Title: Evaluation of Cell Block Techniques in the Cytodiagnosis of Body Fluids in Meenakshi Medical College and Research Institute, Kanchipuram
Authors: Sujoy Sukladas, Shanmugapriya M, Eswari V
DOI: https://dx.doi.org/10.18535/jmscr/v6i9.82
Abstract
Background: Preparation of conventional smear is simpler and less time bound but it has many disadvantages causing difficulties in definitive diagnosis in fine needle aspiration materials and fluids. But cell block techniques are particularly useful in positive for malignancy and suspicious of malignancy cases. Once diagnosed as malignant in cell blocks, this can be taken as definitive diagnosis as a biopsy specimen. This helps in early diagnosis, treatment and better prognosis of patient. But cell block has minor disadvantages too e.g. needs more material and time.
Aim: To study cell block preparation of all the body fluids with conventional cytology smear.
Material and methods: This prospective study conducted in Meenakshi Medical College and Research Institute, a tertiary care hospital which includes fresh body fluids and urine samples of 80 patients with relevant clinical details of both sexes and all ages. Very scanty fluid samples were rejected. Samples were processed on both cell block technique and conventional smear method. For cell block preparation agar gel method was used with 10% buffered formalin used for fixation.
Results: 80 body fluid specimens obtained and evaluated on cell block and conventional smear method, of which ascitic fluid was 16%, Pleural fluid was 13%, peritoneal fluid was 18% and other body fluids were 51%. Most of the patients were in age group of 41 to 60 years. Conventional smear preparation showed accuracy of 75% and cell block technique showed 92% accuracy.
Conclusion: Cell block along with conventional smear increases the accuracy of cytology fluid diagnosis. Cell block techniques provide higher cellularity, better tissue architecture, patterns of malignant cells and use of immunohistochemistry to identify primary site of malignancy over conventional smear method.
Keywords: Cell block, conventional smear, Agar-gel method of cell block preparation
References
- Evaluation of Cell Block Technique in cytodiagnosis of body fluids. Authors: Bansode Shubhada, Kumbalkar D, Nayak S, International Journal of Science and Research (IJSR), ISSN (online): 2319-7064, Index Copernicus Value (2013): 6.14 I Impact factor (2013): 4.438.
- Koss LG et al: Effusions in the presence of cancer. In Koss’ Diagnostic Cytology and its Histopathologic Bases, 5th edition. Edited by Koss LG, Melamed MR, Vol 2, Philadelphia: Lippincott, Williams & wilkins 2006, 950-951.
- Dekker A, Bupp PA. Cytology of serous effusions. An investigation into the usefulness of cellblocks versus smears. Am J Clin Pathol 1978;70 (6):855-860.
- Bodele AK, Parate SN, Wadadekar AA, Bobhate SK, Munshi MM. Diagnostic utility of cell block preparation in reporting of fluid cytology. Journal of Cytology 2003;20 (3):133-135.
- Meenu Thapar, Rajiv K Mishra, Amit Sharma, Vikas Goyal, Vibhuti Goyal. Critical analysis of cell block versus smear examination in effusions Journal of Cytology.April 2009;26(2):60-64
- Manisha B Kulkarni, Sangeeta B Desai, Dulhan Ajit, R.F .Chinoy. Utility of the thromboplastin-plasma cell block technique for fine needle aspiration and serous effusions.Diagnostic Cytopathology 2009 Feb;37(2):86-90.
- Shivkumarswami U. Surekha U. Arakeril, Mahesh H. Karigowdar, B. R. Yelikar : The role of Cell block method in the diagnosis of malignant ascetic fluid effusion Journal of clinical and diagnostic research, 2012 ;September (suppl), vol-6(7):1280- 1283
- Shivkumarswami U. surekha U. Arakeril, Mahesh H. Karigowdar, B. R. Yelikar: Diagnostic utility of the cell block method versus the conventional smear study in pleural fluid cytology: j cytol 2012; 29 : 11-5.
- Sujathan K, Pillai KR, Chandralekha B, Kannan S, Mathew A, Nair MK. Cytodiagnosis of serous effusions: A combined approach to morphological features in Papanicolaou and May-Grunwald Giemsa stained smears and modified cell block technique. Journal of Cytology 2000;17(2):89-95.
- Shidham V, Atkinson B. Collection and processing of effusion fluids. In Cytopathologic diagnosis of serous fluids 1st edition Philadelphia: Saunders Elsevier, 2007; 207-33
- Nathan NA, Narayan E. Smith MM, Horn MJ cell block cytology : improved predation and its efficacy in diagnostic cytology Am. J Clin pathol 2000; 114; 599- 606.
- Takagi F. Studies on tumor cells in serious effusion, Am J Clin Pathol 1954; 24:663-675.
- Khan N, Sherwani KR, Afroz N, Kapoor S. Usefulness of cellblocks versus smears in malignant effusion cases. Journal of Cytology 2006;23(3): 129-132.
- Zemansky AP Jr. The examination of fluids for tumor cells: An analysis of m113 cases hecked against subsequent examination of tissue. Am J M Sci 1928;175:489-504.
- Ceelen GH. The cytologic diagnosis of ascetic fluid. Acta cytol 1964; 8:175-183.