Adjunctive role of cell blocks in cytodiagnosis of pediatric tumors
Journal Title: Medpulse International Journal of Pathology - Year 2018, Vol 5, Issue 3
Abstract
Background: Diagnosis of pediatric tumors often pose problems. To have a definitive diagnosis, fine needle aspiration cytology proves to be a quick, effective, non traumatic, non invasive and inexpensive alternative to biopsy. Cell blocks prepared from residual tissue fluids and fine needle aspirates are useful adjuncts to smears for establishing a more definitive diagnosis. Aim: The present study was done to evaluate the utility of cell block preparations from residual material in fine needle aspirates and direct aspirates for the diagnosis of pediatric tumors and to compare cell block sections with formalin fixed paraffin sections in cases where tissue biopsy was available. Materials and Methods: A total of 31 pediatric cases with mass lesion and strong clinical suspicion of malignancy were subjected to fine needle aspiration cytology. FNAC was done and multiple smears were prepared for each case; some smears were immediately fixed in 95% alcohol while others were kept air dried. Cell blocks were prepared simultaneously from the residual material left in the hub of the needle. Alcohol fixed smears were stained with HandE and Papanicolaou stain and air dried smears with May Grunwald Giemsa. Immunohistochemistry was done on direct FNAC smears in 2 cases and 23 cell block sections to confirm the suspicious diagnosis. Interpretation of all smears and corresponding cell blocks was done independently by two cytopathologists. Results: It was observed that the cell blocks did not have any advantage over the smear findings as far as the morphological diagnosis was concerned. An improvement of 3.2% in diagnosis was observed with cell blocks. Cell blocks combined with IHC confirmed the FNA and Cell block diagnosis in 73.9% (17/23) cases. Conclusion: The cell blocks are found to be good adjunct to fine needle aspiration cytology specially for immunohistochemistry panel for definitive diagnosis of malignant small round cell tumors which otherwise is not possible on FNA alone.
Authors and Affiliations
Gautam Rashmi, Goel Madhumati, Sagar Mala, Kumar Madhu
Keywords
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