Boler Anup Kr, Roy Shreosee, Bandyopadhyay Arghya, Bandyopadhyay Abhishek, Ghosh Mrinal Kanti
Department of Pathology, Burdwan Medical College and Hospital, Burdwan, West Bengal, India.
Department of Radiology, Burdwan Medical College and Hospital, Burdwan, West Bengal, India.
J Cytol. 2020 Apr-Jun;37(2):87-92. doi: 10.4103/JOC.JOC_138_18. Epub 2020 Apr 2.
Being a minimally invasive diagnostic technique, Fine-Needle Aspiration Cytology (FNAC) has become the first-line test and corresponding aspirated material has become the target specimen for diagnosis and ancillary tests in lung carcinoma. Although the role of Cell Blocks (CBs) in diagnosis and in ancillary testing is well recognized in literature, limited attention has been paid to specimen procurement and triage in the preparation of CBs. In the present scenario, CBs are not consistently optimal because of its low cellularity.
This study is aimed to describe an improvised technique of specimen acquisition and cell block preparation in CT-guided FNACs of lung carcinoma cases in a resource-constrained center and to assess its efficacy for optimal representation of cellularity, morphology, and architecture.
Total 85 lung carcinoma cases undergoing CT-guided FNAC in our center from February 2017 to January 2018 were included in this study. 4 to 5 direct smears and subsequent CBs were made from material obtained by single pass. Cellularity of smears and corresponding cell blocks were assessed and categorized according to a scoring system (score 1 to 3 for number of cells <50, 50-100, >100, respectively). Preserved architecture and morphology were also assessed in smears and CBs.
The evaluated samples showed a cellularity score 3 in 65.4%CBs and score 2 in 24.7% CBs. Overall, 90.1% cell blocks had acceptable cellularity. Cell morphology was preserved in all CBs of acceptable cellularity, except for two adenocarcinoma, one squamous cell carcinoma, and one small cell carcinoma blocks. Cellular architecture was also preserved in all CBs of acceptable cellularity.
This simple improvised technique of CB preparation optimized its cellularity, morphology, and architectural preservation, even after adequate cellular FNA smears.
细针穿刺抽吸细胞学检查（FNAC）作为一种微创诊断技术，已成为肺癌诊断的一线检查方法，相应的抽吸物已成为肺癌诊断及辅助检查的目标标本。尽管细胞块（CBs）在诊断和辅助检查中的作用在文献中已得到充分认可，但在细胞块制备过程中，对标本采集和分类的关注较少。在当前情况下，由于细胞数量少，细胞块并非始终处于最佳状态。
本研究旨在描述在资源有限的中心，针对肺癌病例进行CT引导下FNAC时，一种改进的标本采集和细胞块制备技术，并评估其在细胞数量、形态和结构最佳呈现方面的效果。
本研究纳入了2017年2月至2018年1月在我院中心接受CT引导下FNAC的85例肺癌病例。通过单次穿刺获得的材料制作4至5张直接涂片及后续细胞块。根据评分系统（细胞数<50、50 - 100、>100分别评分为1至3分）对涂片和相应细胞块的细胞数量进行评估和分类。同时评估涂片和细胞块中保留的结构和形态。
评估样本显示，65.4%的细胞块细胞数量评分为3分，24.7%的细胞块评分为2分。总体而言，90.1%的细胞块细胞数量可接受。除2例腺癌、1例鳞状细胞癌和1例小细胞癌的细胞块外，所有细胞数量可接受的细胞块均保留了细胞形态。所有细胞数量可接受的细胞块也保留了细胞结构。
这种简单的细胞块制备改进技术优化了细胞数量、形态和结构的保留，即使在FNA涂片细胞数量充足的情况下亦是如此。
