Literature DB >> 26811585

Use of cell block preparation for improving adequacy of cytology smears.

Amit Kumar Chowhan1, Rukmangadha Nandyala1, Rashmi Patnayak1, Asha Thotta1.   

Abstract

Entities:  

Year:  2015        PMID: 26811585      PMCID: PMC4707799          DOI: 10.4103/0970-9371.171259

Source DB:  PubMed          Journal:  J Cytol        ISSN: 0970-9371            Impact factor:   1.000


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Sir, We read the article “Role of rapid on-site evaluation with cyto-histopathological correlation in diagnosis of lung lesion” by Chandra et al.[1] with interest and appreciate highlighting the importance of multidisciplinary approach with rapid on-site evaluation (ROSE). The authors have aptly described the advantages and limitations of cytology in diagnosing lung lesions. In this study, the on-site evaluation was done by cytopathologists after staining the smears with toluidine blue. Although there are a few similar studies available that have used Diff-Quick, ultrafast Papanicolaou, and brilliant cresyl blue stains,[2] one study by Hemalatha et al.[3] went one step further and tried to evaluate the adequacy on unstained smears. They performed microscopic examination under reduced illumination with low condenser. The authors concluded that this technique offers specific advantage in being rapid and avoiding the inordinate delay that is associated with assessing the sample adequacy after using cytological staining techniques. Another method suggested by Mayall et al.[4] demonstrates the importance of macroscopic examination of aspiration smears. In their study, the authors aptly demonstrate the usefulness of this procedure especially when the aspiration is being done by radiologists or clinician, who may have limitations in examining the slides microscopically. We agree with Chandra et al.[1] that smears which were inadequate on first pass after on-site assessment, should undergo re-aspiration and in addition we would like to suggest that instead of discarding the necro-hemorrhagic material and blood clot obtained during first pass, if this material is subjected to cell block preparation, it will save valuable material, which could otherwise have been lost. This technique has special importance in situations where due to poor general condition of the patient or chance of developing pneumothorax it is not possible to repeat aspiration. The value of the cell block technique is well acknowledged and its effectiveness is further enhanced by ensuring optimal preservation of tissue for histochemical and immunohistochemical staining for a battery of markers or microbiological stains for the identification of an infectious cause, if required.[4] Furthermore, the preparation of a cell block is a simple technique that requires putting the blood clot and flushing the syringe in a bottle containing 10% buffered formalin and sending it to the histopathology laboratory for routine processing. Therefore, we propose that cell block preparation should be taken up on a routine basis to improve the adequacy of aspirated material.

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Conflicts of interest

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  4 in total

1.  The utility of assessing the gross appearances of FNA specimens.

Authors:  F Mayall; A Cormack; S Slater; K McAnulty
Journal:  Cytopathology       Date:  2010-12       Impact factor: 2.073

2.  Are unstained smears, effective tools in the evaluation of the cytological sample adequacy?

Authors:  Hemalatha A L; Umarani M K; Asha U; Gayathri M N
Journal:  J Clin Diagn Res       Date:  2012-11-19

3.  Role of rapid on-site evaluation with cyto-histopathological correlation in diagnosis of lung lesion.

Authors:  Smita Chandra; Harish Chandra; Girish Sindhwani
Journal:  J Cytol       Date:  2014 Oct-Dec       Impact factor: 1.000

4.  On-spot brilliant cresyl blue staining in fine needle aspiration, a novel technique for cytological diagnosis.

Authors:  Lateef Ahmad Sofi; Rana K Sherwani; Mehboob Hasan; Hage Nobin
Journal:  Acta Cytol       Date:  2013-10-01       Impact factor: 2.319

  4 in total

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