Objective: The cell block (CB) is an important adjunct to cytological preparations in diagnostic cytopathology. Optimizing cellular material in the CB is essential to the success of ancillary studies such as immunohistochemistry (IHC) and molecular studies (MS). Our aim was to identify which CB method was most suitable in a variety of specimen types and levels of cellularity. Study Design: We assessed 4 different CB methods, thrombin clot method (TCM), MD Anderson method (MDAM), gelatin foam method (GFM), and agar method (AM), with descriptive observations and ranking of the methods based on quantity of cells and morphological features. Results: TCM performed best in ranking for both quantity of cells and morphological features, followed by MDAM, GFM, and AM. Lack of adjuvant in the MDAM resulted in some unique morphological advantages which, however, also resulted in inconsistent performance. In low cellularity cases insufficient cells were frequently identified on slides from MDAM and AM CBs. Technique touch time was similar for all methods, with total processing time being shortest for TCM followed by MDAM, GFM, and AM. Conclusions: TCM was the most robust CB technique, retaining high scores for ranking of quantity and morphology in a variety of specimen cellularities and specimen types.

1.
Billah
S
,
Stewart
J
,
Staerkel
G
,
Chen
S
,
Gong
Y
,
Guo
M
.
EGFR and KRAS mutations in lung carcinoma: molecular testing by using cytology specimens
.
Cancer Cytopathol
.
2011
;
119
(
2
):
111
7
. .
2.
Jain
D
,
Mathur
SR
,
Iyer
VK
.
Cell blocks in cytopathology: a review of preparative methods, utility in diagnosis and role in ancillary studies
.
Cytopathology
.
2014
;
25
(
6
):
356
71
. .
3.
Nambirajan
A
,
Jain
D
.
Cell blocks in cytopathology: an update
.
Cytopathology
.
2018
;
29
(
6
):
505
24
. .
4.
Chai
SM
,
Herba
K
,
Kumarasinghe
MP
,
de Boer
WB
,
Amanuel
B
,
Grieu-Iacopetta
F
,
Optimizing the multimodal approach to pancreatic cyst fluid diagnosis: developing a volume-based triage protocol
.
Cancer Cytopathol
.
2013
;
121
(
2
):
86
100
. .
5.
Mayall
FG
,
Wood
I
.
Gelatin foam cell blocks made from cytology fluid specimens
.
J Clin Pathol
.
2011
;
64
(
9
):
818
9
. .
6.
Kalhor
N
,
Wistuba
II
.
Perfecting the fine-needle aspirate cell block
.
Cancer Cytopathol
.
2013
;
121
(
3
):
109
10
. .
7.
Tian
SK
,
Killian
JK
,
Rekhtman
N
,
Benayed
R
,
Middha
S
,
Ladanyi
M
,
Optimizing workflows and processing of cytologic samples for comprehensive analysis by next-generation sequencing: memorial sloan kettering cancer center experience
.
Arch Pathol Lab Med
.
2016
;
140
(
11
):
1200
5
. .
8.
Harada
S
,
Agosto-Arroyo
E
,
Levesque
JA
,
Alston
E
,
Janowski
KM
,
Coshatt
GM
,
Poor cell block adequacy rate for molecular testing improved with the addition of Diff-Quik-stained smears: need for better cell block processing
.
Cancer Cytopathol
.
2015
;
123
(
8
):
480
7
. .
9.
La Fortune
KA
,
Randolph
ML
,
Wu
HH
,
Cramer
HM
.
Improvements in cell block processing: the cell-gel method
.
Cancer Cytopathol
.
2017
;
125
(
4
):
267
76
. .
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.