Cell Block Research Articles

Diagnostic Value of Preparing Additional Liquid-Based Cytology Slides and Cell Blocks from Residue Material in Thyroid fine Needle Aspiration.

After liquid-based cytology (LBC) technique developed for cervical cytology, it has been used for nongynecological samples and has been very successful. It offers having extra slides of the samples for further examination and ancillary tests. Moreover, cell blocks can be formed from the residue material. The study aimed to evaluate the importance of preparing a second LBC slide or a cell block from the residue material of thyroid fine needle aspiration (FNA) samples to reach a definitive diagnosis in cases diagnosed as nondiagnostic (ND) after the first slide. Seventy five cases diagnosed as ND after the first slide were included in study. For 50 cases, the second LBC slides were prepared (LBC group); for 25 cases, cell block was performed from residue material (CB group). Two groups were compared in terms of reaching a definitive diagnosis. At the end of secondary procedures, a definitive diagnosis was reached in a total of 24 cases (32%). Twenty of 50 cases (40%) in LBC group reached a definitive diagnosis while four cases (16%) in the CB group reached a definitive diagnosis. Achieving a definitive diagnosis was found statistically higher in the LBC group in which the second slide was formed compared to the CB group (P =0.036). Preparing a second slide with LBC method is more purposive than preparing a cell block from the residue material of thyroid FNA samples. Reducing the percentage of ND cases will protect patients from complications and morbidity that may arise from repeated FNA.

Programmed Death Ligand-1 Testing in Adenocarcinoma Lung: A Comparative Study of Cell Block versus Biopsy.

Immunotherapy currently stands as a novel treatment option, specifically in cases of advanced non-small cell lung carcinoma (NSCLC). Expression of programmed death ligand-1 (PD-L1) in tumor cells forms the mainstay for the use of anti-PD-L1 monoclonal antibodies in the treatment of NSCLC. The objectives of the study were to assess utility of cell blocks for testing of PD-L1 in adenocarcinoma lung and to compare the expression of PD-L1 in cell blocks and the corresponding biopsy specimens. The current study was a prospective case series that included 20 cases of NSCLC-adenocarcinoma lung. Cases included in the study had biopsies performed from lung masses, along with which cell blocks were prepared from fine needle aspiration cytology (FNAC) samples. Testing for PD-L1 was done using the monoclonal PD-L1 antibody, SP-263 clone on the Ventana Benchmark XT system. PD-L1 expression was assessed only in the tumor cells, and cases with >1% expression, cytoplasmic or membranous, in tumor cells were categorized as positive. PD-L1 expression was identified in the biopsy samples of tumor cells of 20% of cases (n = 4/20). In the corresponding cell blocks, PD-L1 expression was identified in the tumor cells of 15% of cases (n = 3/20). Sensitivity and specificity of cell blocks were 75% and 100%, respectively. Positive and negative predictive values were 100% and 94.12%, respectively. PD-L1 testing has both predictive and prognostic implications. PD-L1 testing in cell block samples is a potential alternative, specifically in cases where biopsy tissue is minimal or unavailable.

Cell Block versus Cytospin in the Detection of Malignancy in Body Fluids: A Cross-sectional Study

Introduction: Cytological examination of body fluids is a commonly performed investigation that provides information about inflammatory and malignant lesions, aiding in the diagnosis of effusion aetiology and potential differential diagnoses. The cell block technique, combined with cytospin study, offers an additional advantage in such cases. Aim: To compare the diagnostic utility of cell block method and cytospin method in detecting malignancy in body fluids. Materials and Methods: This cross-sectional observational study was conducted for a period of two years at Bharati Vidyapeeth (DTU) Medical College Hospital and Research Centre in Pune, Maharashtra, India. A total of 100 body fluid samples were analysed, including 73 pleural fluids, 24 ascitic fluids, and 3 pericardial fluids. Each fluid sample was divided into two equal parts: one processed for cytospin (CYTOTEK), and the other processed to create a cell block. Four Immunohistochemistry (IHC) markers (Thyroid Transcription Factor-1 (TTF-1), Cytokeratin 7 (CK7), Cytokeratin 20 (CK20), and Calretinin) were applied as needed. Data analysis was performed using the Statistical Package for Social Sciences (SPSS) version 25.0, and results were calculated using the Chi-square test. Results: Of the total 100 fluid samples, 65 were negative, 17 were positive, and 18 were suspicious for malignancy using the cytospin method. In comparison, the cell block method identified 63 samples as negative, 29 as positive, and 8 as suspicious for malignancy. The cell block method exhibited a higher sensitivity (100.00%) and specificity (94.03%) than the cytospin method (81.82% and 88.06%, respectively) in this study. Conclusion: Cell block method accurately diagnosed 10 cases as positive for malignancy that were initially deemed suspicious on cytospin smear. Therefore, the cell block method proved to be a superior diagnostic tool for malignancy compared to cytospin smear. Given that cell blocks allow for longer storage and additional analysis such as IHC and microarray, they should be adopted in addition to cytospin for effusion cytology

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.

Fine Needle Aspiration Cytology's Role in the Diagnosis of Ovarian Tumor.

Fine needle aspiration cytology (FNAC) is a cost-effective, minimally invasive technique for diagnosing a wide range of benign and malignant lesions. However, there are a number of reasons why its use is limited in the diagnosis of ovarian cancer, such as the fear of tumor cells spilling into the peritoneal cavity and the difficulty of subtyping with cytology alone. In experienced hands, FNAC is a safe, cost-effective procedure with acceptable diagnostic accuracy. In ovarian cystic lesions, secondary degenerative changes and the sample's low cellularity were the primary causes of false negative FNAC results. Preparing cell block can partially avoid this, so we recommend doing so. All of the clinical and sonographic findings, in addition to the FNAC findings, the preparation of the cell block, and the application of immunohistochemistry, need to be taken into consideration in order to arrive at an accurate diagnosis.

A method of preserving crystalline components of joint fluid using cell blocks and its application to education

A method of preserving crystalline components of joint fluid using cell blocks and its application to education

Cell Block and IHC Emerging Tool for Differentiating Liver SOL

Cell Block and IHC Emerging Tool for Differentiating Liver SOL

MASC Gets UNMASKED: Visiting a Rare Tumor with Emphasis on Cytomorphological Features.

Secretory carcinoma (SC) is a newly described entity which has been often misdiagnosed earlier as acinic cell carcinoma on cytology. Diagnosing SC was initially based upon identifying the ETV6:NTRK3 fusion gene with the help of fluorescence in situ hybridization (FISH). Lately, with more knowledge of the reliable histomorphology, cytology, and immunohistochemistry features, definitive diagnosis can be confidently made without the help of FISH in almost every case. Six histologically confirmed cases of SC were studied. The cytology slides of all the six cases were retrieved and reviewed to identify the characteristic features which could have helped in raising the possibility of SC on fine needle aspiration cytology itself. Cell blocks were also studied, wherever available. Patients were all male with average age of 35.2 years. The six cases in the current study demonstrated at least focal cytoplasmic vacuolization of varying sizes, papillae formations, and bland nuclear features on fine needle aspirate smears. It was also seen that S-100 and mammaglobin immunohistochemistry (IHC) are very helpful in confirming the diagnosis. The results of the current study highlight the cytomorphological features which may help in clinching the diagnosis SC on cytology itself. They also highlight certain cytological features which help to rule out the other differential diagnoses.

Molecular testing opportunities on cytology effusion specimens: the pre-analytic effects of various body fluid cytology preparation methods on RNA extraction quality and targeted sequencing.

RNA sequencing (RNAseq) analysis is emerging as a clinical research or diagnostic approach for cytologic samples, but there is need for formal comparison of different sample preparation methods in the cytology laboratory to identify which pre-analytic methods could provide alternatives to formalin-fixed paraffin-embedded (FFPE) sections. We prepared 13 malignant effusions (metastatic estrogen receptor-positive breast cancer) in the cytology laboratory using 6 routine cytologic methods: FFPE cell block, Carnoy's solution, 95% ethanol (EtOH), air-dried and Diff-Quik, ThinPrep, and SurePath preparations. Measurements of RNA quality, expression of 2 multigene expression signatures, molecular subtype, and 4 common activating mutation sites in each preparation were compared with fresh frozen (FF) cell pellet in RNA preservative using distribution of fragment length and concordance correlation coefficient (CCC). The fraction of RNA fragments measuring 200 bases or more (DV200) were 24% higher from cytospins fixed in Carnoy's solution or 95% EtOH than DV200 from FFPE cell blocks. SurePath samples failed RNAseq quality control. There was high concordance of gene expression measurements with FF samples using cytospins fixed in Carnoy's solution, 95% EtOH, Diff-Quik (CCC = 0.829, 0.812, 0.760, respectively), or ThinPrep (CCC = 0.736), but lower using FFPE cell block (CCC = 0.564). The proportion of mutant transcripts was concordant between FF and any cytologic preparation methods. Cytospin preparations fixed with Carnoy's or 95% ETOH then Papanicolaou stained produced RNAseq results that were equivalent to FF samples and superior to FFPE cell block sections.

Role of Guided FNA in Gallbladder Cancer: A Retrospective 3-Year Study.

A majority of the patients with gall bladder cancer (GBCa) present at an advanced stage and have poor survival. The aim is to retrospectively study the role of guided FNA in the diagnosis of GBCa in a superspecialty institute and to describe the cytomorphologic spectrum of gall bladder (GB) lesions in the North Indian population. All suspected cases of GBCa who underwent guided FNA from the primary GB mass or metastatic liver space-occupying lesion from 2017 to 2019 were included. The aspirate smears were retrieved and analyzed for cytomorphological features independently by two cytopathologists. The neoplastic lesions were classified according to the WHO 2019 classification. Of 489 cases, fine needle aspiration cytology (FNAC) was diagnostic in 463 cases (94.6%), of which 417 (90.1%) were positive for malignancy, 35 (7.5%) were inflammatory, and 11 (2.4%) were inconclusive for malignancy. Adenocarcinoma not otherwise specified (NOS) was the most common type seen in 330 cases (79.1%) and 87 (20.9%) were unusual variants. These included papillary adenocarcinoma (22, 5.2%), mucinous adenocarcinoma (12, 2.8%), signet ring carcinoma (2,0.4%), adenosquamous carcinoma (8, 1.9%), squamous cell carcinoma (10, 2.4%), neuroendocrine neoplasms (7, 1.7%), undifferentiated carcinoma (24, 5.7%) and non-Hodgkin lymphoma (2,0.4%), respectively. Immunohistochemistry on the cell block confirmed the diagnosis wherever possible. Histopathology was discordant in 5 out of 33 cases. Guided FNAC is a sensitive investigation that plays a crucial role in confirming the diagnosis and deciding the further treatment options in advanced-stage GBCa patients. The uncommon variants of GBCa can be reliably categorized on cytology.

Cytologic and immunohistochemical study on cell blocks of effusion fluids in patients with serous adenocarcinoma of the ovary

Cytologic and immunohistochemical study on cell blocks of effusion fluids in patients with serous adenocarcinoma of the ovary

An improved method for paraffin-embedded cytological preparations: application to the detection of circulating tumour cells.

Conventional tissue biopsy is a key examination in cancer diagnosis. However, liquid biopsy is an alternative and less invasive solution that allows the detection of circulating tumour cells (CTCs). CTCs have emerged as a potential screening, diagnostic, and prognostic tool in cancer management. There are many technologies available for the detection and characterization of these cells, but most are either expensive or complicated to apply routinely. Cytological cell blocks (cytoblocks) may be a more practical and cost-effective method to enrich and characterize CTCs and even perform molecular studies. These cytoblocks allow the processing, analysis, and storage of cell suspensions and fluid aspiration samples containing CTCs. Here we detail a manual protocol based on isolation by density gradient centrifugation, formalin fixing, and paraffin embedding as well as morphological identification for cytological analysis and phenotyping by immunocytochemistry. This method is the result of technical adjustments of previously established protocols. We succeeded in modifying a protocol for the construction of cytoblocks and applied it to study CTCs in lung and colorectal cancers, respectively. This less expensive protocol offers a possibility for use in routine diagnosis and can be applied in other fields of research, such as hematology for hematological malignancies and immunology.

Comparative evaluation of diagnostic efficacy of cell block versus aspiration cytology

Comparative evaluation of diagnostic efficacy of cell block versus aspiration cytology

A single tertiary institution review of the international system for serous fluid cytopathology and the impact of cell block and ancillary studies on its performance.

We sought to assess the utility of the International System for Serous Fluid Cytopathology (TIS) in the context of our department's routine practice. We examined 1028 archived effusion cytology (pleural, peritoneal, and pericardial) cases from 2018 to 2019, and re-classified them along the international system into the following diagnostic categories: nondiagnostic (ND), negative for malignancy (NFM), atypia cells of undetermined significance (AUS), suspicious for malignancy (SFM), and malignant (MAL). The full distribution of the cases examined was as follows: ND 2.0%; NFM 66.1%; AUS 6.0%; SFM 4.7%; MAL 21.2%. Overall risk of malignancy for each category was calculated as: ND 30.0%; NFM 18.0%; AUS 61.9%; SFM 100%; MAL 94.4%. The overall performance attributes of TIS were as follows: sensitivity 57.1%; specificity 98.3%; positive predictive value 94.4%; negative predictive value 82.0%; diagnostic accuracy 84.5%. The new classification was simple and intuitive to use and our results appear to fall within the expected ranges of the new guidelines, with risk of malignancy and accuracy comparable to similar studies. The availability of a cell block allowed for refinement of the diagnosis in a majority of cases with equivocal cytology, though this was dependent on the cell yield.

The FCH2RAIL Project: A Demonstration of a Modular Fuel Cell Hybrid Power Pack

In this paper, the Horizon 2020 project FCH2RAIL is outlined. The project aims to develop a bi-modal propulsion system, which combines an overhead catenary powertrain and a hydrogen fuel cell battery electric hybrid system to enable operation on tracks with mixed electrification. A key element is the fuel cell hybrid power pack and its modularity. Therefore, a methodology was developed to derive generic and well-suited fuel cell and battery block sizes. A work flow is set up, which combines a vehicle simulation and a fuel cell hybrid propulsion system model. Using statistical analysis, required battery and fuel cell block sizes are derived. With the developed methodology, 17 kWh were determined for the battery block and 47 kW for the fuel cell block. These dimensions are well-covered by market-available components, which demonstrates the applicability of the proposed methodology.

The Application of Thoracoabdominal Effusion Cell Block Technology in Tumor Origin Diagnosis and Gene Detection of Lung Adenocarcinoma

The Application of Thoracoabdominal Effusion Cell Block Technology in Tumor Origin Diagnosis and Gene Detection of Lung Adenocarcinoma

Hot deformation behavior of a cryogenic high manganese steel based on the microstructure and texture evolution

The correlation between microstructure evolution, texture development and hot deformation behavior of high manganese steel for LNG were investigated through uniaxial hot tensile tests at different temperatures (800, 850, 900 and 980 °C). Hot tensile tests were carried out on a Gleeble 3800 thermomechanical simulator with a strain rate of 10 /s. Texture analysis was conducted by the orientation distribution functions acquired from the electron backscatter diffraction (EBSD). Detailed microstructure and dynamic recrystallization (DRX) were indicated by the grain orientation spread of EBSD and transmission electron microscopy (TEM). The results show that there are only two stages in the work hardening rate when the deformed microstructure is non-recrystallized or mostly recrystallized. The work hardening rate exhibits a wave-like fluctuation when the tensile temperature is near the critical DRX temperature, due to the continuous competition between the dislocation packing caused by deformation and the softening intrigued by DRX. The deformed microstructure contains the highly dense dislocation wall (HDDW) structure and the cell block structure, and the HDDW structure mostly occurs in the 〈001〉//td fiber while the latter corresponds to the 〈111〉//td fiber. What's more, <001>//td fiber has stronger orientation gradient and work hardening rate than <111>//td fiber. DRX preferentially nucleated on the <001>//td fiber through two nucleation methods: strain-induced grain boundary migration and twining nucleation. DRX grains only retain the weak {111} 〈112〉 F and {110} <112> A textures, and the overall texture was weakened and randomized.

Usefulness of Cell Blocks From Forceps and Brush Washing Fluid in Bronchoscopy

Usefulness of Cell Blocks From Forceps and Brush Washing Fluid in Bronchoscopy

Clinicopathological Evaluation of Endobronchial Ultrasound Guided Transbronchial Needle Aspiration (EBUS-TBNA) in Diagnosis of Mediastinal Lesions

Background: The diagnosis of mediastinal lesions is not easy. Special techniques are indicated for evaluation and confirmation of diagnosis. Objectives: The aim of the study is the endobronchial ultrasound guided transbronchial needle aspiration (EBUS TBNA) is an important tool for clinicopathological evaluation as well as diagnosis of different mediastinal lesions. Materials and Methods: It was an observational study. EBUS-TBNA was done in eighty six patients. All these individuals have mediastinal pathology. Endobronchial aspiration was done from the lesions seen by ultrasonography and its cytomorphological analysis was done. Tissue morphology was also examined from cell block preparation. Immediate post procedure complications were monitored. Results: In the study, total eighty six (86) cases with adequate material were included. Fifty one (51) cases were granulomatous lymphadenitis, necrotizing granulomatous lymphadenitis were identified in 20 cases and 28 had non-necrotizing granulomas and only three cases are granuloma with suppuration. Tuberculosis was diagnosed in 23 patients (26.7% of granulomatous) and sarcoidosis was found in twenty eight cases (32.6% of granulomatous). Seventeen (19.8%) patients had malignant disorders. Out of 17 cases of malignancy, adenocarcinoma was the predominant (07cases), five cases were non-small cell carcinoma, small cell carcinoma was four cases and non-Hodgkin lymphoma was only one. Eighteen cases (20.9%) had cytological features of reactive lymphadenitis. During procedure no complications developed. Conclusions: For diagnosis of different mediastinal pathology and collection of adequate cytological as well as tissue material (cell block), EBUS TBNA is an important diagnostic procedure with minimal invasion.

Fine‐needle aspiration cytology for the diagnosis of plasma cell neoplasms in the head and neck region: A systematic analysis of the literature

Cytopathologic analysis is feasible and provides detailed morphological characterisation of head and neck lesions. To integrate the available data published on fine-needle aspiration cytology (FNAC) used for the diagnosis of plasma cell neoplasms (PCN) of the head and neck region. Searches on PubMed, Web of Science, Embase, and Scopus were performed to compile data from case reports/case series published in English. The Joanna Briggs Institute tool was used for the critical appraisal of studies. A total of 82 studies comprising 102 patients were included in this review. There was a predilection for men (68.6%) (male/female ratio: 2.1:1). Individuals in their 50s (29.4%), 60s (22.5%), and 70s (22.5%) were more often affected. The thyroid gland (26.2%) was the main anatomical location, followed by scalp (15.5%), neck/cervical region (15.5%), jaws (13.6%), and major salivary glands (13.6%). For FNAC analysis, a smear was employed in 41 (40.6%) cases and a cell block was used in four (3.9%). In 56 (55.4%) reports, no cytological methods were available. Morphologically, 34 (56.7%) cases had a diagnosis of PCN with agreement between cytopathology and histopathology. The rate of wrong diagnoses when using cytology was 27.5%. Immunophenotyping was performed in 49 (48%) of the cases. The 69-month disease-free survival rate was 60.2%, while the 27-month overall survival rate was 64.1%. This study reinforces that FNAC can be an ancillary tool in the first step towards the diagnosis of PCN of the head and neck region, especially when applying a cell block for cytological analysis.