Title: A Qualitative Comparison of Conventional Cytosmears and Thromboplastin-Plasma Cell Blocks from Liver Space Occupying Lesions
Authors: Utkarsh Sharma, Ajay Yadav
DOI: https://dx.doi.org/10.18535/jmscr/v7i6.115
Abstract
Introduction: Most of the radiologically evident hepatic lesions are quite easily approachable using Fine Needle Aspiration (FNA). However, limited material and less architectural details are few of the drawbacks frequently encountered with FNA. Thromboplastin-Plasma cell block technique is cost effective, simple, reproducible and can provide improved cytomorphological features. This study applies Mair et al. point scoring system in comparing conventional cytosmears and thromboplastin-plasma cell blocks from liver space occupying lesions.
Methodology: This was a prospective study over a period of 1 year (from January 2018 to December 2018), comprising of a total of eighty cases with liver space occupying lesions. A comparison between the cellularity, morphological preservation, architectural preservation and background was performed on both conventional smears and cell blocks based on the point scoring system described by Mair et al.
Results: On comparing overall quality, cellularity, extent of cellular degeneration, amount of obscuring background and architecture and applying Fischer exact test, cell blocks were of better quality with p-value for superior quality being 0.009 which was statistically significant; cell blocks provided minimal obscuring background with p-value 0.01 which was statistically significant. The architecture analysis in cell blocks showed excellent resemblance to histology in 14 cases (17.5%) from liver SOL aspirates, the p-value for excellent architecture being 0.003, which was statistically significant.
Conclusion: Thromboplastin-Plasma cell blocks prepared from liver SOL aspirates reveal better architecture and less obscuring background, when compared to conventional cytosmears and cell blocks should be prepared whenever possible to aid to the cytosmear diagnosis.