Cellblockistry

CellBlockistry is a science and an art for ‘cell-blocking’ with optimum results with the final cell-blocks at a quantitative and qualitative level. The cell-blocks, in brief, are formalin-fixed paraffin-embedded (FFPE) blocks with cells and micro-components in various cytology specimens. In addition to the preservation of morphological and structural features, the cell-blocks should also conserve the qualitative integrity so that results on various ancillary studies including immunohistochemistry (IHC) and the molecular tests are accurate. It is important that the results obtained with cell-blocks on these ancillary tests are comparable to those with FFPE of surgical pathology specimens because most of the data with which the results will be compared are based on the FFPE tissue.
However, various searches including and online dictionaries refer to the ‘cellblocks’ and ‘cell blocks’ as structures related to the prisons . Similarly, the search internet for ‘cellblock’ and ‘cell block’ mostly results in sites related to the ‘prison cells’ with a few in recent years as cytopathology related searches. To prevent this confusion, the word in relation to cytopathology should be hyphenated and spelled as ‘cell-block’ .
The role of cell-blocks in cytopathology has been important for a long time but is increasingly critical with tendency and expectations of performing a variety of tests on least available material with minimally invasive procedures such as fine-needle aspiration (FNA) biopsy and other simple procedures such as effusion fluid taps . Many ongoing advances, including molecular pathology tests and IHC with multiple advances such as rabbit monoclonal antibodies, multicolor IHC, and SCIP (subtractive coordinate immunoreactivity pattern) approach have further enhanced the significance of cell-blocks .
In addition to the benefits and role of cell-blocks in cytopathology mentioned above, the cell-blocks also extend the benefit of sampling enhancement of the cytology specimens with relatively scant diagnostic material. Cell-blocks allow evaluation of various architectural parameters suggesting specific diagnostic patterns and structures such as duct-like formations, papillary, acinar, and psammoma bodies, etc. .
A variety of approaches have been used for cell-blocking . The basic principle is very simple. Sediments in cytology specimens are conglomerated by various methods so that the block is easy to be manipulated while processing for paraffin embedding to generate FFPE. However, there are many concerns related to the quantitative and qualitative integrity of the final FFPE of cell-blocks. CellBlockistry as a science of cell-blocking addresses these concerns for improving the cell-blocks with maximally optimum outcome .

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