Satisfactory for evaluation - All of the following present:
(1) appropriate labeling and identifying information
(2) relevant clinical information
(3) adequate numbers of well-preserved and well-visualized squamous epithelial cells (epithelial cells on more than 10% of slide surface)
(4) an adequate endocervical/transformation zone component (from a patient with a cervix)
where:
• An adequate endocervical/transformation zone component consists of at least 2 clusters of well-preserved endocervical glandular and/or squamous metaplastic cells, with each cluster composed of at least 5 cells.
• If marked atrophic change is present, the absence of an identifiable endocervical or transformation zone component does not affect the specimen adequacy categorization if the specimen is otherwise determined to be adequate for evaluation.
Satisfactory for evaluation but limited by: If ANY of the following apply:
(1) lack of pertinent clinical information (minimum data is age and date of last menstrual period, additional data as appropriate)
(2) partially obscuring blood, inflammation, thick areas, poor fixation, air-drying artifact, contaminant, etc. that precludes interpretation of approximately 50-75% of the epithelial cells
(3) absence of an endocervical/transformation zone component
(4) abnormal cells are detected where scant squamous component or obscuring material would qualify for "unsatisfactory for evaluation"
Unsatisfactory for evaluation: If ANY of the following apply:
(1) lack of patient information on the specimen and/or requisition form
(2) a slide that is broken and cannot be repaired
(3) scant squamous epithelial component (well-preserved and well-visualized squamous epithelial cells covering less than 10% of the slide surface)
(4) obscuring blood, inflammation, thick areas, poor fixation, air-drying artifact, contaminant, etc., that precludes interpretation of 75% or more of the epithelial cells
Significance of specimen adequacy:
(1) Satisfactory for evaluation: The specimen is probably reliable for detection of cervical epithelial abnormalities.
(2) Satisfactory for evaluation but limited by: The specimen may provide useful information but interpretation may be "compromised".
(3) Unsatisfactory for evaluation: The specimen is unreliable for detection of cervical epithelial abnormalities.
(4) The presence of both squamous and endocervical cells does not guarantee adequate sampling of the transformation zone.
(5) In post-menopausal women endocervical cells may be absent due to physiologic change rather than poor technique.
