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 Wikipedia and online dictionaries refer to the ‘cellblocks’ and ‘cell blocks’ as structures related to prisons [1,2,3,4,5,6]. Similarly, the internet search for ‘cellblock’ and ‘cell block’ mostly results in sites related to ‘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’ [4,5].
The role of cell-blocks in cytopathology has been important for a long time but is increasingly critical with the 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 [7,8,9]. 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 [10,11].
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. [11,12].
A variety of approaches have been used for cell-blocking [4,5,13]. 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 a maximally optimum outcome [4,5,13].
References
1. Shidham VB. CellBlockistry: Chemistry and art of cell-block making- A detailed review of various historical options with recent advances (Review). CytoJournal 2019, 16:12 (28 June 2019) Available FREE in open access from: [1] DOI:10.4103/cytojournal.cytojournal_20_19
2. Shidham VB. CellBlockistry: Science of Cell-Block Making as Ancillary Cytopathology Component in the Era of Minimally Invasive Techniques with Increasing Role of Molecular Pathology (Invited Short communication). Clinics in Surgery 2019; Volume 4; Article 2510 Remedy Publications LLC., [2] Available FREE at: [3]
3.Cell block: Search results (Wikipedia) [4] (performed on 5-9-2020)
4. TheFreedictionary.com- cellblock cell·block [5]
5. Dictionary.com- cellblock [6]
6. Wiktionary- See also: cell block cellblock [7]
7. Saqi A. The State of Cell Blocks and Ancillary Testing: Past, Present, and Future. Archives of Pathology & Laboratory Medicine: December 2016, Vol. 140, No. 12, pp. 1318–1322. [8]
8. Jain D, Mathur SR, Iyer VK.Cell blocks in cytopathology: a review of preparative methods, utility in diagnosis and role in ancillary studies. Cytopathology. 2014 Dec;25(6):356-71. doi: 10.1111/cyt.12174. Epub 2014 Aug 11.
9. Nambirajan A, Jain D. Cell blocks in cytopathology: An update. Cytopathology. 2018 Dec;29(6):505-524. doi: 10.1111/cyt.12627. Epub 2018 Sep 27.
10. Shidham VB, Kajdacsy-Balla AA. Immunohistochemistry: Diagnostic and Prognostic Applications. In Detrick B, Hamilton RG, Folds JD eds. Manual of Molecular and Clinical Laboratory Immunology. American Society of Microbiology Press. 7th ed, Chapter 47, Year 2006, p408-413 ([9]).
11. Shidham VB, Epple J. AppendiX I: Collection and processing of effusion fluids for cytopathologic evaluation. In: Shidham VB and Atkinson BF. Editors ‘Cytopathologic Diagnosis of Serous Fluids’ First edition, Elsevier (W. B. Saunders Company); 2007. Ch 14, pp. 207–235.
12. Shidham VB, Falzon M. Serous effusions: reactive, benign and malignant. In Gray & Kocjan, ed. Diagnostic Cytopathology, Elsevier, 3rd edition, Chapter 3.
13. Elmas H, Gamsızkan M, Önal B. Cell Block Preparation Methods and Advanced Techniques. In: Önal B, Ed. Techniques in Cytopathology-from basic to molecular (ISBN 978-605-7578-06-8 Search this book on 
.). Ankara: Nobel Tıp Kitabevleri; 2019. p:128-46 (In Turkish language).
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