How to Prepare Optimum Cell Blocks in Lung Cancer: A Clinical Approach

Fine needle aspiration with cell blocks can diagnose lung cancers in high-risk patients. As ancillary study is important for lung cancer diagnosis, sub typing and prediction of targeted therapy response, it is important that cell block made have good cellularity and morphology. Inadequate cellularity of Cell blocks (CBs) is a common problem due to lack of standardization of cell block preparatory methods. Here we describe the novel cell block preparation technique for pulmonary cytology specimens in which sediments from centrifuged aspirates were collected on layered filter papers followed by application of partially melted 2% agarose gel on cell button. Out of 41 cell blocks, 22 cases of lung cancers were sub typed without immunohistochemistry. Immunohistochemistry was done in 14 cases for sub typing. Four cases showed only benign respiratory epithelium with fibrosis. We found adequate cellularity in all cases (100%), however, confirmatory diagnosis could not be given in 4 (9.7%) cases.