Analysis of Cell Block and Cytology Specimen Preservation from Lung Aspiration Biopsy
DOI:
https://doi.org/10.21776/ub.jkb.2020.031.01.5Keywords:
Artifacts, cytology, cell block, inflammatory cellsAbstract
Cytology smear technique is often used in Indonesia because the process is safe, simple, easy, fast, and cost effective. At present, several studies have found that smears with cell block techniques are of better quality than smears with cytology smear techniques. The aim of this study was to analyze whether the cytology smear technique can produce adequate specimens compared to cell block towards results of lung Fine Needle Aspiration Biopsy (FNAB). Lung FNAB specimens were divided into two parts: one part was processed with cytology and the other part with cell block technique. The specimens were observed under a microscope to count the number of inflammatory cells and the number of artifacts. The numbers of inflammatory cells and artifacts were scored 0-3. The inflammatory cells consisted of neutrophils, lymphocytes and plasma cells, also macrophages. The result showed no significant difference between the number of inflammatory cells in cytology and cell block (p neutrophils=0.543; p lymphocytes and plasma cells=0.192; p macrophages=0.487) in 38 samples. The artifact score comparison test result showed a significant difference between the number of artifacts in cytology and cell block (p=0.027) with more artifacts in cytology. The most common artifact in cytology was air bubble artifacts, while cell block was dominated by torn pieces artifacts. There was no significant difference between the number of inflammatory cells found in cytology and cell block techniques. Cell block technique has less artifacts than cytology, but artifacts found in cytology can be corrected so that the cytology smear technique is still an option.
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References
Al-Abbadi M. Basics of Cytology. Avicenna Journal of Medicine. 2011;1(1):18-28.
Noda Y, Fujita N, Kobayashi G, Itoh K, Horaguchi J, Takasawa O et al. Diagnostic Efficacy of the Cell Block Method in Comparison with Smear Cytology of Tissue Samples Obtained by Endoscopic Ultrasound-Guided Fine-Needle Aspiration. Journal of Gastroenterology. 2010;45(8):868-875.
Naylor B. Pleural, Peritoneal fluids. In: Bibbo M. Editor Comprehensive Cytopathology. 1st Ed. Philadelphia: WB Sounders , 1991; 551-621
Jain D, Mathur S, Iyer V. Cell blocks in cytopathology: a review of preparative methods, utility in diagnosis and role in ancillary studies. Cytopathology. 2014;25(6):356-371.
Malukani K, Matreja S, Nandedkar S, Varma A, Saxena A, Ajmera A. Comparison of Efficacy of Cell Block Versus Conventional Smear Study in Exudative Fluids. Nigerian Postgraduate Medical Journal. 2017;24(4):245 -249
Suri J, Gandotra V, Abrol D, Bhardwaj S. Analysis of Cell Block vs . Conventional Smear in Fluid Cytology. Journal of Evidence Based Medicine and Healthcare. 2015;2(39):6464-6471.
Mody DR. Defining Adequacy in Nongynecologic Specimens. CAP today. 2003; 17:68-70
Sahay K, Mehendiratta M, Rehani S, Kumra M, Sharma R, Kardam P. Cytological Artifacts Masquerading Interpretation. Journal of Cytology. 2013;30(4):241.
Mehrotra R, Gupta A, Singh M, Ibrahim R. Retraction: Application of Cytology and Molecular Biology in Diagnosing Premalignant or Malignant Oral Lesions. Molecular Cancer. 2012;11(1):57.
Koksal D, Demirag F, Bayiz H, Koyuncu A, Mutluay N, Berktas B et al. The Cell Block Method Increases the Diagnostic Yield in Exudative Pleural Effusions Accompanying Lung Cancer. Turkish Journal of Pathology. 2013;29(3):165.
Jing X, Li Q, Bedrossian U, Michael C. Morphologic and Immunocytochemical Performances of Effusion Cell Blocks Prepared Using 3 Different Methods. American Journal of Clinical Pathology. 2013;139(2):177-182.
Ugurluoglu C, Kurtipek E, Unlu Y, Esme H, Duzgun N. Importance of the Cell Block Technique in Diagnosing Patients with Non-Small Cell Carcinoma Accompanied by Pleural Effusion. Asian Pacific Journal of Cancer Prevention. 2015;16(7):3057-3060.
Assawasaksakul T, Boonsarngsuk V, Incharoen P. A Comparative Study of Conventional Cytology and Cell Block Method in the Diagnosis of Pleural Effusion. Journal of Thoracic Disease. 2017;9(9):3161-3167.
Valente P, Schantz H. Iatrogenic Artifacts in Cytology. Pathology Case Reviews. 2003;8(3):126-133.
Kahwash S. Artifacts, Contaminants, and Mimics in Cytology. Pediatric Cytopathology. 2017;:231-244.
Xiang Y, Yang Z. Detachment of Methacrylate-Embedded Sections from Microscope Slides can be Prevented by Heating on Hotplate. Journal of Histology and Histopathology. 2014;1(1):10.
How to prevent Air Bubbles in Wet Mounts – Microbehunter Microscopy [Internet]. Microbehunter.com. 2019 [cited 27 June 2019]. Available from: http://www.microbehunter.com/how-to-prevent-air-bubbles-in-wet-mounts/
Pradhan P. Can anyone suggest solutions to avoid air bubbles underneath the cover slips in the slides with sections 120 microns? [Internet]. Research Gate. 2015 [cited 4 June 2019]. Available from: https://www.researchgate.net/post/Can_anyone_suggest_solutions_to_avoid_air_bubbles_underunder_the_cover_slips_in_the_slides_with_sections_120_microns2
Ekundina V, Eze G. Common artifacts and remedies in histopathology (a review). African Journal of Cellular Pathology. 2015;4(1):6-12.
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