Diagnostic utility of cell block in fine needle aspiration cytology of thyroid gland

Background: Fine needle aspiration cytology is a standard screening technique for the diagnosis and assessment of thyroidnodules. However, this approach has some drawbacks, such as false negative or positive outcomes and high rates ofunsatisfactory results.Objective: To describe the utility of cell block technique as an adjunct to conventional smear in the cytodiagnosis of thyroidepithelial lesions.Material and Methods: This Descriptive Cross-sectional study was done at the Pathology department of Saidu Group of TeachingHospital Saidu Sharif Swat from 1st November 2017 to 31st April 2018. Fine needle aspirates for both the direct smear and cell blockwere collected simultaneously from 60 patients, through non- probability convenient sampling. All patients having clinicallyenlarged thyroid, solitary or dominant thyroid nodule were included in the study.All patients below 22 years old and patients who didnot give informed consent were excluded. Ethical clearance was obtained from the ethical research committee before carrying outthe study. Written informed consent was taken from all the participating patients.Cellularity, obscuring background material, morphological and architectural preservation as well as cytodiagnosis on direct smearand cell block technique were compared. Data were analyzed using SPSS software version 21. McNemar's chi-square test wasapplied for significant difference. P-value of = 0.05 was considered significant.Results: Male to Female ratio was 1:7.5, (13%: 87%). The age ranged from 22 to 81 years with a mean age of 44.9 and standarddeviation of ±14.5 years. The study showed that the cell block technique has high cellularity, minimal obscuring background, betterarchitectural preservation and poor morphological preservation on cell block in comparison to direct smear. The majority of thecases were benign on both techniques. The unsatisfactory rate was reduced in cell block technique and showed additionalinformation in 13 % cases.Conclusion: The study demonstrated no significant difference in the diagnostic utility of both techniques.Keywords: Cell Block Cytopathology, FNAC, Mair et al criteria

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Cell Block and Its Impact in the Diagnosis of Jaw Lesions over Fine Needle Aspiration Cytology

Acta Cytologica ◽

10.1159/000517166 ◽

2021 ◽

pp. 1-7

Author(s):

Kaveri Hallikeri ◽

Biji Babu ◽

Archana Sudhakaran ◽

Roshni Monteiro

Keyword(s):

Fine Needle Aspiration ◽

Fine Needle Aspiration Cytology ◽

Dentigerous Cyst ◽

Needle Aspiration ◽

Histopathological Diagnosis ◽

Cell Block ◽

Aspiration Cytology ◽

Fine Needle ◽

Dentigerous Cysts ◽

Needle Aspiration Cytology

Objectives: To determine the role and efficacy of fine needle aspiration cytology (FNAC) and cell block in diagnosis of jaw lesions and compare the agreement between FNAC and cell block to predict the diagnosis. Method: The sample comprised 51 cases, including 12 odontogenic keratocysts (OKCs), 8 ameloblastomas, 22 radicular cysts, 7 dentigerous cysts, and 1 each of intraosseous mucoepidermoid carcinoma (MEC) and adenomatoid odontogenic tumor (AOT). FNAC samples remaining after hematoxylin and eosin (H&E)-stained cytosmear diagnosis were centrifuged at 3,000 rpm for 10 min. The supernatant was discarded and sediment mixed with 2–3 mL alcohol and filtered. To this, 10% formalin was added, filtered, taken for routine processing, and stained with H&E. The result of FNAC smear and cell block was compared with histopathological diagnosis. Results: On cytological examination of the smears, 7 OKCs and 22 radicular cysts were diagnosed, whereas ameloblastomas, AOT, intraosseous MEC, and dentigerous cysts were not. This gave an agreement of 56.8% with the biopsy reports. Cell block sections stained with H&E of 12 OKCs, 22 radicular cysts, 1 MEC, and 3 cases of ameloblastoma offered a diagnosis in accordance with the biopsies giving an agreement of 74.5%, while dentigerous cyst and AOT failed to do so. In comparison with FNAC, additionally 5 cases of OKC and 1 of MEC could be detected, and in ameloblastoma, out of 8 cases, only 3 yielded a concordant diagnosis through the cell block technique. Conclusion: In comparison with FNAC, the architectural pattern and the morphology of the cells were better preserved by the cell block technique. This substantiates that cell block could be used as an ancillary technique to aid in definitive diagnosis of head and neck swellings.

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