B.P.Koirala Institute of Health Sciences, Nepal
Dr Anju Pradhan is a consultant Pathologist at B. P. Koirala Institute of Health Sciences (BPKIHS), Nepal. She completed her MD in 2008 from the same university. Having special interest in cytopathology, gastrointestinal and liver pathology and medical education, she completed short term training in cytopathology from Siriraj hospital, Mahidol University, Bangkok, Thailand in 2015, in adult and pediatric liver pathology from Geneva University Hospitals, Geneva, Switzerland in 2016 and in Problem-based Learning in Medicine, Health and Behavioural Sciences from Maastricht University, Maastricht, The Netherlands in 2012. She is also working as a coordinator of Phase I MBBS Program.
Background and Objectives
In diagnosing a neoplastic lesion from any area, fine needle aspiration cytology can provide a level, as to whether the lesion is benign or malignant. Cell block preparation in a way will mimic the histopathological sections, thus help in sub classifying various neoplastic lesions as well. The objectives of this research was to evaluate the diagnostic utility of cell block in fine needle aspiration of malignant lesions.
Materials and Methods
This was a prospective hospital based study conducted in the department of pathology, BPKIHS over a period of 1 year. A total of 41 cases who were suspected or diagnosed as cases of malignancy in FNAs smear of whom cell block and histopathology specimens, available were included in this study.
Smear were diagnostic in 93% of cases while Cell block were diagnostic in 80% of cases Smear supplemented by Cell block improved diagnosis which reached to 98%.The cell block diagnosis confirmed that of smear diagnosis in 56% cases. It established specific diagnosis in 24% cases and hence contributed especially in cases where smears were non-diagnostic. Therefore, CB were found to be superior to smears in these cases. The cell block was non-confirmatory in 20% cases. The main non-confirmatory nature of cell block was mainly due to the non-diagnostic yield of cell block.
This study concludes that Cell Blocks have a synergistic effect on Conventional Smear diagnosis. In selected cases where CS falls into suspicious for malignancy category, Cell Blocks can render a specific diagnosis.
Keywords: Cell block, Malignant lesion, Smear diagnosis