Chandra Krishnan, MD Profile picture
Oct 12, 2022 5 tweets 5 min read Read on X
🚨 Ever find yourself in need of a cellular cell block for #cytopath workup? Here is my "bulletproof" way of getting it!

You'll need:
1. Conical vial (lab)
2. Sheep's agar (micro)
3. Plating loop (micro)
4. Plasma/Thrombin (blood bank)
5. Wrapping paper (histo)

1/5

#pathology Image
1. Spin down your fluid in a conical vial at high rpm (~1200) for 6-8 mins and remove supernatant

You'll have a soft slurry.

2. Add 3 drops plasma, 3 drops thrombin and spin again to form clot

#pathology #cytopath
2/5 Image
3. Cut out 2 squares of agar

4. In one square, scrape away a shallow "bowl" to place your clotted cell slurry

5. In the other square, trim in 1/2 and use the thin flap to cover the slurry in an agar sandwich. Agar protects pellet from dissolution!

#pathology #cytopath
3/5 ImageImageImage
6. Wrap the agar sandwich in tissue wrap paper and let fix in formalin

7. After fixation, the agar becomes firm and the cell block will fix in place, without losses into paper or formalin dilution

#pathology #cytopath
4/5 ImageImage
8. Embed sandwich so histotech can see agar cutting away during facing = cell block isn't over faced

9. Enjoy plenty of material for IHCs, FISH or NGS.

I've had great success in critical samples (brain CUSA, effusions, aspirates) and hope you do too.

#pathology #cytopath
5/5 ImageImage

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