A comparative study of conventional cytology and cell block in the diagnosis of pleural effusion with special reference to immunohistochemistry

Background: Body cavity fluids are evaluated by cell block (CB) technique. In conventional cytological smears (CS), appropriate identification of the cells as either reactive mesothelial cells or malignant cells is a diagnostic problem. In CB method, there is increase in cellularity, so it gives more morphological details of cells and improving the sensitivity of diagnosis. Sections obtained by CB method are also can be stored for future study like immunohistochemistry (IHC). Aims and Objectives: The aim of the study was to determine the diagnostic efficacy of CB technique over conventional CS and to study of IHC in CB of malignant pleural effusion. Materials and Methods: This will be institution-based, cross-sectional, and observational study. The pleural fluid (except blood and pus) obtained by thoracocentesis from both male and female patient (>18 years of age) 100 cases was included in the study. Pleural fluid mixed with blood/pus, fluid from cystic lesion, and inadequate sample (<15 ml vol.) were excluded in the study. Results: Association between architectural pattern in CB versus architectural pattern in cytology smear showed statistically significant value Chi-square: 201.7417, P < 0.0001. Conclusion: We may conclude that CB technique is better than conventional cytology smear technique especially in case of malignant pleural effusion. It increases true positive cases and decreases false negative cases. It also increases cellularity, maintain architectural pattern, and cellular morphology.

Application of removing red blood cell block technique in diagnosis of lung adenocarcinoma in bloody pleural effusion / 肿瘤研究与临床

Objective:To investigate the value of paraffin-embedded section of cell block in the diagnosis of lung adenocarcinoma in bloody pleural effusion.Methods:The data of 60 patients with lung adenocarcinoma diagnosed by bloody pleural effusion and confirmed by pathological biopsy in the First Affiliated Hospital of Xi'an Jiaotong University from June 2018 to June 2019 were retrospectively analyzed. Cell smears and paraffin-embedded sections of cell blocks using removed red blood cells sedim entation method were used to make cytological examination in bloody pleural effusion. The expressions of carcinoembryonic antigen (CEA), cytokeratin 7 (CK7), NapsinA, thyroid transcription factor 1 (TTF-1), cytokeratin 5/6 (CK5/6), calretinin, P63 and P40 in the specimens were detected by using immunohistochemistry. The results of histopathological examination were used as the gold standard, and the diagnostic values of cell block paraffin-embedded sections and cell smears for lung adenocarcinoma in bloody pleural effusion were evaluated and compared.Results:The cell block sections had a clear background, clear and easy to distinguish cell morphology, and can be made into permanent specimens. The bloody pleural effusion cell smears results of 60 cases of lung adenocarcinoma showed that 21 cases were diagnosed as atypical cells, 39 cases were diagnosed as adenocarcinoma, and the coincidence rate with the diagnosis of adenocarcinoma by histopathological examination results was 65% (39/60); the immunohistochemistry results of cell block paraffin-embedded sections of bloody pleural effusion showed that CK7, NapsinA, TTF-1 and CEA were positive, and P40, P63, CK5/6 and calretinin were negative, all 60 cases were diagnosed as adenocarcinoma according to the results, and the coincidence rate with the diagnosis of adenocarcinoma by histopathological examination results was 100% (60/60), which was significantly higher than that of cytological smears ( χ2 = 23.088, P < 0.01). Conclusions:The technique of paraffin-embedded section of cell block using removed red blood cells sedim entation method has a high diagnostic rate for lung adenocarcinoma in bloody pleural effusion, and it has a high coincidence rate with histopathological diagnosis. It can improve the accuracy of diagnosis of lung adenocarcinoma in bloody pleural effusion, and it also has a good reference value for cytological typing.

Diagnostic utility of cytospin, cell block and immunocytochemistry in pleural effusion cytology

Background: With the introduction of cytospin, the sensitivity of diagnosing malignancies has increased mainly due to the increase in cellular yield. Cell block also gives the advantage of ancillary testing and allows for retrospective studies. Immunocytochemical markers are used to differentiate and subtype various malignancies in body effusions.Aim of the study was to compare the morphological features of both technique and to assess the diagnostic utility of cell block methods in the cytodiagnosis of pleural effusions.Methods: This was a Prospective observational comparative study of two cytopreparatory techniques. All samples were examined and processed by cytospin and cell block techniques. Continuous data were expressed as Mean±SD (standard deviation) while categorical data were expressed in number, percentage and compared by chi-square (χ2) test.Results: The final diagnosis of both cytospin (147 cases) and cell block (150 cases) techniques was divided into four broad categories: Inadequate, Benign, Suspicious and Malignant. The significant diagnostic cytospin (AUC=0.857, p<0.001) in discriminating positive and negative malignant cases with 75.00% sensitivity (95% CI=53.3-90.2) and 100.00% specificity (95% CI=86.7-100.0) and with 100.0% positive predictive value and 81.2% negative predictive value. In contrast, cell block also showed significant diagnostic but with higher accuracy (AUC=1.000, p<0.001) and sensitivity 100.00% (95% CI=86.7-100.0) and specificity 100.00% (95% CI=86.7-100.0) and 100.0% positive predictive value and 100.0% negative predictive value than cytospin technique.Conclusions: Cell block as a technique should be used in routine practice as it not only increases the diagnostic yield but ancillary test can also be done.

Approach for reporting serous effusion fluid in pleural, peritoneal and pericardial cavity and immunohistochemistry

Background: The aim of this study is to make a detailed cytological study of effusion fluids and compare with cell block study of the representative cases and IHC studies were done.Methods: Prospective study of 216 cases effusion fluids from in and around hospitals, Mangalore. This study conducted over a period of 18 months from October-2014 to April-2016. This study scrutinized and approved by Institutional Ethics Committee. The samples were processed by conventional cytology using Papanicolaou-stain and Cell Block (CB) method using 10% Alcohol-formalin fixative and stained with H and E. The cellularity, architectural patterns, morphological details were studied both smears. Ancillary immunohistochemical staining with calretinin and EMA are done.Results: A total of 216 cases of effusion fluids with cell block study were included, age range of 13 years to 93 years. Pleural fluid comprised of 55.09%, peritoneal fluid of 43.51% and pericardial fluid of 1.38%. 71% were clinically diagnosed as non-neoplastic and 29% were neoplastic condition. In CS study, 84.5% cases were benign/reactive effusion and 8.5% were positive for malignancy. In CB study, 84.5% were benign/reactive effusion and 10.2% were positive for malignancy. In comparison authors found an increase in diagnostic efficacy by 18%. IHC EMA for adenocarcinoma cells has sensitivity of 100% and calretinin for reactive mesothelial cells has specificity of 100%.Conclusions: Authors concluded that cell block technique when used as an adjuvant to routine smear examination in effusion fluids has increased the diagnostic yield and better preservation of architectural pattern. IHC is helpful in differentiating between reactive mesothelial and adenocarcinoma cells.

Diagnosis of malignant effusion using cell block and immunohistochemistry

The distinction between reactive mesothelial and adenocarcinoma cells specially signet ring type in serous effusions may be very difficult based only on morphological features particularly in early stage. Reactive mesothelial cells show varying degree of cytological atypia hence posing difficulty in differentiating it from adenocarcinoma cells. We report a case of 45 year old female patient presented with abdominal distension. Patient was an operated case of adenocarcinoma of stomach. Smears prepared from ascitic fluid and cell block shows large number of reactive mesothelial cells and few atypical cells. Atypical cells were immunoreactive for cytokeratin, epithelial membrane antigen and carcinoembryonic antigen. These confirmed the presence of malignant epithelial cells so we reported it as a malignant effusion.

An unusual giant schwannoma over face diagnosed on FNAC: a case report

Schwannoma is a slow growing benign peripheral nerve sheath tumor arising from schwann cells. It is also known as neurilemmoma. Although it is common in the head and neck region, it rarely exceeds 10 cm in size. Usually Schwannomas are notlarger than 5 to 6 cm in diameter.Large tumors are uncommon and are found in posterior mediastinum or retroperitoneum. We are presenting an unusual giant cell schwannoma over face (cheek) measuring 12×10cmsin size which caused facial deformity to the patient. The tumor was diagnosed on FNAC where cell block was prepared and IHC was done which showed S-100 positivity. This size schwannomaover cheek site has not been reported in the literature as far our knowledge. Therefore this case is unique for its size over face.

Role of Cell Block Preparation in Cytopathological Diagnosis

Introduction: Though Fine needle Aspiration Cytology(FNAC) is good method for diagnosis of lesions, sometimes itdoes not provide precise diagnosis due to inadequate material.Present study was based on use of residual FNAC materialto make cell block in order to find out utility of cell blockpreparation of FNAC.Material and Methods: The two years prospective studycarried out in a tertiary Heath care hospital of central India,included 360 patients referred for FNAC of the lesions fromall body sites. After making the conventional FNAC smears,the remaining material in the needle hub and syringe wasobtained by flushing it with 10% alcohol –formalin. Aftercentrifugation the supernatant was decanted and depositfixed in freshly prepared 10% alcohol-formalin. After halfan hour alcohol-formalin was drained, cell button was takenon whatman-filter paper and processed as surgical tissue inautomated tissue processing machine. FNAC smears andcell block sections were examined separately for cellularity,reporting done and results correlated with histopathology.Results: Of 360 cases FNAC smears and cell blockswere adequate in 324(90%) and 313(86.94%) casesrespectively. Statastical analysis was done in 98 cases inwhich histopathology available. Sensitivity of FNAC was88.06%,specificity of 92.86% and accuracy of 89.47%.Sensitivity of cell block was 90.91%, specificity of 92.86%and accuracy of 91.47%. Sensitivity of combined FNAC andcell block technique was increased to 98.53% with specificityof 93.33% and accuracy of 96.94%.Conclusion: Cell blocks as an adjuvant to FNAC smears isvery effective technique in cytology to reach the definitivediagnosis.

Comparative Analysis of Cell Block Preparation Versus Smear Examination in the Fine Needle Aspirates of Head & Neck Lesions with Application of IHC Markers on Cell Block Preparation

Introduction: Diagnostic cytology is the science of interpretation of cells that are exfoliated from the epithelial surfaces or removed from various tissues. The aim of this study was to assess the utility of cell block in increasing the cytodiagnosis of fine needle aspirates of head and neck lesions and to apply immunohistochemical markers on cell blocks. Material and methods: Total sample of 50 patients of head and neck lesions were received in the Department of Pathology, after approval from the Institutional Ethics Committee. Informed consent of the patient was taken. Relevant history of the patient was taken as per the written proforma. Patients of all age group presenting with head and neck lesions underwent FNAC and histopathological examination was included in the study. Results: Thus FNAC served better than cell block in determining the cellularity (kappa κ – statistic = -0.04, P 0.0002) while on morphological preservation grounds,superior nuclear and cytoplasmic characteristics were observed in cell block in comparision to FNAC (κ – statistic= -0.08).Overall Sensitivity and positive predictive value of cell block method with imunohistochemistry (96% and 100% respectively) proved to be better as compared to FNAC alone (88.8% and 95.65%). Conclusion: The diagnostic value of a Cell Block technique with immunohistochemistry is found to be superior to FNAC smears for the diagnosis of benign and malignat lesions of head and neck region. Taking into consideration the advantages of Cell Block method an excellent complementary tool for improving cytodiagnosis, we can recommend that cell blocks preprations should be routine practice so as to augment the information that is obtained solely from FNAC smear cytology.

Diagnostic Utility of Cell Block of Bronchial Brush Tip Washing in the Diagnosis of Carcinoma Lung and Application of Cytokeratin 5/6, TTF-1 & CD 56 Expression for Subclassification

Lung cancer is one of the most common malignancies worldwide with high mortality. Furthermore being one of the most insidious and aggressive neoplasm in the realm of oncology, it’s timely diagnosis and accurate subclassification becomes pre-requisite for administering appropriate and timely target therapy. In the present study, cell block from brush tip washings were prepared and immunoreactivity assessed for cytokeratin5/6, TTF-1 and CD56 with aim to diagnose and sub-classify carcinoma lung. Methods: The present study was conducted on 25 specimens of brushtip washings from suspected cases of carcinoma lung. Bronchoscopic investigation of pulmonary lesions was performed and routine brush smears were made and these brush tip were processed into cell block. Immunohistochemical staining for marker CK5/6, CD56 & TTF 1 was done and evaluated. Results: Brush smear cytology finding was mostly benign seen in 12 (48%) followed by SCC seen in 4 (16%), ADC in 3 (12%). Cell block microscopy showed SCC in 11 (44%), ADC in 5 (20%), small cell carcinoma in 3 (12%) and carcinoma in 3 (12%). It was inadequate in 3 (12%). The difference was significant (P< 0.05). Sensitivity and specificity of brush smear cytology in diagnosing lesion was 33.3 % and 52.6% respectively.Whereas for cell block microscopy in diagnosing lesion sensitivity was 91.67% and specificity 86.6%. The overall sensitivity of IHC CK 5/6 in diagnosing SCC was 100% and specificity was 52.4%. CD56, TTF1 were negative in these cases. CD56 showed 100% sensitivity in diagnosing small cell carcinoma with specificity being 24.6%, The overall sensitivity of IHC TTF 1 in diagnosing ADC was 100% & for small cell carcinoma was 40%. Conclusion: Cell block preparation is a simple method that increases diagnostic yield of flexible bronchoscopy, is cost effective & hence can be routinely used. IHC panel consisting CK 5/6, CD 56 and TTF 1 has more diagnostic value in precise subtyping of different types of lung carcinoma in adjunction to routine H&E staining.

Evaluation of Effusion Fluid (Pleural and Peritoneal) with Special Reference To Cell Block Preparation and Immunohistochemistry for Differentiating Between Reactive Mesothelial and Malignant Effusion

Background: The serous cavities are lined by a single layer offlat mesothelial cells called the serosa. Normally these cavitiesare collapsed and contain only a small amount of fluid, enoughto lubricate the adjacent surfaces. Cytological examination ofserous fluid is of paramount importance. It reveals informationabout inflammatory conditions of serous membrane, infectionby bacteria, fungi, virus and presence of malignant cells.Differentiation of population of reactive mesothelial cells fromthose of malignant cells remains a diagnostic challenge inconventional cytological smear. To overcome this challenge,cell block technique along with immunocytochemistry gives abetter histoarchitectural pattern and support immensely forcategorising the effusion to be reactive or malignant.Aims and Objectives: To evaluate utility of cell blocktechnique in effusion fluid (pleural and peritoneal) using limitedimmunohistochemistry markers for differentiating betweenreactive mesothelial and malignant mesothelial cells.Materials and Methods: The present study was carried out inDepartment of Pathology at M.K.C.G MCH, Berhampur,Odisha over a time period from July 2016- July 2018. A total of90 cases were evaluated. The fluids were stained with routinecytological stains. Cases on evaluation of cytomorphology ifsuspicious for malignancy, cell block was prepared. Cell blockwere stained both for routine hematoxylin and eosin andimmunohistochemistry with EMA (Epithelial marker antigen) forepithelial cells and Calretinin for mesothelial cells.Results: A total of 90 cases were evaluated cytologically. 40cases showed benign features and 24 cases showedmalignant features on cytomorphology alone. 26 cases weresuspicious for malignancy which on cell block preparation andimmunocytochemistry were differentiated as benign (10 cases)or malignant (16 cases). EMA showed 97.5 % sensitivity and98% specificity. Calretinin showed 100 % sensitivity and 97.5%specificity.Conclusion: The use of cytopathology of pleural andperitoneal effusion is helpful for early diagnosis and treatment.The technique is cheap, easy to perform and produces speedydiagnosis. In the identification of malignant cells in effusion andits differentiation from cells showing reactive and degenerativechanges there were diagnostic difficulties in some of the cases.Immunocytochemistry is an important diagnostic tool ineffusion cytology.

Values of exfoliated cell smear, DNA ploidy analysis, cell block and their combined detection in diagnosis of malignant pleural effusion / 吉林大学学报(医学版)

Objective: To study the values of exfoliated cell smear, DNA ploidy analysis, cell block and their combined detection in the diagnosis of malignant pleural effusion, and to provide the evidence for the diagnosis and treatment of malignant pleural effusion Methods: A total of 300 cases of pleural effusion specimens were analyzed by DNA ploidy analysis to judge the benign and malignant pleural effusion; the centrifuged cell pellet was used for smear, the cell block was made, and the source of malignant pleural effusion was judged by immunohistochemistry method The sensitivities and specificities of three methods and their combined detection in the diagnosis of malignant pleural effusion were compared Results: The sensitivities of exfoliated cell smears, DNA ploidy analysis and cell block in the diagnosis of malignant pleural effusion were 83. 13%, 84. 44%, and 79. 52%, respectively; the specificities were 82. 95%, 86. 64%, and 83. 87%, respectively; the sensitivity of parallel test in the diagnosis of malignant pleural effusion was 98. 79%; the specificity of serial test in the diagnosis of malignant pleural effusion was 99. 54%. Conclusion: The combined detection of three methods can significantly improve the clinical diagnotic effect of malignant pleural effusion compared with single detection of three methods.

Comparision Of Pleural Fluid Cytology And Cell Block In Pleural Effusion

AIMS AND OBJECTIVES To assess the diagnostic utility of cell block technique in comparison to conventional cytosmear, in the study of pleural fluids. To compare our results with existing literature. MATERIAL AND METHODS The present prospective study was done for a period of two years from 1st August 2015 to July 31st 2017 in the Department of Pathology, Kakatiya Medical College, Warangal. During this period, pleural fluids obtained by aspiration were analyzed. A total of 53 cases were studied RESULTS Out of the total 53 cases included in our study of pleural effusion males were 32 and female were 21 contributing 60.3% and 39.6% respectively. Age range of our patient was from 18years to oldest patient being 68 years with the dominant age group being 31–40 years. Cytosmear analysis showed 35 (66.05%) benign/inflammatory effusions, 11 (20.75%) suspicious of malignancy, 7 (13.20%) malignant cytology’s. On cell block analysis 43 (81.20%) were diagnosed as benign/ inflammatory effusions, 10 (18.8%) were diagnosed to be malignant. CONCLUSION The present study demonstrates that the pleural fluid cytology is the most useful test in establishing the diagnosis of pleural effusion. From the results it can be concluded that cell block technique demonstrates a higher diagnostic rate of malignant effusions compared to cytosmear as the morphological features were better identified by this method. We conclude that the cell block technique method when used as an adjuvant to routine smear examination increases the diagnostic yield and also carries the advantage of carrying further IHC studies.

Analysis of factors affecting the standardization of in vitro mouse embryo test / 中国比较医学杂志

Infertility has become a global problem affecting human reproductive health.As an important treatment for infertility, assisted reproductive technology has made great progress over the past few decades.Rapid development has also taken place in medical devices for human assisted reproductive technology.It is imperative to establish the risk management and safety evaluation system of these products.In 2016, the industry standard YY/T 1434-2016 Human in vitro Assisted Reproductive Technology With Medical Equipment in vitro Mouse Embryo Test was officially released.In this paper, the key notes and elements of this in vitro mouse embryo test are briefly reviewed.

Increasing diagnostic effectiveness of thyroid nodule evaluation by implementation of cell block preparation in routine US-FNA analysis

ABSTRACT Objective Ultrasound-guided fine-needle aspiration (US-FNA) biopsy has proven to be an accurate and efficient tool in thyroid nodule evaluation. We evaluated whether cell block adds to the diagnostic accuracy of US-FNA. Subjects and methods Three hundred twenty-eight consecutive patients underwent US-FNA, cytology and cell block evaluation. Six slides were prepared for each patient and stained by Papanicolaou and Giemsa techniques. The residual hemorrhagic aspirate in the syringe and needle was fixed in 10% formalin and paraffin-embedded (cell block). The histological sections were examined as a complementary diagnostic tool to US-FNA. Results The study population comprised 89% females and the mean age was 57.4 ± 13.7 years. The mean nodule size was 2.3 ± 1.2 cm. US-FNA cytological results were as follows: Bethesda I, 17.1% (n = 56); Bethesda II, 61.6% (n = 202); Bethesda III, 9.5% (n = 31); Bethesda IV, 5.8% (n = 19); Bethesda V, 2.4% (n = 8), and Bethesda VI, 3.6% (n = 12). Cell blocks were obtained in 100% of cases and were considered diagnostic in 89.6%. Combined cytological and cell block (cyto-cell block) results were as follows: unsatisfactory, 4.3% (n = 14); benign, 72.6% (n = 238); indeterminate, 11.3% (n = 37); follicular lesion, 5.8% (n = 19); suspicious for malignancy, 2.4% (n = 8), and malignant, 3.6% (n = 12). The sensitivity and specificity for cyto-cell block was 100% and 90%, respectively, and the accuracy was 94%. Cyto-cell block analysis reduced the rate of unsatisfactory samples (p < 0.001). Conclusions The cyto-cell block interpretation improved the efficiency of US-FNA. This simple, fast and low-cost technique should be used as an adjunctive test in thyroid nodule evaluation. Arch Endocrinol Metab. 2016;60(4):367-73.

IDENTIFICATION OF CANINE VISCERAL LEISHMANIASIS IN A PREVIOUSLY UNAFFECTED AREA BY CONVENTIONAL DIAGNOSTIC TECHNIQUES AND CELL-BLOCK FIXATION

After the report of a second case of canine visceral leishmaniasis (CVL) in São Bento da Lagoa, Itaipuaçu, in the municipality of Maricá, Rio de Janeiro State, an epidemiological survey was carried out, through active search, totaling 145 dogs. Indirect immunofluorescence assay (IFA), enzyme-linked immunosorbent assay (ELISA), and rapid chromatographic immunoassay based on dual-path platform (DPP(r)) were used to perform the serological examinations. The parasitological diagnosis of cutaneous fragments was performed by parasitological culture, histopathology, and immunohistochemistry. In the serological assessment, 21 dogs were seropositive by IFA, 17 by ELISA, and 11 by DPP(r), with sensitivity of 66.7%, 66.7% and 50%, and specificity of 87.2%, 90.2% and 94%, respectively for each technique. The immunohistochemistry of bone marrow using the cell-block technique presented the best results, with six positive dogs found, three of which tested negative by the other parasitological techniques. Leishmania sp. was isolated by parasitological culture in three dogs. The detection of autochthonous Leishmania infantum in Itaipuaçu, and the high prevalence of seropositive dogs confirm the circulation of this parasite in the study area and alert for the risk of expansion in the State of Rio de Janeiro.

Clinical efficacy of the fine needle aspiration of the cell block in the diagnosis of parotid gland masses / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the clinical significance of cell blocks obtained by ultrasound-guided fine needle aspiration in diagnosing parotid gland masses.</p><p><b>METHODS</b>Cell blocks were made in 285 parotid gland masses by ultrasound-guided fine needle aspiration. Diagnosis was conducted using the cell blocks. Non-tumor masses were subjected to conservative treatment, and cysts and tumors were treated with surgery. The cell block sections from masses with the diagnosis of adenoid cystic carcinoma (ACC) and pleomorphic adenoma (PA) were applied to the detection of immunocytochemical staining for the stem cell factor receptor CD117.</p><p><b>RESULTS</b>The satisfaction rate of the specimen was 95.1% (271/285). The accuracy rate of the diagnosis was 94.5% (256/271), the sensitivity was 87.0% (67/77), and the specificity was 98.1% (157/160). The positive rate of CD117 in ACC was 95.2% (20/21), whereas that in PA was 20.3% (25/123). The positive rate of CD117 in ACC was higher than that in PA (P<0.01).</p><p><b>CONCLUSIONS</b>The use of cell blocks obtained from ultrasound-guided fine needle aspiration, together with molecular marker detection, has great significance in diagnosing parotid gland masses.
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High-quality cell block preparation from scraping of conventional cytology slide: a technical report on a modified cytoscrape cell block technique

Background: Immunocytochemistry (ICC) on formalin-fixed paraffin embedded cell blocks is an ancillary tool commonly recruited for differential diagnoses of fine needle aspiration cytology (FNAC) samples. However, the quality of conventional cell blocks in terms of adequate cellularity and evenness of distribution of cytologic material is not always satisfactory for ICC. We introduce a modified agarose-based cytoscrape cell block (CCB) technique that can be effectively used for the preparation of cell blocks from scrapings of conventional FNAC slides. Methods: A decoverslipped FNAC slide was mounted with a small amount of water. The cytological material was scraped off the slide into a tissue mold by scraping with a cell scraper. The cytoscrape material was pelleted by centrifugation and pre-embedded in ultra-low gelling temperature agarose and then re-embedded in conventional agarose. The final agarose gel disk was processed and embedded in paraffin. Results: The quality of the ICC on the CCB sections was identical to that of the immunohistochemical stains on histological sections. By scrapping and harvesting the entirety of the cytological material off the cytology slide into a compact agarose cell button, we could avoid the risk of losing diagnostic material during the CCB preparation. Conclusion: This modified CCB technique enables concentration and focusing of minute material while maintaining the entire amount of the cytoscrape material on the viewing spot of the CCB sections. We believe this technique can be effectively used to improve the level of confidence in diagnosis of FNAC especially when the FNAC slides are the only sample available.

Application and development of FNA cell block on preoperative breast cancer molecular typing / 国际外科学杂志

Fine needle aspiration cytopathology of the breast is an effective means of distinguishing malignant from benign,and the aspirated sample collections techniques is the primary and key part of fine needle aspiration.Fine needle aspiration cell block has been improved and used on preoperative breast cancer molecular portraits.This paper will provide an introduction to application of specimens collection techniques,application and development of fine needle aspiration cell block on preoperative breast cancer molecular portraits.

Aplicação do Método “Plasma Tromboplastina/Trombina” no Preparo de Amostras Citológicas para Pesquisa de Câncer no Laboratório de Anatomia Patológico / Application of the “Plasma-Thromboplastin/Thrombin” Method for Preparation of Cytological Samples for Cancer Research in Pathological Anatomy Laboratories

Realizar uma revisão da literatura sobre a aplicação dométodo “plasma-tromboplastina/trombina” no preparo de “cell block”de amostras citológicas para pesquisa de câncer no laboratório deAnatomia Patológica. Material e Métodos. Para a elaboração do estudoforam realizadas buscas na base de dados PubMed, SciELO e LILACSutilizando os descritores “Cell block effusion”, “Cell block preparation”e “Cell block method”. Resultados: O método “plasma-tromboplastina/trombina” tem sido descrito no preparo de diferentes tipos de amostrascitológicas: efusões (líquidos das cavidades pleural, peritoneal,pericárdica), lavado peritoneal, aspirados e amostras em meio líquido.A descrição da técnica não foi realizada em alguns estudos ou foirealizada apenas parcialmente e com variações entre eles com relaçãoà velocidade e tempo de centrifugação, quantidades de plasma,trombina e tromboplastina. Os estudos que comparam o método“plasma-tromboplastina/trombina” com outros métodos de preparo do“cell block”, usando diferentes tipos de amostra, são escassos, emuitas vezes, com pequeno número de amostras e isto dificulta umaconclusão definitiva sobre suas vantagens sobre outras técnicas. Osmétodos mais usados no preparo do “cell block” são os que utilizamágar e plasma-tromboplastina/trombina. As vantagens do “métodoplasma-tromboplastina” em relação aos outros métodos são execuçãofácil, baixo custo, ausência de artefatos celulares relacionados aoaquecimento, melhor celularidade, melhor distribuição celular emelhores resultados da imunocitoquímica. Conclusão: O “cell block”preparado pelo método “plasma-tromboplastina/trombina” pode serconsiderado uma ferramenta diagnóstica complementar aocitocentrifugado e aplicável na rotina de laboratórios de AnatomiaPatológica públicos e privados para a pesquisa de câncer...

To perform a literature review on the application of the“plasma-thromboplastin/thrombin” method for cell block preparationof cytological samples in cancer research in pathological anatomylaboratories. Material and Methods: Bibliographical searches werecarried out in the databases PubMed, SciELO and LILACS using thedescriptors “cell block effusion”, “cell block preparation” and “cellblock method”. Results: The “plasma-thromboplastin/thrombin” methodhas been described for preparation of different types of cytologicalsamples, including effusions (liquids from the pleural, peritoneal andpericardial cavities), peritoneal lavage, aspirated samples, and samplesin liquid medium. The description of the technique was not reported insome studies or was performed just partially. Variations in the studieswere found with regard to centrifugation time and speed, as well as toquantity of plasma, thrombin and thromboplastin used. Only a fewstudies have compared the “plasma-thromboplastin/thrombin method”with other cell block preparation methods using different types ofsamples. The studies have frequently included a small sample size,which makes it difficult to establish a solid conclusion on theadvantages of this method over other approaches. The most commonlyused methods for cell block preparation include those using agar andthromboplastin/thrombin. The advantages of the “plasma/thromboplastin” method in relation to other methods are easiness toimplement, low cost, no cell artifacts related to heating, bettercellularity, better cellular distribution and better immunocytochemistryresults. Conclusion: Cell block preparation using the plasmathromboplastin/thrombin method can be considered a diagnostic tooladjunctive to the cytocentrifuged one that is applicable to the routineof public and private pathological anatomy laboratories for cancerresearch...

Características clínicas y epidemiológicas de los pacientes hospitalizados con derrame pleural / Clinical and epidemiological characteristics of patients hospitalized with pleural effusion

El derrame pleural tiene una prevalencia mundial de aproximadamente 400 de cada 100.000 habitantes y Venezuela tiene cifras similares. Se relaciona con múltiples patologías, por lo que determinar sus características podría ayudar a obtener un mejor diagnóstico y tratamiento. Métodos: Se realizó un estudio de casos, retrospectivo y descriptivo, obteniendo información de las historias de pacientes hospitalizados con derrame pleural en el servicio de Medicina Interna del Hospital Dr. Domingo Luciani en el período Enero 2010- Abril 2015. Resultados: La edad promedio fue de 49±19 años, género masculino (53%). Motivo de consulta: disnea (81%), dolor torácico (44%) y tos (37%). Los síntomas: disnea (92%), dolor pleurítico (58%) y fiebre (54%). Antecedentes personales: HTA (32%), DM (22%) e IC (20%). Radiografía de tórax: (60%) derrame pleural derecho y (26%) izquierdo. Tomografía de tórax realizada en (77%). Citoquímicos: (85%) exudado (53% mononuclear y 32% polimorfonucleares). La prueba de ADA positiva en 25%, cultivo para bacterias realizado en 89 casos, positivos 18%. Bloque celular con resultado inflamatorio (80%). Biopsia pleural realizada (22%): inflamatorio (36,4%), seguido por ADC metástasico (31,8%). Estancia hospitalaria > 15 días (76%) y el diagnóstico final fue infeccioso (51%). Conclusión: Contando con estos datos clínicos- epidemiológicos se puede caracterizar el comportamiento del derrame pleural en nuestro centro para el rápido y acertado diagnóstico, igualmente proponer una investigación prospectiva donde se analice el comportamiento de dicha enfermedad, y crear protocolos de actuación(AU)

Pleural effusion has a worldwide prevalence of approximately 400 per 100,000 inhabitants and Venezuela has similar statistics. It is related to multiple pathologies, which determine their characteristics which could help for better diagnosis and treatment. Methods: A retrospective descriptive case study was conducted, obtaining information from the charts of hospitalized patients with pleural effusion in Internal Medicine Dr. Domingo Luciani Hospital Venezuela in the period January 2010-April 2015. Results: Mean age 49 ± 19 years, male genre (53%). Complaints: dyspnea (81%), chest pain (44%) and cough (37%). Symptoms: dyspnea (92%), pleuritic pain (58%) and fever (54%). Personal history: hypertension (32%), DM (22%) and HF (20%). Chest x-ray: right pleural effusion (60%), left (26%). Chest tomography performed on (77%). Cytochemical: exudate: 85% (53% mononuclear and polymorphonuclear 32%). ADA testing positive in 25%. For bacteria culture: performed in 89 cases, 18% positive. Cell block inflammatory (80%). Pleural followed by metastatic ADC (31.8%). Hospital stay> 15 days (76%) and final diagnosis was infection (51%). Cause of discharge from hospital: improvement (80%). Conclusion: Having these clinical and epidemiological data can characterize the behavior of pleural effusion for quick and accurate diagnosis(AU)