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Varna Medical Forum

Modified technique for cell-block preparation in effusions

George St. Stoyanov, Lilyana Petkova, Deyan Dzhenkov, Peter Ghenev


Preoperative and pre-therapeutic morphological diagnosis in the treatment of malignant conditions is the gold standard in the 21st century. There are two standardized methodologies for its implementation - cytological and histological, both of which have their advantages and disadvantages. An intermediate methodology for performing morphological diagnosis in patients with effusions in body cavities and unclear primary locus is the implementation of a cellular block - filtration and centrifugation of large volumes of effusions to optimize the amount of cells, their aggregation, as a result of which the material, taken atraumatically from the patient can be processed similarly to a histological biopsy.

The aim of this report is to present a simplified methodology for the realization of a cellular block by means of equipment widely used in the laboratories in Bulgaria, allowing a rapid and efficient implementation suitable for immunohistochemical diagnostics.

A standardized laboratory centrifuge, heparinized vacuum containers and 10% buffered formalin were used. Samples from patients with three different tumor localizations were used, the volume of the test effluent being between 5 and 50 mL, centrifuged twice at 5300 rotations per minute and fixed in 10% buffered formalin. The described methodology provides a quick and easy way to morphologically diagnose patients with malignant effusions. The volume of the precipitated material, even with a small amount of biological fluid, is adequate to produce enough slides for diagnosis. The methodology combines the advantages of standard cytology and histology. Demonstrative for the efficiency of the methodology is the identical picture of immunocytochemistry and immunohistochemistry in the case described, where despite the high centrifugation rates both the characteristics of the cells have been retained and the diagnostic proteins have not undergone denaturation.


biopsy, cytology, cell block, effusions, neoplasms

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Frable WJ.Fine-needle aspiration biopsy: a review. Hum Pathol (1983) 4(1):9-28. doi:10.1016/s0046-8177(83)80042-2

Dekker PA, Bupp PA. Cytology of serous effusions. An investigation into the usefulness of cell blocks versus smears. Am J Clin Pathol (1978) 70(6):855-60. doi:10.1093/ajcp/70.6.855

Mishra R, Sharma A, Goyal V, Goyal V, Thapar M. Critical analysis of cell block versus smear examination in effusions. J. Cytol. (2009). doi:10.4103/0970-9371.55223

Massad L S, Collins YC. Strength of correlations between colposcopic impression and biopsy histology. Gynecol Oncol (2003) 26(2):60-4. doi:10.1016/S0090-8258(03)00082-9

Nathan NA, Narayan E, Smith MM, Horn MJ. Cell Block Cytology. Am J Clin Pathol (2004) 114(4):599–606. doi:10.1309/g035-p2mm-d1tm-t5qe

Fetsch PA, Simsir A, Brosky K, Abati A. Comparison of three commonly used cytologic preparations in effusion immunocytochemistry. Diagn Cytopathol (2002) 26(1):61-6 . doi:10.1002/dc.10039


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