Cervix
Cytologic features
Unsatisfactory specimen
Author: Farnaz Hasteh, M.D.
Topic Completed: 1 March 2011
Minor changes: 3 December 2020
Copyright: 2006-2021, PathologyOutlines.com, Inc.
PubMed search: cervix unsatisfactory specimen
Cite this page: Hasteh F. Unsatisfactory specimen. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/cervixcytologyunsatisfactoryspecimen.html. Accessed January 22nd, 2021.
Definition / general
- Unsatisfactory if more than 75% of specimen is obscured by blood or inflammation
- Also due to scant cellularity or if specimen is rejected not processed or unsatisfactory for evaluation due to another reason
- An adequate conventional Pap test should have 8,000 to 12,000 squamous cells
- An adequate liquid based preparation (LBP) should have at least 5,000 squamous cells (review at least 10 microscopic fields at 40×)
Terminology
- Examples of sample reports for unsatisfactory cases:
- Unsatisfactory because of obscuring inflammation
- Unsatisfactory because of insufficient squamous cellularity
- Unsatisfactory because of obscuring blood
Clinical features
- May be due to atrophy
- For Thin Prep, reprocessing of unsatisfactory slides is useful (Am J Clin Path 2002; 117:457)
- May be fewer unsatisfactory specimens with liquid based cytology (Eur J Gynecol Oncol 2005;26:646, Expert Rev Mol Diagn 2005;5:857, Gynecol Oncol 2005;99:597)
- A lower number of cells may be acceptable in vaginal smears (post hysterectomy) or with severe atrophy (The Bethesda System for Reporting Cervical Cytology:2004)
- Presence of endometrial cells does not convert a specimen from unsatisfactory to satisfactory
- Unsatisfactory cases are more often from high risk patients which may exhibit SIL on follow up (Cancer Cytopathology 1997; 81:139)
Cytology images
Contributed by Dr. Marilin Rosa
Unsatisfactory, scant and obscuring inflammation
Adequate pap, 5x
Images hosted on other servers:
Unsatisfactory poorly cellular smear
