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Updated: May 24, 2026

Determination of Protein Expression Level in Cultured Cells by Immunocytochemistry on Paraffin-embedded Cell Blocks
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Enhanced cellularity in plasma-thrombin cell block preparations: an improved method.

Joseph Hellrung1, Erek Kucher2, Mariah Vande Berg2

  • 1Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.

Journal of the American Society of Cytopathology
|May 22, 2026
PubMed
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An improved plasma-thrombin method for cell blocks significantly increases cellularity and diagnostic adequacy in cytologic preparations. This cost-effective enhancement improves the diagnostic yield from body fluid samples.

Area of Science:

  • Cytopathology
  • Histology
  • Laboratory Medicine

Background:

  • Cell blocks are crucial for histologic evaluation and ancillary testing in cytology.
  • Standard plasma-thrombin methods often result in low cellularity, limiting diagnostic potential.
  • Suboptimal cellular material can hinder accurate cytologic diagnoses.

Purpose of the Study:

  • To validate an improved plasma-thrombin method for enhancing cell block cellularity.
  • To assess the impact of method modifications on diagnostic adequacy in cytologic samples.
  • To evaluate the clinical utility and cost-effectiveness of the enhanced method.

Main Methods:

  • An improved plasma-thrombin method was developed, incorporating a second centrifugation step and phloxine dye.
  • Paired body fluid samples (n=20) were processed using standard and improved methods.
Keywords:
Body fluidsCell blocksEnhanced cellularityPlasma-thrombin improved methodQuality improvement

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  • Cellularity was quantified using digital image analysis; adequacy was compared before and after hospital-wide implementation.

    • Main Results:

    • The improved method increased median cell counts from 178 to 292 cells per field (P = 0.039).
    • Diagnostic adequacy improved significantly from 56.5% to 80.1% after implementation (P < 0.001).
    • The enhanced method demonstrated complete diagnostic concordance in validation cases.

    Conclusions:

    • Simple modifications to the plasma-thrombin method substantially improve cellularity and adequacy of cell blocks.
    • This low-cost approach enhances the diagnostic yield of cytologic preparations.
    • The improved method has the potential to reduce the need for repeat procedures.