Cell blocks in cytology: review of preparation methods, advantages, and limitations

Torous, Vanda F.; Cuda, Jacqueline; Manucha, Varsha; Randolph, Melissa; Shi, Qiuying; VandenBussche, Christopher J.

doi:10.1016/j.jasc.2022.11.003

Cited by 16 publications

(22 citation statements)

References 39 publications

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“…As compared to formalin-fixed paraffin-embedded tissue, cytologic specimens, primary cell block and clot preparations are commonly alcohol-fixed. 11 There is a loss of tissue architecture and difference in cellular composition in cytologic specimens. 5 In view of the potential factors affect the interpretation of immunostaining, 12 extensive validatory studies have been conducted for immunocytochemistry, including comparison with immunocytochemistry, paired surgical or core biopsy specimens and/or clinical data as reference standards.…”

Section: Immun Oc Y Toc Hem Ic Almarker Smentioning

confidence: 99%

“…78 DNA extraction requires cell blocks produced not by the plasma thrombin method, as donor plasma carries a risk of DNA contamination. 11 In terms of RNA testing, tissue material obtained from FNA was showed to be suitable for gene expression profiling and demonstrated good prognostic correlation. 79 RNA extraction is feasible on fresh frozen lymph node aspirates of metastatic lung cancer, 80 and tissue material processed with liquid-based cytology fixatives (alcohol-based).…”

Section: Properties Notablepitfallsmentioning

confidence: 99%

“…As compared to formalin‐fixed paraffin‐embedded tissue, cytologic specimens, primary cell block and clot preparations are commonly alcohol‐fixed 11 . There is a loss of tissue architecture and difference in cellular composition in cytologic specimens 5 .…”

Section: Immunocytochemical Markersmentioning

confidence: 99%

“…FISH is an exception to other DNA‐based tests, as there is preservation of cytomorphology for reference 78 . DNA extraction requires cell blocks produced not by the plasma thrombin method, as donor plasma carries a risk of DNA contamination 11 …”

Section: Molecular Testing On Cytology Materialsmentioning

confidence: 99%

See 3 more Smart Citations

Immunocytochemical markers, molecular testing and digital cytopathology for aspiration cytology of metastatic breast carcinoma

Li,

Tse

2023

Cytopathology

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Fine‐needle aspiration cytology (FNAC) is a versatile diagnostic procedure uniquely suited for tissue biopsy of breast carcinomas and axillary metastases and/or recurrences. With the expanding treatment options and accompanying theragnostic tests, it is crucial to recognize the developments on ancillary testing and digital cytopathology techniques related to aspiration cytology of metastatic breast carcinoma. In this review, we aim to summarize and update the evidence of immunocytochemistry, for the detection of carcinoma cells (epithelial markers), confirmation of breast primary (breast‐specific markers), assessment of surrogate immunostains (hormone receptors, ki‐67 proliferative index and HER2) and theragnostic biomarkers, with discussion on potential diagnostic pitfalls, followed by the application of molecular tests, and digital cytopathologic techniques for assessing metastatic breast carcinoma in cytology.

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Section: Immun Oc Y Toc Hem Ic Almarker Smentioning

confidence: 99%

Section: Properties Notablepitfallsmentioning

confidence: 99%

Section: Immunocytochemical Markersmentioning

confidence: 99%

Section: Molecular Testing On Cytology Materialsmentioning

confidence: 99%

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Immunocytochemical markers, molecular testing and digital cytopathology for aspiration cytology of metastatic breast carcinoma

Li,

Tse

2023

Cytopathology

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“…The main advantages of CBs are preservation of potential architectural features, easy archiving for future studies, and application of ancillary diagnostic tests already validated for FFPE tissue samples. [1][2][3][4] However, preparation of CBs significantly increases laboratory workload, cost, and turnaround time. 1,3 Besides, there is no standardized and optimized method for CB preparation or guidelines for good laboratory practice.…”

Section: Introductionmentioning

confidence: 99%

Cell block practices in European cytopathology laboratories

Srebotnik Kirbis,

Kholova,

Huhtala

et al. 2024

Cancer Cytopathology

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BackgroundThere are numerous methods and procedures described for the preparation of cell blocks (CBs) from cytological samples. The objective of this study was to determine current practices and issues with CBs in European laboratories.MethodsA link to an online survey, with 11 questions about CB practices, was distributed to cytology laboratories via participants of United Kingdom National External Quality Assurance Service for Cellular Pathology Techniques and national representatives in the European Federation of Cytology Societies.ResultsA total of 402 laboratories responded completely (337/402, 84%) or partially (65/402, 16%) to the survey by February 4, 2022. The most common CB practice is embedding cell pellets using plasma and thrombin (23.3%), agar (17.1%), Shandon/Epredia Cytoblock (11.4%), HistoGel (7.9%), and Cellient (3.5%). Other methods such as CytoFoam, albumin, gelatin, Cytomatrix, and collodion bags are rarely used (1.0%, 0.7%, 0.7%, 0.3%, and 0.2%, respectively). CBs are also prepared from naturally occurring clots or tissue fragments (29.5%) and cells scraped from unstained or prestained smears (4.4%). The most frequent issues with the CBs in a daily cytology practice are low cellularity (248/402, 62%) and dispersed cells (89/402, 22%), regardless of the CBs preparation method or how the samples for embedding were selected.ConclusionsThere is a great variability in CB practices in European laboratories with low cellular CBs as the main issue. Additional studies are mandatory to evaluate and improve performance and cellular yield of CBs.

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Utility and performance of cell blocks in cerebrospinal fluid cytology: Experience at two teaching hospitals

Yoon,

Chen,

Krishnan

et al. 2024

Cancer Cytopathology

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BackgroundCytology cell blocks (CBs) are not routinely made for cerebrospinal fluid (CSF) specimens. The goal of this study was to identify when CSF CB preparation improves diagnostic performance.Materials and MethodsUnder institutional review board approval, a retrospective review of CSF cytology cases was conducted at a tertiary university‐based hospital and an affiliated county hospital. Patient history, CSF volume, final diagnosis, use of stains, and whether the CB was contributory was determined from the cytopathology report. CSF nucleated cell count data was obtained from the medical record.ResultsA total of 69 CSF specimens with CBs from January 2006 to March 2023 were identified from 61 patients. The median CSF volume was 8 mL (interquartile range, 4–13 mL; range, 1–800 mL), with immunohistochemical stains performed on 29 (42%) cases. Per cytology report, CB was contributory in 23 cases (33%), not contributory in 34 cases (49%), and not discussed in 12 cases (17%). The median volume was 8 mL for cases in which CB was contributory, not contributory, or not discussed. There was no difference in average nucleated cell counts between cases in which CB was contributory versus not contributory (73.9 vs. 40.0, p = .175).ConclusionsCBs for CSF samples were contributory in a subset (33%) of cases. The authors were unable to identify any specific pre‐analytic factors, including specimen volume and average nucleated cell counts, for cases in which CB was contributory. Further evaluation is needed to identify if there are scenarios in which CSF CBs should be routinely prepared.

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Cell blocks in cytology: review of preparation methods, advantages, and limitations

Cited by 16 publications

References 39 publications

Immunocytochemical markers, molecular testing and digital cytopathology for aspiration cytology of metastatic breast carcinoma

Immunocytochemical markers, molecular testing and digital cytopathology for aspiration cytology of metastatic breast carcinoma

Cell block practices in European cytopathology laboratories

Utility and performance of cell blocks in cerebrospinal fluid cytology: Experience at two teaching hospitals

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