Impact of routine cell block preparation on results of head and neck fine needle aspirates

Objectives: Cell block preparation is a recognized technique in histopathological diagnosis. This technique aids in maintaining an intact architecture and reducing the diagnostic errors associated with fine-needle aspiration cytology. Numerous techniques have been put forth, but the need for an optimal technique for routine use in the laboratory still persists. The aim of our study was to establish a cell block technique which aids in the accurate diagnosis of head and neck pathology. Methodology: A modified cell block technique was developed using alcohol-formalin as a fixative. Forty fine-needle aspiration fluids from clinically and radiologically diagnosed cases of head and neck pathology were used as samples. The cell block sections were compared with the cytology smears to determine the utility of the technique. Results: The cell blocks presented with better preservation of the architectural framework and enabled a quick diagnosis. Cellular clumping was negligible, and nuclear as well as cellular details were maintained similar to tissue sections. It led to the integration of conventional techniques using 10% neutral buffered formalin with that of the 10% alcohol-formalin technique. Conclusion: Modified cell block technique can be used as a simple and effective tool in the routine diagnosis of head and neck pathology.

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Novel Modification of HistoGel-Based Cell Block Preparation Method: Improved Sufficiency for Molecular Studies

Archives of Pathology & Laboratory Medicine ◽

10.5858/arpa.2017-0030-oa ◽

2017 ◽

Vol 142 (4) ◽

pp. 529-535 ◽

Cited By ~ 15

Author(s):

Natasha Rekhtman ◽

Darren J. Buonocore ◽

Dorota Rudomina ◽

Maria Friedlander ◽

Crisbane Dsouza ◽

...

Keyword(s):

Preparation Method ◽

Ex Vivo ◽

Substantial Improvement ◽

New Method ◽

Cell Block ◽

Cell Capture ◽

Preparation Methods ◽

Fine Needle ◽

Fine Needle Aspirates ◽

Molecular Studies

Context.— Cell block preparation methods vary substantially across institutions and are frequently suboptimal. The growing importance of biomarker testing in the era of targeted therapies makes optimization of cell block preparation critically important. Objective.— To develop an improved cell block preparation method. Design.— Ex vivo fine-needle aspirates and scrapes from surgically resected tumors were used to develop an improved HistoGel (Thermo Fisher Scientific, Waltham, Massachusetts)-based cell block preparation method. Cellularity yield with the new versus the standard method was assessed in ex vivo split samples and in consecutive clinical fine-needle aspirates processed before (n = 100) and after (n = 100) the new method was implemented in our laboratory. Sufficiency of cell block material for potential molecular studies was estimated by manual cell quantitation. Results.— The key modification in the new method was pretreatment of the pelleted cells with 95% ethanol before the addition of HistoGel (HistoGel + ethanol method). In addition, we optimized the melting conditions of HistoGel and added a dark, inorganic marker to the cell pellets to highlight the desired level of sectioning during microtomy. Cell blocks from ex vivo split samples showed that the HistoGel + ethanol method yielded, on average, an 8.3-fold (range, 1–20) greater cellularity compared with the standard HistoGel-only method. After the switch from the standard HistoGel method to the modified method in our clinical practice, sufficiency of positive fine-needle aspirates for some molecular studies increased from 72% to 97% (P = .002). Conclusions.— We describe a simple and readily adoptable modification of the HistoGel method, which results in substantial improvement in cell capture in cell blocks, leading to a significant increase in sufficiency for potential molecular and other ancillary studies.

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