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In some selected cases, in addiction to the diagnosis oncologists are asking cytopathologists to do immunohistochemistry they need to make decisions about patient. Gold standard is biopsy but this can’t be done in all of the cases.
Often the cytological specimen is too much bloody and the cells are dispersed in more than one slide, also considering the extracellular substances may inhibit immuno-reaction, we find very difficult to meet the demand.
This is the way to obtain material to obtain paraffin embedded tissue for further investigation/ancillary methods:
- wash the syringe & the needle used to obtain material with saline solution
- centrifuge (2000 rpm 2 min.)
- discard excess fluid
- sediment: add 10% formalin & alcohol 95% solution (50%/50%)
- centrifuge (1500 rpm 2 min.)
- transfer the sediment in the cassette
- processing and inclusion in paraffin
- ready to go
Example – Case Report: Peri-rectal lymphadenopathy
Age: 71, Sex: female
Patient previously trated with surgery and chemoterapy for right colon adenocarcinoma (2007) T3N1, M1
Cytological specimen: EUS-FNA
Preliminary cytological diagnosis : Positive for malignancy – adenocarcinoma
Paraffin embedded tissue from cytological specimen
final diagnosis: Metastasis from colonic adenocarcinoma (recurrence of disease)