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Cell block cellularity: A comparison of two fixatives and their impact on cellularity
Lester J Layfield1, Magda Esebua1, Jonathan Ang2
1Department of Pathology & Anatomical Sciences, University of Missouri, Columbia, Missouri.
Diagnostic Cytopathology
|November 24, 2018
Summary
Formalin-fixed cell blocks provide superior cellularity for ancillary testing compared to CytoLyt. This finding is crucial for optimizing diagnostic accuracy in cytologic specimen evaluation.
Area of Science:
- Cytopathology
- Histopathology
- Molecular Diagnostics
Background:
- Ancillary testing, including immunohistochemistry and molecular diagnostics, is vital for cytologic specimen evaluation.
- Cell block specimens are commonly used for ancillary testing, with success dependent on cellularity.
- Testing aids in diagnosis, prognosis, and predictive evaluation.
Purpose of the Study:
- To compare the cellularity of cell blocks prepared using formalin versus CytoLyt fixation.
- To determine the optimal fixation method for maximizing cell block cellularity for ancillary testing.
Main Methods:
- Forty-six paired cytologic cases were fixed in both formalin and CytoLyt.
- Two evaluators assessed overall cellularity for each method.
- Linear regression analyzed inter-rater reliability; cell counts were averaged and compared between fixation methods.
Main Results:
- High inter-rater agreement was observed for both formalin and CytoLyt methods (R²=1.0 and 0.99).
- Cell blocks prepared with formalin fixation demonstrated significantly higher cellularity than those prepared with CytoLyt.
- Formalin fixation optimizes cellularity for effective ancillary testing.
Conclusions:
- Formalin-fixed cell blocks yield significantly greater cellularity than CytoLyt-fixed cell blocks.
- Formalin fixation is recommended to optimize cell block cellularity for ancillary testing in cytopathology.
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