Successful retrieval of fine-needle aspiration biopsy material from previously stained smears for immunocytochemistry: a novel technique applied to three soft tissue tumors

Abstract

Fine-needle aspiration biopsies of soft tissue tumors are often not fully diagnostic on conventional Papanicolaou or Giemsa stains. Often, more useful information can be gleaned from preparing cell blocks, which are amenable to immunocytochemistry. However, sufficiently diagnostic cell block material is not always forthcoming. We subvent this problem by employing a new 'cytoscrape' technique to create cell blocks from previously Papanicolaou-stained smear material in two cases of mesenchymal tumors where smear diagnoses were limited to 'sarcoma, not otherwise specified'. After thorough text and photographic documentation of the smear results, the slides were decolorized and tumor cells were removed for processing as for routine preparation of cell blocks. Sections cut were then submitted for immunocytochemical profiling. This resulted in definitive diagnoses in both cases, averting the need for more invasive diagnostic procedures. We applied the same technique to a third case of a lung nodule, in which the smear was inconclusive and the original cell block nondiagnostic. The subsequent immunocytochemical testing enabled a definitive diagnosis to be made. This novel technique is described here; its value and applicability are discussed in the context of fine-needle aspiration biopsies of soft tissue tumors.

Cell Sample Preparation for Clinical Cytopathology: Current Status and Future Development

“…They found cytoscrape cell blocks were able to provide not only equally good cytomorphology as conventional cell blocks, but also opportunities to test a diagnostic panel for ICC. 31 A similar experience with this method has also been reported by Nga et al 35 Cytoscrape cell block opens up a unique way to make use of nondiagnostic thick cell clusters and blood clot -covered cell aggregates on smear slides. However, the studies regarding this methodology were all small with only three to seven cases for ICC analysis.…”

Cytology of pancreatic acinar cell carcinoma

“…Cell blocks were made for patients 1 and 2 by scraping material from highly cellular smears into a gel, and then processing it by routine histology, somewhat akin to what has been previously described. 16 The cytologic features are summarized in Table I (Figs. 1-4).…”

A technique to improve diagnostic information from fine‐needle aspirations

“…Nga et al described a similar method for making clots from 3 mesenchymal tumors. 11 Those authors reported that the cohesive mesenchymal nature of the tumor cells enables the cells to be scraped off the slide, because they form cohesive clusters that withstand the mechanical stresses of being removed from the smear and embedded in paraffin blocks. We demonstrated that this method also may be applied successfully to noncohesive epithelial tumors without microbiopsies on the slides.…”

“…Microbiopsies from stained smears were picked up and processed directly through paraffin. 11,12 However, microbiopsies often are not present on the smears.…”