Review
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Aug 25, 2015; 7(11): 1014-1022
Published online Aug 25, 2015. doi: 10.4253/wjge.v7.i11.1014
Cell-block procedure in endoscopic ultrasound-guided-fine-needle-aspiration of gastrointestinal solid neoplastic lesions
Antonio Ieni, Valeria Barresi, Paolo Todaro, Rosario Alberto Caruso, Giovanni Tuccari
Antonio Ieni, Valeria Barresi, Rosario Alberto Caruso, Giovanni Tuccari, Department of Human Pathology “Gaetano Barresi”, Section of Anatomic Pathology, University of Messina, Azienda Ospedaliera Universitaria “Gaetano Martino”, 98125 Messina, Italy
Paolo Todaro, Department of Human Pathology “Gaetano Barresi”, Section of Cytopathology, University of Messina, Azienda Ospedaliera Universitaria “Gaetano Martino”, 98125 Messina, Italy
Author contributions: Ieni A and Tuccari G wrote the paper; Barresi V, Todaro P and Caruso RA collected the literature data; all authors read and approved the manuscript.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Giovanni Tuccari, MD, Full Professor of Pathology, Department of Human Pathology “Gaetano Barresi”, Section of Anatomic Pathology, University of Messina, Azienda Ospedaliera Universitaria “Gaetano Martino”, Via Consolare Valeria 1, 98125 Messina, Italy. tuccari@unime.it
Telephone: +39-90-2212539
Received: April 12, 2015
Peer-review started: April 15, 2015
First decision: June 24, 2015
Revised: July 1, 2015
Accepted: July 29, 2015
Article in press: August 3, 2015
Published online: August 25, 2015
Processing time: 138 Days and 17.3 Hours
Abstract

In the present review we have analyzed the clinical applications of endoscopic ultrasound-guided-fine-needle-aspiration (EUS-FNA) and the methodological aspects obtained by cell-block procedure (CBP) in the diagnostic approach to the gastrointestinal neoplastic pathology. CBP showed numerous advantages in comparison to the cytologic routine smears; in particular, better preservation of cell architecture, achievement of routine haematoxylin-eosin staining equivalent to histological slides and possibility to perform immunohistochemistry or molecular analyses represented the most evident reasons to choose this method. Moreover, by this approach, the differential diagnosis of solid gastrointestinal neoplasias may be more easily achieved and the background of contaminant non-neoplastic gastrointestinal avoided. Finally, biological samples collected by EUS-FNA CBP-assisted should be investigated in order to identify and quantify further potential molecular markers.

Keywords: Endoscopic ultrasound-guided-fine-needle-aspiration; Cell-block procedure; Gastrointestinal tract; Immunohistochemistry; Diagnosis

Core tip: Cell-block procedure (CBP) represents the most suitable complement in diagnostic cytopathology of many gastrointestinal lesions. Hence this method allows high quality morphological evaluation and immunocytochemical analyses. On this way, the differential diagnosis of solid gastrointestinal neoplasms may be more easily achieved and the background of contaminant non-neoplastic gastrointestinal avoided, with an evident gain compared to the traditional cytological techniques. In the present review, the application of CBP in gastrointestinal solid lesions approached by endoscopic ultrasound-guided-fine-needle-aspiration, the methodological aspects and the accuracy of this diagnostic process are analyzed and discussed.