title: Role of Cell Block in Guided FNAC of Abdominal Masses.
abstract: BACKGROUND
  Fine Needle Aspiration (FNA) of space occupying lesions in superficial or deep anatomic sites is an increasingly common procedure, providing rapid and safe diagnosis. However, sometimes FNA does not yield sufficient information for a precise diagnosis and the risk of false negatives and indeterminate diagnosis is always present. Therefore, we attempted to obtain additional information via the preparation of Cell Block (CB) from the residual material of aspirates and thus enhance the diagnostic accuracy.
  
  
  OBJECTIVE
  This study was carried out to evaluate the role of CB as a useful adjunct to smears for establishing a more definitive cytopathologic diagnosis and for its utility in special staining and Immuno-histochemistry (IHC).
  
  
  METHODS
  A total of 66 cases of image-guided FNA of abdominal masses were studied. In addition to the routine smears, CBs were prepared from the residual tissues for all possible cases and its diagnostic efficacy was analysed. Further, the use of CBs for special staining and IHC was also established.
  
  
  RESULTS
  This study included a total of 66 patients with abdominal masses who were referred for guided FNA cytology. Out of these cases, adequate material was obtained on FNAC in 64 cases (96.96%) and on CB in 45 cases (68.18%) and the diagnosis was provided. There was a good agreement between the FNA smear diagnosis and CB diagnosis. The histopathology of CB sections further helped in precise final cytopathological diagnosis. Two FNA smears were unsatisfactory for evaluation and hence the diagnosis was done on CB sections alone. With FNA cytology and CB in combination, a cytopathological diagnosis was given for all the 66 cases. The sensitivity of FNA in comparison to the histopathology of CB was 91.6% and specificity was 88.8%. The diagnostic accuracy was 62% and the discordance was 6%.
  
  
  CONCLUSIONS
  CB in addition to the routine FNA is a simple, reliable and cost-effective technique that further contributes to the final cytopathological diagnosis.
authors.affiliation: Assistant Professor, Deprtment of Pathology, Vydehi Institute of Medical Sciences and Research Centre , Bangalore, India .
authors.forename: Shashikala
authors.initials: S
authors.lastname: Vinayakamurthy
authors.affiliation: Professor, Department of Pathology, JSS University , Karnataka, India .
authors.forename: Nandini
authors.initials: N
authors.lastname: Manoli
authors.affiliation: Associate Professor, Department of Pathology, Vydehi Institute of Medical Sciences and Research Centre , Bangalore, India .
authors.forename: Prathima
authors.initials: P
authors.lastname: Shivajirao
authors.affiliation: Head of Department and Professor, Department of Pathology, JSS University , Karnataka, India .
authors.lastname: Manjunath
authors.affiliation: Professor, Department of Pathology, JSS University , Karnataka, India .
authors.forename: Sunila
authors.initials: S
authors.lastname: Jothady
keywords: Cytodiagnosis; Diagnostic accuracy; Fine needle aspiration cytology