The Efficacy of Using the Tissue Fragments Present in Cervical Scrapes for the Histologic Diagnosis of Cervical Neoplasia

• Mathilde E. Boon

  Leiden Cytology and Pathology Laboratory, Leiden, The Netherlands; 2Facoltà di Medicina e Chirurgia, Università di Salerno, Italy

• Pio Zeppa

  Leiden Cytology and Pathology Laboratory, Leiden, The Netherlands; 2Facoltà di Medicina e Chirurgia, Università di Salerno, Italy

 Cervical scrapes to diagnose cervical neoplasia, collected by the clinician with brushes, are sent to the Leiden Cytology and Pathology Laboratory (LCPL) in vials containing BoonFix, a noncross-linking coagulant fixative. Because the residual material left in the vials contains tissue fragments with important diagnostic information, we stored the residual material in our archives. The tissue fragments can be mummified and archived in commercially available histology cassettes. We can produce paraffin sections thereof. Immunostaining is beautiful on serial paraffin sections cut from these blocks.

We experienced that it is important to leave the brush in the vial such that all tissue fragments can be used for histologic diagnosis. In order to optimize the system, tissue fragments left in the endocervical part of the brush are removed in a paint shaker.

We illustrate this principle of recovering mummified tissue fragments in a false negative case with cytology containing many undiagnosable collapsed tissue fragments. This case shows clearly the efficacy of using the tissue fragments present in cervical scrapes for the histologic diagnosis of cervical neoplasia.

Boon ME, Risse EKJ, Ouwerkerk-Noordam E. Biomarker p16INK4a on paraffin sections from residual material: cancerous tissue fragments overlooked in false negative Papanicolaou-stained thin-layer slide. Acta Cytol 2009; 53: 239-240. http://dx.doi.org/10.1159/000325134

Brons-Holloway PA, Risse EKJ, Meijer-Marres EM, Duineveld SM, Ouwerkerk-Noordam E, Boon ME. Biomarker p16INK4a on paraffin sections prepared from cervical brush samples highlights nuclear changes resulting in unquestionable cytohistodiagnosis. Acta Cytol 2009; 53: 144-149. http://dx.doi.org/10.1159/000325115

Risse EK, Ouwerkerk-Noordam E, Meijer-Marres EM, Boon ME. Exploiting the residual of cervical thin layer brush samples through cytohistology in cases with invasive carcinoma with application of antibodies. Acta Cytol 2010; 54: 175-182. http://dx.doi.org/10.1159/000325004

Risse EKJ, Ouwerkerk-Noordam E, Boon ME. Endometrial cells in liquid-based cervical cytology: a diagnostic pitfall solved by preparing cytohistology from the residual thin layer sample. Acta Cytol 2011; 55: 327-333. http://dx.doi.org/10.1159/000327525

• PDF