Cell block definition and types indication with procedures and advantages and disadvantages

1. CELL BLOCK PREPARATIONAND ITS
IMPORTANCE
PRESENTED BY:-DR. SHUBHADIP GHOSH
MODERATOR:-
DR.PAYEL BANDYOPADHYAY

2. WHAT IS CELL BLOCK
• It is prepared from cytological material so that it
can be processed sectioned, stained and viewed
as a histology section.
• It can provide diagnostic information from
cytology slides.
• It is easier to do special stains and
immunohistochemistry from a FNA specimen.

3. NEED FOR CELL BLOCK
• It has both diagnostic specificity and sensitivity.
• It requires minimum effort and is cost efficient.
• Moreover tissue preserved in cell block can be
stored easily.

4. MATERIALS REQUIRED FOR CELL
BLOCK

5. METHODS OF CELL BLOCK
PREPARATION
 Fixed sediment method
 Histogel method
 Gelatin embedding
 Bacterial agar method
 Plasma thrombin method
 Colloidion bag
 Cytospinning method
 Cell blocks from Millipore
 Automated preparation
 Albumin method

7. PLASMA THROMBIN METHOD
 Principle is to place cellular material in the clot.
 Very simple and cost effective.
METHOD:
Place specimen in the tube and centrifuge for 10 mins at 1650 rpm
Discard supernatant
For approximately 1ml sediment add 4 drops of plasma and 4 drops of
thrombin and mix well
Clot form 30-60 sec
Place clot in the cassette containing formalin
Routine histological processing

8. PLASMA THROMBIN METHOD

9. HISTOGEL METHODS
 The concentrated sediment is supported by a cell
adjuvant (agar)
 Agar solidifies below 50 C and cell pellet can be
obtained
 This is more time consuming method
 It creates an excellent block with various cells
distributed in layers for best visualisation

10. PROCEDURE OF HISTOGEL METHOD
Centrifuge the cell suspension
Melt 4%agar by placing the tube of agar in a small
beaker of water and heating in a microwave
Add approximately 4ml of completely melted agar to
the sediments in a centrifuge tube. Mix gently
Refrigerate to get a cell button
Place in a cassette and process routinely

11. COLLODION BAG TECHNIQUE
Collodion, a liquid polymer nitrocellulose material is
poured into a tube
After coating the tube completely remove excess collodion
and air dried for 8-10 mins in inverted position
Formalin fixed specimen transfer to the coated tube and
centrifugation done
The bag is removed from the tube
Placed in a cassette for tissue processing

12. Collodion bag method

13. CYTOSPINNING METHOD
 It is a method where machine centrifuge and
collection of sediment on center of the slides.
This method is useful for hypocellular
specimen.
 The basic principle is to concentrate cells
within a defined areas and a filter card
between the chamber sample and the glass
slide resulting in cell to slide adhesion.

14. CYTOSPINNING METHOD

15. Automated cell block preparation
Cellient system
• It is an automated cell block technology
• It uses "vacuum assisted filtration" to capture
and concentrate available cells
• It collect specimens in methanol based
solution

16. • The cellient automated cell block system
concentrates, processes, and embeds loose
cells into a paraffin block ready for sectioning.
• Cells are concentrated into a well in the
cassette by vacuum, and subsequent washes
with alcohol and xylene fix and clear the
specimen
• • The cell button is the infiltrated with
paraffin in the same cassette

17. AUTOMATED CELL BLOCK ANALYSER
MACHINE

18. CELL BLOCK FIXATION
Media includes …
a. SALINE
b. RPMI( Rosewell Park Memorial Institute)
c. NAFS (Nathan Alcohol Formalin Substitute)
d. Formalin
e. Alcohol based (methanol
/ethanol/isopropanol)

19. ADVANTAGES OF CELL BLOCK
 Cell block is simple , reproducible and readily available in routine labs.
 Increased cellularity
 Better morphological and architectural patterns
 Additional yield of cells ,thereby increasing diagnostic yield
 Unlimited storage of the samples
 Application of ancillary studies (ICC and molecular testing)

20. DISADVANTAGE OF CELL BLOCK
 Compared to routine smears takes longer time
 Distortion artifacts.
 Cellular loss in an already small specimen may
occur during multiple transfers during processing

21. TAKE HOME MESSAGE
 Cell block contains aspirated materials
embedded in paraffin that increases the
diagnostic value of cytology .
 Cell block technique is sensitive and specific
tool for diagnostic cytology .
 Combination of cell block to conventional
cytology smears inadequacy of FNAC is
reduced.
 It is a bridge between cytology and
histopathology

22. REFERNCES
1.Bancroft’s Theory and Practice of
Histopathological Techniques
2.Diagnostic Cytology by Pranab Dey

23. THANK YOU