[382] Frequency and Etiology of Unsatisfactory Cervical Cytology by ThinPrep® Method in a Tertiary Care Urban Setting – A Snapshot of Brief Duration

Tatyana Kalinicheva, Neelofur Nazeer, LaQuita King, Tamar Giorgadze, Sudeshna Bandyopadhyay, Shashi Madan, Dongping Shi, Vinod Shidham. Detroit Medical Center and Wayne State University School of Medicine, Detroit, MI

Background: The rate of unsatisfactory cervical cytological specimens is usually higher (up to 3.5%) for ThinPrep® preparation (TP) as compared to the conventional or SurePath™ preparations.
Design: We studied 7,644 cervical cytology specimens (ages 13 to 84, mean- 38 years) over a brief period of 6 weeks for unsatisfactory TP preparations submitted to our tertiary care center with annual turnover of more than 80,000 cervical specimens. Out of these, 233 (3.1%) specimens were interpreted as unsatisfactory. We analyzed various etiologic factors responsible for unsatisfactory interpretation in these specimens.
Results: Several causes for inadequate interpretations were identified (Table 1).

Table 1. Causes associated with unsatisfactory interpretations.
CausesNumber of specimens (Total 233)(%)
LUBE10043
LUBE & blood4017
LUBE & inflammation94
LUBE, blood, & inflammation21
LUBE & ACC209
LUBE, ACC, & inflammation11
ACC42
ACC with inflammation (atrophic vaginitis)42
Blood42
Blood & Inflammation42
Inflammation73
Inflammation with scant squamous cells11
Scant squamous cells229
Acellular135
Other (e.g. cell clumping without particular reason)21
LUBE, lubricant-like material; ACC, Atrophic cellular changes.

The most frequent etiologic factor was association with lubricant-like material (LUBE) with or without additional components such as atrophic cellular changes (ACC), blood and/or inflammation. Five specimens reported previously as unsatisfactory with scant cellular component due to LUBE with ACC were repeated during this time period. All these five repeated specimens did not show LUBE in TP. Satisfactory cellularity was present with ACC in 3 of these repeated specimens. However, 2 specimens with ACC still showed scant cellularity with unsatisfactory interpretations.
Conclusions: Lubricant-like material (with or without blood) is the most common underlying cause of unsatisfactory TP. The next common association is ACC (with or without inflammation). Although, based on a small number during this brief period of observation, a few repeated cases achieved satisfactory cellularity after repeating the cervical cytology, which did not show LUBE in repeated specimens. However, the chance of unsatisfactory may persist in cases with ACC. A larger study over a longer duration with retrospective and prospective repeat findings is suggested and has been initiated.
Category: Cytopathology

Tuesday, March 20, 2012 9:30 AM

Poster Session III # 52, Tuesday Morning

 

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