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Correspondence
The precious cell block
  1. Frederick George Mayall1,
  2. Ian Bodger1,
  3. Justin Pepperell2,
  4. Lara Stevanato3,
  5. Arianna Hustler3,
  6. Kyra Mhairi Mumford3
  1. 1 Department of Cellular Pathology, Musgrove Park Hospital, Taunton, UK
  2. 2 Department of Respiratory Medicine, Musgrove Park Hospital, Taunton, UK
  3. 3 Research and Development, ANGLE Europe Ltd, Guildford, UK
  1. Correspondence to Dr Frederick George Mayall, Department of Cellular Pathology, Musgrove Park Hospital, Taunton TA1 5DA, UK; DrMayall{at}me.com

https://doi.org/10.1136/jclinpath-2018-205151

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    We describe a method for preparing a cell block from a very sparsely cellular cytology fluid sample. The aim is to ensure that cells are not lost during processing. We developed this method to perform immunohistochemistry on circulating tumour cells (CTC) extracted from the blood of patients with metastatic carcinoma, in which there are typically less than 20 cells in a 10 mL blood sample. The method could also be applicable to other sparsely cellular samples such as cerebrospinal fluid (CSF) samples, or eye vitreous fluid samples. 

    First, the cells are concentrated into a 90 µL volume of fluid. In the case of CTCs this is obtained from a phosphate buffered saline backwash of a Parsortix CTC blood filter cassette (figure 1A–C; arrows mark CTCs). This filter cassette separates cells based on their size and deformability. Circulating carcinoma cells, and cells from other non-haematological neoplasms, tend to be larger and more rigid than other blood cells. The concentrate could also be from centrifugation of a CSF sample, vitreous humour or similar, with removal of most of the supernatant and …

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