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Purpose To explore the role of cell blocks combined with immunohistochemical examination in the diagnosis and differential diagnosis of malignant pleural effusion,and to explore the role of pleural effusion cell blocks in lung adenocarcinoma molecular pathology examination.Methods 142 cases of malignant pleural effusion based cytology,cell blocks of HE staining and immunohistochemical staining by EnVision twostep were retrospectively analysed,the tumor classification was made through analyzing the characteristics of the cells combined with antibody expression.The detection of epidermal growth factor receptor (EGFR) gene mutation of 40 cases of lung adenocarcinoma diagnosed after immunohistochemical staining were used by ARMS-PCR method.Results Among 142 cases of malignant pleural effusion,there were 99 cases caused by lung adenocarcinoma,4 cases of lung small cell carcinoma,3 cases of lung squamous cell carcinoma,13 cases of breast carcinoma,9 cases of ovarian carcinoma,2 cases of gastric carcinoma,1 case of thyroid carcinoma,1 case of endometrial carcinoma,5 cases of mesothelioma,3 cases of lymphoma,1 case of malignant melanoma,1 case of synovial sarcoma.In 40 cases of lung adenocarcinoma pleural effusion cell block,there were 20 cases with EGFR mutations,9 cases of 19del mutations and 11 cases L858R mutations.Conclusion The pleural effusion cell blocks combined immunohistochemistry are useful to improve the accuracy of diagnosis of patients with pleural effusion,and helpful for the determination of classification and the primary site of tumor,assessment of prognosis.Pleural dffusion cell block may used to detect EGFR mutations of lung adenocarcinoma,which provide new source of specimen for the gene detection of lung adenocarcinoma.
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Background: Ascites refers to increased volume of fluid collecting within peritoneal cavity which becomes clinically detectable when atleast 500 ml has accumulated. Cytological examination of ascitic fluid gives information about inflammatory and noninflammatory lesions including malignancies, which is done by conventional cytosmears, SurePath liquid based cytological smears and cell block preparations. Aims: The aim of our study was to study the different causes of ascites and their comparison on liquid based cytology with conventional cytology and cell blocks. Methods: Ascitic fluid was obtained from 75 patients of either sex. Microscopic examined was carried out by SurePath liquid based cytology, conventional fixed sediment smears, and cell blocks. Results: Observations were categorised into inflammatory, malignant and inconclusive. Out of 75 cases examined by conventional smears, cytological diagnosis of inflammatory or benign was rendered in 45(60%), 7(9.3%) were diagnosed as malignant and 5(6.7%) were given suspicious of malignancy and 18(24%) were inconclusive. By liquid based cytology 53(70.7%) were rendered inflammatory or benign, 12 (16%) as malignant, 2(2.7%) as suspicious of malignancy and 8(10.7%) were rendered inconclusive. By cell block methodology 52(69.3%) were rendered inflammatory or benign, 11(14.7%) as malignant and 12(16%) as inconclusive. Statistical analysis: Revealed that liquid based cytology was most sensitive (85.71%) and accurate (97.33%) method for analysis of ascitic fluid and conventional smears were least sensitive (50%) and accurate (90.67%). Conclusion: Liquid based cytology showed more sensitivity and accuracy than conventional cytosmears and cell block methods in diagnosing malignant lesions.
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Background: Processing is the next step in the histological process after tissue fixation. There are three methods commonly used for such tissue processing. They are the routine manual, rapid manual and the microwave methods. This study aimed to proceed a simple new manual method in a trial to take the advantages of rapid manual and microwave methods and avoid their disadvantages. Methods: One hundred samples of different tissues and cell blocks were included in this study. They were divided into two equal halves. One half is processed by the routine manual method and the other managed by new suggested technique. Results: The time consuming in the new method was about 7 hours vs. 20 hours in the routine processing. Also, the histologic quality was better in the new method as compared to the routine manual technique. Conclusions: The current simplified method of tissue and cell block processing using mild temperature and moderate agitation possess the advantages of reduction of time of processing, as well as the economic benefit of the utilization of fewer fluids.