Spontaneous clots in body fluids: can they cellblock?

Area of Science:

• Cytopathology
• Histopathology
• Diagnostic Pathology

Background:

• Cell blocks are essential for cytologic specimen analysis, but often lack sufficient cellularity.
• Improving cell block cellularity is key for diagnostic and prognostic assessments.
• Spontaneous clots in body fluids offer a potential source for enhanced cell block preparation.

Purpose of the Study:

• To compare the cellularity of cell blocks prepared from spontaneous clots versus cell pellets.
• To evaluate the utility of spontaneous clot cell blocks for ancillary testing.

Main Methods:

• Eighteen body fluid specimens were processed to create two cell blocks each: one from a spontaneous clot (SC) and one from a concentrated cell pellet (CP).
• Cellularity was assessed and scored on a scale of 0 (no cells) to 3 (abundant cells) for each block.
• Hematoxylin and eosin-stained slides were used for cellularity assessment.

Main Results:

• Spontaneous clot (SC) cell blocks showed significantly higher cellularity than cell pellet (CP) blocks.
• Only 6% of SC blocks had no cells (score 0), compared to 28% of CP blocks.
• SC blocks from malignant fluids exhibited denser tumor nuclei, proving adequate for genomic testing where CP blocks were insufficient.

Conclusions:

• The spontaneous clot method yields superior cell block cellularity compared to the cell pellet method.
• Enhanced cellularity in SC blocks supports their use for advanced analyses like genomic testing.
• Spontaneous clot preparation is a valuable technique to improve cell block utilization in cytopathology.