title: Improvements in cell block processing: The Cell-Gel method.
abstract: BACKGROUND
  The ability to produce adequate cell blocks profoundly impacts the diagnostic usefulness of cytology specimens. Cell blocks are routinely processed from fine-needle aspiration specimens or concentrated fluid samples. Obtaining directed passes for the sole purpose of producing a cell block is common practice, particularly when the cytopathologist anticipates the need for ancillary immunocytochemical stains and/or molecular studies.
  
  
  METHODS
  The authors developed an effective and inexpensive process for producing cell blocks that consistently yields abundant cellular material, which they have termed the Cell-Gel method. This method can be simplified into 3 main steps: 1) preparing the sample; 2) constructing the cell block; and 3) processing the cell block. Highlights of the protocol include using a hemolytic fixative for sample preparation and disposable base molds for cell block construction.
  
  
  RESULTS
  The cell block failure rate in the current study decreased from 18% with the HistoGel Tube method (January 2014-December 2014) to 6% with the Cell-Gel method (January 2015-December 2016). The authors evaluated 110 cell blocks processed with the HistoGel Tube method and 110 cell blocks processed with the Cell-Gel method, for a total evaluation of 220 cell blocks.
  
  
  CONCLUSIONS
  The authors have developed an effective and inexpensive protocol for producing cell blocks that consistently yields abundant cellular material. The Cell-Gel method uses a hemolytic fixative and disposable base molds to produce adequate cell blocks. When the method was implemented, the cell block failure rate of the study laboratory decreased by approximately 67%. Cancer Cytopathol 2017;125:267-276. © 2016 American Cancer Society.
authors.affiliation: Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Kristin A
authors.identifier: http://orcid.org/0000-0003-3129-8551
authors.initials: KA
authors.lastname: La Fortune
authors.affiliation: Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Melissa L
authors.initials: ML
authors.lastname: Randolph
authors.affiliation: Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Howard H
authors.initials: HH
authors.lastname: Wu
authors.affiliation: Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Harvey M
authors.initials: HM
authors.lastname: Cramer
mesh_terms: D003581:Cytodiagnosis / Q000191:economics / Q000295:instrumentation / Q000379:methods*; D005782:Gels; D016591:Histocytological Preparation Techniques / Q000191:economics / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D009369:Neoplasms / Q000175:diagnosis / Q000473:pathology*
chemical_list: D005782:Gels
keywords: clinical; cytological technique; cytology; cytopathology; fine-needle aspiration; laboratory techniques