Megha Sharma1, Kuldeep Singh2
Cytological examination of serous fluid is a commonly performed and well accepted procedure. It helps in diagnosis as well as prognosis of the disease, thus helping in management of the patients. But, diagnosis by conventional cytology is often difficult due to presence of reactive mesothelial cells, abundance of inflammatory background, delaying artifact, air drying, poor fixation and leaving behind useful material causes lower diagnostic yield in conventional smear. Cell block technique is one of the oldest and complementary method and takes an intermediate position between histological and cytological method. Cell block preparation increases the sensitivity of detecting malignancies and also has the ability to reduce false-positive interpretations. Gelatin cell block is a simplified, inexpensive and reproducible technique that produces results, which are equivalent to routine cell block and it can be an adjuvant to conventional smear in evaluation of cytological effusions.
MATERIALS AND METHODS
In our study, we analysed 100 fluid samples pleural (65) and ascitic (35) by both conventional cytology (pap and giemsa staining) and cell block technique. We modified cell block method by gelatin cell block technique using gelatin surgical dressing material.
Our results showed that gelatin cell block was superior to conventional cytology by reducing false-negative results and provided more accurate diagnosis. It also reduced the grey zone for suspicious of malignancy. Gelatin cell block were more simplified and reduced the mean time of making of cell block and thus are strongly recommended for cell block method than other methods for cell block.
To conclude, the present study showed that cell block technique, which used gelatin as fixative was a simple, reproducible and inexpensive method, which does not require any special instrument or training. This method yielded more cellularity with better architectural patterns. Hence, the gelatin cell block technique can be recommended as an adjuvant in evaluating the fluid cytology for a final diagnosis along with routine conventional smear method.