Development of a cost-effective method for cell block preparation: A simple way of tumor representation

Anup K Boler; Abhishek Bandyopadhyay; Arghya Bandyopadhyay; Shreosee Roy

doi:10.4103/JOC.JOC_8_18

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LETTER TO EDITOR

Year : 2018 | Volume : 35 | Issue : 4 | Page : 265-266

Development of a cost-effective method for cell block preparation: A simple way of tumor representation

Anup K Boler, Abhishek Bandyopadhyay, Arghya Bandyopadhyay, Shreosee Roy
Department of Pathology, Burdwan Medical College, Burdwan, Purba Bardhaman, West Bengal, India

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Date of Web Publication

19-Oct-2018

How to cite this article:
Boler AK, Bandyopadhyay A, Bandyopadhyay A, Roy S. Development of a cost-effective method for cell block preparation: A simple way of tumor representation. J Cytol 2018;35:265-6

How to cite this URL:
Boler AK, Bandyopadhyay A, Bandyopadhyay A, Roy S. Development of a cost-effective method for cell block preparation: A simple way of tumor representation. J Cytol [serial online] 2018 [cited 2023 Mar 28];35:265-6. Available from: https://www.jcytol.org/text.asp?2018/35/4/265/235505

Sir,

Currently, the utility of cell block study as an integral part of cytology is further appreciated, largely owing to the significant role they play in ancillary testing, particularly molecular diagnosis.^[1] In the present era of specific targeted therapy, appropriate diagnosis including morphological, immunohistochemical, and molecular characterization of malignant neoplasm has become very important and challenging. This needs availability of tumor in the specimen. Adequately cellular cell blocks serve as a source of tumor cells for ancillary testing. Role of cell block preparation in modern diagnostic approach of lung carcinoma, particularly in non-small-cell carcinoma (NSCLC), has become very important. As most of the ancillary testing platforms are developed on formalin-fixed paraffin-embedded (FFPE) tissue, cell block preparations processed in this way generally do not require additional validation.^[2]

Plasma thrombin and HistoGel are the most commonly used methods,^[3] while tissue coagulum and collodion are other variations of the above-mentioned techniques.^[4] Though their value is acknowledged and they are widely used across laboratories, methods for cell block preparations are not standardized.

Considering resource constraints in our setup, we developed a simple but effective method for cell block preparation from fine needle aspiration (FNA) material of lung lesions. The material was obtained by inserting 21-gauze spinal needle attached to a 10-cc syringe. The needle was passed into the target lesion under the guidance of computed tomography scan. The syringe fitted with an FNA gun was then attached to the spinal needle after withdrawal of the stellate. Mild negative pressure was created in the syringe and the material was chiselled and sucked in by brief, rapid to and fro movements. The needle was withdrawn as soon as blood was seen to cross the needle hub. The needle was kept aside after detaching it from the syringe. The material present in the syringe was used to make smears in four to five slides of which one was kept for alcohol fixation and others were allowed to air dry. The remaining material from syringe was ejected into a glass slide and allowed to clot. Next, the material present in the needle hub was scooped out by pin head and added to the remaining material in the glass slide. Residual material if present in the needle was also collected by introducing the stellate. The clotted material was then transferred to a glass test tube containing 10% buffered formalin and centrifuged subsequently [Figure 1]. The deposited material was processed routinely and stained with hematoxylin and eosin for cell block sections. The air-dried and alcohol-fixed smears were also stained with MGG and PAP stains [Figure 2].

Figure 1: (a) Smears being prepared from the aspirated material present in the syringe while the needle is kept aside, (b) smears are ready and material in the needle hub is being scooped out, (c) scooped out material is being added to the remaining material on the slide, (d) the congealed material is being transferred to a test tube containing 10% buffered formalin

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Figure 2: (a) FNA smear of adenocarcinoma showing high cellularity with presence of acini and papillae (MGG stain, ×100). (b) Corresponding cell block preparation showing high cellular yield with preserved well-formed papillae (H and E stain, ×100)

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This technique requires skill in collection of specimen and its judicious allocation among smears and cell blocks. This not only avoids the need of biopsy but also minimizes the number of passes and maximizes the yield. A comprehensive cost-effective study on lung tumors has been undertaken to assess the cellularity, morphology, architecture, and final outcome of the cell blocks, which will be shared in future.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1.	Saqi A. The state of cell blocks and ancillary testing, past present and future. Arch Pathol Lab Med 2016;140:1318-22.
2.	Jain D, Mathur SR, Iyer VK. Cell blocks in cytopathology: A review of preparative methods, utility in diagnosis and role in ancillary studies. Cytopathology 2014;25:356-71.
3.	Crapanzano JP, Heymann JJ, Monaco S, Nassar A, Saqi A. The state of cell block variation and satisfaction in the era of molecular diagnostics and personalized medicine. Cytojournal 2014;11:7. [PUBMED] [Full text]
4.	Yung RC, Otell S, Illei P, Clark DP, Feller-Kopman D, Yarmus L, et al. Improvement of cellularity on cell block preparations using the so-called tissue coagulum clot method during endobronchial ultrasound-guided transbronchial fine-needle aspiration. Cancer Cytopathol 2012;120:185-95.