Browsing by Author "Mulenga, Maurice"

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    Determining the suitability of bio-specimens obtained by fine needle aspiration biopsy at a tertiary hospital in Malawi for immunocytochemical assessment
    (Stellenbosch : Stellenbosch University, 2022-04) Mulenga, Maurice; Schneider, Johann Werner; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Pathology.
    ENGLISH SUMMARY: Fine-needle aspiration biopsy (FNAB) is a quick, economical, least invasive and easy to perform a minor surgical procedure. In resource-limited settings, FNAB is of utmost importance in providing a rapid diagnosis that facilitates timely and correct institution of treatment. The FNAB smear preparation provides an opportunity for either rapid on-site evaluation or routine diagnosis if ancillary tests are necessary to establish a specific diagnosis. Cell blocks (CB) prepared from FNAB specimens improve the diagnostic yield, increase the sensitivity and reduce false-positive interpretations of detecting a malignant neoplasm. In addition, CB allow for additional morphological evaluation with a better architectural pattern, enable the performance of numerous ancillary diagnostic studies, including immunocytochemistry and molecular studies and offer the storage of material that can be used for future research studies. Delays in fixing the cell block have been challenges in various cell block preparatory techniques. However, a special alcohol-based fixative, commercially available solution called CytoRich Red® (CRR) has been described to be comparative to liquid-based cytology due to its effectiveness in lysing red blood cells, reducing background material, and improving staining qualities of the nucleus and cytoplasm in routine preparations of non-gynaecological material in suspension or fluids. Despite this breakthrough, there is a paucity of data on the suitability of CRR cell blocks for immunocytochemical and DNA assessment from FNAB material obtained from solid tumours. This study aimed to establish and confirm the suitability of CytoRich Red® Cell Blocks and FNAB biospecimens obtained and prepared at Kamuzu Central Hospital, Lilongwe, Malawi, for cytomorphological and immunocytochemical assessment. This study analysed 144 cell blocks and 128 FNAB smears. It is one of the first within sub-Saharan Africa to describe diagnostic efficacy from FNAB specimens obtained from various superficial and deep masses fixed in CRR. It describes the advantage of using an alcohol-based fixative immediately to reduce pre-fixation time lag. This study showed that CRR-fixed cell blocks improve sensitivity and architectural preservation, and immunocytochemical staining characteristics of the aspirate compared to routine FNAB smears. It is envisioned that CRR-fixed cell blocks will be a source of extractable, stable and usable DNA that supports research in biorepositories and biobanks.