Objective: To evaluate the diagnostic value and compare morphological features of cell block sections of high-grade squamous intraepithelial lesions (HSIL) and squamous cell carcinomas (SCC). Study Design: A total of 135 cell blocks were prepared from residual Liqui-PREP samples. Of these, 43 biopsy-confirmed cases (24 HSIL and 19 SCC) were reviewed. Morphological features determined included cell clusters, epithelial-stromal interface, stromal invasion and tumor necrosis. Results: Ninety-three percent (40/43) of cell block diagnoses were consistent with histological diagnoses, which was better than the cytological diagnoses (81.4%; 35/43). The mean cell block size was 0.54 cm (range, 0.3–1.0 cm) for HSIL and 0.84 cm (range, 0.4–1.4 cm) for SCC (p < 0.0001). Cell clusters were present in 70.8% (17/24) of HSIL and 100% (19/19) of SCC (p < 0.0001). No epithelial-stromal interface, stromal invasion or tumor necrosis was observed on HSIL cell block sections, which is in contrast to the 84.2% (16/19), 68.4% (13/19) and 42.1% (8/19) on SCC cell blocks, respectively (p < 0.05). Conclusion: Cell blocks may increase the diagnostic accuracy of liquid-based cytology. The presence of stromal invasion, epithelial-stromal interface and tumor necrosis on cell block sections may be useful for accurate SCC diagnosis.

1.
Coleman DV, Poznansky JJ: Review of cervical smears from 76 women with invasive cervical cancer: cytological findings and medicolegal implications. Cytopathology 2006;17:127–136.
2.
Clark SB, Dawson AE: Invasive squamous-cell carcinoma in ThinPrep specimens: diagnostic clues in the cellular pattern. Diagn Cytopathol 2002;26:1–4.
3.
Selvaggi SM: Atrophic vaginitis versus invasive squamous cell carcinoma on ThinPrep cytology: can the background be reliably distinguished? Diagn Cytopathol 2002;27:362–364.
4.
Chacho MS, Mattie ME, Schwartz PE: Cytohistologic correlation rates between conventional Papanicolaou smears and ThinPrep cervical cytology: a comparison. Cancer 2003;99:135–140.
5.
Demay RM: Hyperchromatic crowded groups: pitfalls in pap smear diagnosis. Am J Clin Pathol 2000;114(suppl):S36–S43.
6.
Renshaw AA, Mody DR, Wang E, et al: Hyperchromatic crowded groups in cervical cytology – differing appearances and interpretations in conventional and ThinPrep preparations: a study from the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology. Arch Pathol Lab Med 2006;130:332–336.
7.
Verbeek DH, Smedts F, Wijnen-Dubbers CW, et al: Histologic processing of thick tissue specimens from cytology slides. A novel technique. Acta Cytol 1996;40:1198–1204.
8.
Nathan NA, Narayan E, Smith MM, et al: Cell block cytology. Improved preparation and its efficacy in diagnostic cytology. Am J Clin Pathol 2000;114:599–606.
9.
Gangane N, Mukerji MS, Sharma SM: Utility of microwave processed cell blocks as a complement to cervico-vaginal smears. Diagn Cytopathol 2007;35:338–341.
10.
Risse EK, Ouwerkerk-Noordam E, Meijer-Marres EM, et al: Exploiting the residual of cervical thin layer brush samples through cytohistology in cases with invasive carcinoma with application of antibodies. Acta Cytol 2010;55:175–182.
11.
Rowe LR, Marshall CJ, Bentz JS: Cell block preparation as an adjunctive diagnostic technique in ThinPrep monolayer preparations: a case report. Diagn Cytopathol 2001;24:142–144.
12.
Kabbani W, Raisanen J, Thomas S, et al: Cell block findings from residual PreservCyt samples in unsatisfactory ThinPrep Paps: no additional benefit. Diagn Cytopathol 2002;27:238–243.
13.
Diaz-Rosario LA, Kabawat SE: Cell block preparation by inverted filter sedimentation is useful in the differential diagnosis of atypical glandular cells of undetermined significance in ThinPrep specimens. Cancer 2000;90:265–272.
14.
Richard K, Dziura B, Hornish A: Cell block preparation as a diagnostic technique complementary to fluid-based monolayer cervicovaginal specimens. Acta Cytol 1999;43:69–73.
15.
Yeoh GP, Chan KW: Cell block preparation on residual ThinPrep sample. Diagn Cytopathol 1999;21:427–431.
16.
Yu L, Wang L, Zhong J, et al: Diagnostic value of p16INK4A, Ki-67, and human papillomavirus L1 capsid protein immunochemical staining on cell blocks from residual liquid-based gynecologic cytology specimens. Cancer Cytopathol 2010;118:47–55.
17.
Kerstens HM, Robben JC, Poddighe PJ, et al: AgarCyto: a novel cell-processing method for multiple molecular diagnostic analyses of the uterine cervix. J Histochem Cytochem 2000;48:709–718.
18.
Freitas C, Milanezi F, Dias AJ, et al: Use of cell block preparation for morphological, immunocytochemistry, and ploidy analysis in ThinPrep monolayer preparations. Diagn Cytopathol 2001;25:415–417.
19.
Keyhani-Rofagha S, Vesey-Shecket M: Diagnostic value, feasibility, and validity of preparing cell blocks from fluid-based gynecologic cytology specimens. Cancer 2002;96:204–209.
20.
Afify A, Yu C, Hejazi N, et al: The diagnostic utility of cell blocks prepared from residual SurePath Pap material for detection of human papilloma virus. Appl Immunohistochem Mol Morphol 2009;17:108–114.
21.
Nigro K, Tynski Z, Wasman J, et al: Comparison of cell block preparation methods for nongynecologic ThinPrep specimens. Diagn Cytopathol 2007;35:640–643.
22.
Norimatsu Y, Kawanishi N, Shigematsu Y, et al: Use of liquid-based preparations in urine cytology: an evaluation of Liqui-PREP and BD SurePath. Diagn Cytopathol 2009.
23.
Park J, Jung EH, Kim C, et al: Direct-to-vial comparison of a new liquid-based cytology system, liqui-PREP versus the conventional pap smear. Diagn Cytopathol 2007;35:488–492.
24.
Jesdapatarakul S, Tangjitgamol S, Nguansangiam S, et al: Liqui-Prep® versus conventional Papanicolaou smear to detect cervical cells abnormality by split-sample technique: a randomized double-blind controlled trial. Diagn Cytopathol 2010.
25.
Canda MT, Demir N, Sezer O, et al: Clinical results of the liquid-based cervical cytology tool, Liqui-PREP, in comparison with conventional smears for detection of squamous cell abnormalities. Asian Pac J Cancer Prev 2009;10:399–402.
26.
Cioc AM, Julius CJ, Proca DM, Tranovich VL, Keyhani-Rofagha S: Cervical biopsy/cytology correlation data can be collected prospectively and shared clinically. Diagn Cytopathol 2002;26:49–52.
27.
Thiryayi SA, Marshall J, Rana DN: An audit of liquid-based cervical cytology screening samples (ThinPrep and SurePath) reported as glandular neoplasia. Cytopathology 2010;21:223–228.
28.
Gupta S, Halder K, Khan VA, Sodhani P: Cell block as an adjunct to conventional Papanicolaou smear for diagnosis of cervical cancer in resource-limited settings. Cytopathology 2007;18:309–315.
29.
Hoda RS: Non-gynecologic cytology on liquid-based preparations: a morphologic review of facts and artifacts. Diagn Cytopathol 2007;35:621–634.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.