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Cellient® Atlas Introduction

Andrew H. Fischer, M.D
In spite of years of research progress, the diagnosis of many diseases, especially cancer, still requires light microscopic evaluation of a sample of cells. To make a diagnosis, pathologists look for alterations in cell structure, and for changes in the composition and organization of tissues [1]. It is obviously an advantage to be able to make a diagnosis, or to guide therapy, based on the smallest possible biopsy sample: the smaller the biopsy, the fewer are the risks and complications for the patient.

Cytology is the field that uses the smallest possible "microbiopsies" for diagnosis.

The appeal of cytology is that it can provide a small but diagnostic sample. By minimizing risks and complications for detecting certain diseases, cytology can be used for the screening of disease.

When cellular level alterations alone are sufficient for a diagnosis, a minimal sample size is acceptable. For many diagnoses, however, it may be necessary to be able to recognize the larger-scale alterations in tissue architecture, or to study biochemical and molecular characteristics of the cells. Cell blocks fulfill this need.

Cell blocks are microbiopsies embedded in paraffin. A standard histologic section, measuring four or five microns in thickness, shows the organization and cellular composition of a microbiopsy fragment. Generally, diagnoses can be made with the most confidence when combinations of cellular and tissue level morphology are present.

Cell blocks are microbiopsies embedded in paraffin. They broaden the diagnostic value of cytology specimens and are complementary to cytology preparations.

References
  1. Fischer AH, Zhao C, Li QK, Gustafson KS, Eltoum IE, Tambouret R., Benstein B, Savaloja LC, Kulesza P. The Cytologic Criteria of Malignancy. J Cellular Biochem 110:795-811, 2010
  2. Istvanic S, Fischer, A. H., Banner, B., Eaton, D., Larkin, A., Khan, A. Cell blocks of breast FNA's frequently allow diagnosis of invasion or histological classification of proliferative changes. Diagnostic Cytopathology 2006; In press.
  3. Burbank F, Parker SH, Fogarty TJ. Stereotactic breast biopsy: improved tissue harvesting with the Mammotome. American Surgeon 1996; 62:738-44.
  4. Jackman RJ, Burbank F, Parker SH, et al. Stereotactic breast biopsy of nonpalpable lesions: determinants of ductal carcinoma in situ underestimation rates. Radiology 2001; 218:497-502.
  5. Fahey C, Bedrosian, U. K. Collodion Bag: A cell block technique for enhanced cell collection. Laboratory Medicine 1993; 74:94-96.
  6. Gao H-G, Savas L, Woda B, Fischer A. Validation of Cellient-type processing for immunohistochemistry. Cancer Cytopathology 114(S5):404-5. Poster presentation at American Society of Cytopathology 56th annual meeting, November 2008.
  7. Fischer AH, Mou, Z., Woda, B. A. High-Quality preservation of RNA and morphology in paraffin. Modern Pathology 2006; 19:328A.

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