility of cellblock technique in reporting body fluid cytology

Introduction: Body fluids are processed by routine cytology techniques like preparing a slide and staining it with PAP stain. By this method it is difficult to give definitive diagnosis particularly to the cases where some abnormal cells seen suspicious of malignancy. In our study we utilized cell lock technique for reporting body fluid cytology. Objectives: Our objective is to prepare cellblock from body fluid, to use it for diagnosis of benign and malignant lesions and also to check advantage and drawbacks of cell block technique over the conventional cytology examination. Materials and Method: This study was carried out in medical collage hospital in Department of Pathology. We selected total 52 body fluids with good cellularity for cell block preparation. Result: Out of 52 cases 45 were diagnosed as benign and 7 as malignant using cell block technique. Conclusion: We conclude with findings that cell block technique is better than routine cytology technique. By cell block technology tissue architecture can be well appreciated and definite diagnosis can be given. Also, we can utilize cell block for definitive diagnostic methods like Immunohistochemistry.

The diagnostic utility of ultrasound scanning, fine needle aspiration cytology and cell block technique in the pre-operative diagnosis of suspicious thyroid nodules

Journal of Diagnostic Pathology is a peer reviewed journal published biannually by the College of Pathologists of Sri Lanka. The journal publishes manuscripts dealing with all aspects of pathology. The aim of the journal is to update knowledge and encourage original research in the field of pathology.

Serous Effusion Cytology in Sudanese Patients

The purpose of this study was to determine the etiology and cytological patterns of serous effusions among Sudanese patients. Methods and Results: This descriptive study was carried out in hospitals of Khartoum state in the period from February 2019 to June 2020. One hundred and seventy-eight patients “clinically and/or radiological” diagnosed as having an accumulation of serous effusions were included in this study. Smears were prepared and stained according to the conventional pap staining procedure. The majority of the study population (121[68%]) had malignant effusion (MEs), and the other group (57[32%]) - benign effusions (BEs). Among patients with MEs, breast cancer was the major etiology (75[62%]), followed by lung (23[19%]), GIT (12[9.9%]), and thyroid cancers (11[9.1%]), while among patients with BEs, parapneumonic conditions were the main factor (28[49.1%]), followed by tuberculosis (18[31.6%]) and pulmonary embolism (11[19.3%]). The majority of patients with MEs were pleural effusion (109[90.1%]), followed by peritoneal effusion (12[9.9%]), whereas no patients in this group had pericardial effusion. Pleural effusion (29[50.9%]) was also the major one among patients with BEs, followed by peritoneal (21[36.8%]) and pericardial effusions(7[3.9%]). Conclusion: Malignant serous effusion is commonly seen among patients with malignant tumors; pleural effusions presented a large proportion, especially among females with breast cancer. Thoracentesis and cytological methods (i.e., conventional smear and cell block technique) should be the first line for the diagnosis of malignant pleural effusions, along with confirmatory adjunct techniques such as immunohistochemistry and immunocytochemistry.

Malignant Serous Effusions among Hospital In-patients in a Tertiary Care Hospital: A Descriptive Cross-sectional Study.

Cell block technique is an adjunct to conventional smears in the diagnosis of malignancy in effusion fluid. It aims at retrieving cellular material and concentrating cells in a small field, with preservation of cytomorphologic details. The objective of this study was to find the proportion of malignant serous effusions using cell block technique among hospital in-patients in a tertiary care centre. This was a descriptive cross-sectional study conducted among patients visiting a tertiary care centre between 1st June 2020 to 30th November 2020. Ethical approval was taken from the Institutional Review Committee (Reference number: 305202001). Using a convenience sampling method, 96 hospital in-patients were included in the study. Serous effusions were evaluated by conventional smears and cell block sections. Data was analysed using the Statistical Package for the Social Sciences version 23. Point estimate at 95% Confidence Interval was calculated along with frequency, percentage, mean and standard deviation. Among 96 hospital in-patients, 15 (15.62%) (8.35-22.88 at 95% Confidence Interval) were diagnosed as positive for malignancy by using cell block technique. By conventional smears, 80 (83.33%) cases turned out to be negative for malignancy, 13 (13.54%) were positive for malignancy and three (3.12%) were suspicious for malignancy. Of the three (3.12%) cases suspected for malignancy, two turned out to be positive for malignancy and one was found to be negative for malignancy on cell block technology. The proportion of malignant serous effusions was similar in comparison to other studies. Cell block technique could be routinely incorporated along with conventional smears for a more accurate diagnosis of malignancy on serous effusion.

Comparative Evaluation of Cell Block Histopathology and Conventional Smear Cytology in FNAC of Clinically Suspected Cervical Lymph Node Malignancy

Introduction: Cervical lymphadenopathy is a common clinical presentation in various departments of clinical practice. Fine needle aspiration cytology (FNAC) is usually the first choice to diagnose superficial cervical lymphadenopathy. However, FNAC sometimes does not yield information for precise diagnosis, and the risk of false-negative and indeterminate diagnosis is always present. In order to overcome these problems, cell block technique has been resorted to make the best use of the available material. Objective: The aim of this article is to evaluate whether there are any diagnostic advantages of cell block histopathology over conventional smear cytology by corroborating with excisional biopsy. Materials and Methods: A descriptive study with cross-sectional design was performed among 106 cases with clinical suspicion of malignancy. FNAC was performed without anesthesia, and the aspirated material was flushed on slides and then fixed immediately. The remaining materials were processed into cell blocks followed by HE staining. The data obtained were analyzed using SPSS (IBM Statistics, Version 20.0, SPSS, Chicago, IL, USA) statistical software. Ethical approval was obtained from the Institutional Ethics Committee, and informed consent was taken from all the participants before the procedure. Results: Out of the 106 cases, 101 (95.28%) cases were diagnosed as malignant lesions and 5 (4.72%) cases diagnosed as non-malignant lesions. The majority of the patients were in the 40–59 year age group and were males. The sensitivity of cytology to provide specific diagnosis in malignant lesions was 90.57%, whereas those of cell block histopathology and cell block histopathology with cytology were 94.34% and 98.11%, respectively. Conclusion: Cell block as an adjunct to FNAC can be a useful diagnostic technique in cervical lymphadenopathy. Compared with FNAC, it gives more accurate diagnostic architecture and apparent histopathological features.

Two cases of colorectal cancer in which ascitic examination by the cell block technique was useful for differentiation from ovarian cancer

Two cases of colorectal cancer in which ascitic examination by the cell block technique was useful for differentiation from ovarian cancer

Immunohistochemical features of canine ovarian papillary adenocarcinoma and utility of cell block technique for detecting neoplastic cells in body cavity effusions.

Dogs with ovarian papillary adenocarcinoma occasionally present with ascites and/or pleural effusion. These aspirated fluids often contain a large number of cells, and distinction between neoplastic cells and activated mesothelial cells can be difficult. In this study, 7 cases of canine ovarian papillary adenocarcinoma, including 3 with ascites and pleural effusion, were immunohistochemically examined. Ovarian tumor cells were positive for cytokeratin CAM5.2 (CAM5.2), Wilms’ tumor 1 (WT-1) and progesterone receptor (PR) in all 7 cases. A metastatic lesion of the mediastinum in one case was also positive for CAM5.2, WT-1 and PR. Immunohistochemistry on cell blocks obtained from ascites and/or pleural effusion of 2 cases revealed the presence of PR-positive epithelial cells. Whereas, activated mesothelial cells in ascites or pleural effusion collected from dogs without neoplastic lesions were negative for PR. In addition, surface epithelium and subsurface epithelial structures (SES) of normal canine ovaries, that are considered to be the cell of origin for ovarian papillary adenocarcinoma, were also positive for CAM5.2, WT-1 and PR. These results indicate that, together with CAM5.2, WT-1 and PR is a useful diagnostic marker for canine ovarian papillary adenocarcinoma. Expression of PR may be associated with progesterone-dependent nature of canine ovarian papillary adenocarcinoma.

Needle rinse cell blocks as an ancillary technique: Diagnostic and clinical utility in gastrointestinal neoplasia.

Fine-needle aspirate (FNA) cytology is often the first-choice method for diagnosing gastrointestinal nodular lesions. The FNA material can be converted to histopathology specimens by a needle rinse cell block (NRCB) technique, allowing ancillary studies to refine the cytologic diagnosis. Despite use in human pathology, NRCB has never been applied to canine or feline gastrointestinal neoplasia. This study described NRCB methodology and its diagnostic utility in specific cases of neoplastic gastrointestinal lesions. Needle rinses with saline were performed after ultrasound-guided FNAs of two intestinal lymphomas (canine and feline) and a canine gastrointestinal stromal tumor (GIST). The NRCB was prepared using the cell tube block technique and processed for paraffin embedding. Routine immunohistochemistry protocols (using CD3, PAX-5, and Ki-67 for lymphoma cases and vimentin, desmin, S-100, and KIT markers for GIST) were applied to NRCB sections, and the results were compared with matched tissue biopsies. NRCBs with adequate cell numbers, preservation, and good separation of blood were obtained. The diagnosis and immunophenotyping were confirmed in both cases of lymphoma in NRCBs. In the GIST, the immunolabeling of the neoplastic cells in NRCB was completely concordant with the tissue biopsy. The described methodology is suitable for veterinary settings, having few technical requirements and low invasiveness. The presented cases of gastrointestinal neoplasia highlight the utility of NRCBs as a platform to conduct ancillary studies and refine the cytologic diagnosis.

Cellblockistry in serous effusion cytology- A systematic review with recent concepts

Serous effusion cytology being a minimally invasive, readily accessible and inexpensive diagnostic procedure. Nevertheless, the accuracy of SEC could vary widely due to the multitude factors including the level of experience of the cytologists Conventional smear has its own limitations with varied efficacy and hence warranting ancillary studies. Cell block has emerged as a paramount and robust platform for sample processing techniques in cytology. Research studies have proved that the efficiency of cytological diagnosis increases by significant margin of 15-20 percent when it is done in conjunction with cell block techniques especially in cases of exudative fluids in picking up crucial cases and based on this, we intended with a novel aim to analyse the accuracy of Serous effusion cytology by combining conventional smear and cell block technique with an attempt to assess the effectiveness of the cell block by our indigenous Modified Bouin’s method.Cell block method prepared by our indigenous Modified Bouin’s preparation with formalin fixative proved to show high quality significance and hence it could be followed in routine practice across laboratories. Cell block technique is quantitatively superior both standalone as well as in conjunction with conventional smear by improving the effective diagnosis of SEC. Diligent use of cell block technique eliminates the suspicious of malignant category on CS and thereby giving more definite diagnosis and thus it is mandated that combined approach of CB in conjunction with CS should be practiced as binary protocol which proved to have obvious influence on patient management.