Evaluation of Cell Block Diagnostics in Intra-Abdominal Lesions with Radiological and Clinical Correlation in a Tertiary Centre in North Karnataka Region

Author(s): Md Hamed Altaf Mali1, Anita A. M.2, Meenakshi3, Anuradha G. Patil4

Cytological examination of intra-abdominal lesions is crucial in diagnosis, staging,
and prognosis of suspected malignancies. Fine needle aspiration cytology (FNAC)
is a routine diagnostic modality for diagnosis. FNAC is a reliable, rapid, cost
effective procedure and plays an important role particularly in low resource
centres. FNAC along with cell block has shown remarkable result in diagnosis of
malignant lesions and its sub-classification using various antibody markers.
A total of 102 cases of intra-abdominal lesions were studied over a period of one
year in this descriptive study. Ultrasound sonography (USG) guided FNACs were
done in 89 cases and ascetic / peritoneal fluid analysis in 13 cases. Cell blocks
were made in 95 cases and immunohistochemistry (IHCs) were done in 69 cases
of suspected / malignant intra-abdominal lesions to confirm the diagnosis.
Out of 102 cases, cytological smears in 89, fluid smears in 13 and cell blocks in 95
cases were available respectively. Most common intra-abdominal organ involved
was liver (21.56 %) followed by retroperitoneum (17.65 %) and lymph nodes
(14.70 %). The intra-abdominal lesions were classified into non - neoplastic (16.67
%) and neoplastic lesions (83.33 %). Neoplastic lesions (83.33 %) were further
sub classified into benign (15.68 %) and malignant (67.65 %). IHC was done in
all malignant lesions for confirmation of primary and / or metastasis. Complete
concordance between cell blocks and smears was observed in 95 / 102 cases
(93.14 %), while discordances were noted in 05 out of 102 cases (06.86 %).
Cell blocks play a vital role in cytopathology and as an adjunct to the routine
cytology smears and body fluids. Cell buttons are cost effective and simple to make
without involving much higher technicality. Cell block sections offer advantages
with respect to cellular architecture, archival storage and application of IHCs which
help in pin-pointing the diagnosis. Hence, cell blocks must be considered to
increase the diagnostic yield and efficacy.