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

ABSTRACT

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.