Targeting cytolytic samples for quality control

Abstract

In the presence of Lactobacillus, intermediate squamous cells often exhibit cytolysis. This lysis of the cytoplasm of glycogen-rich intermediate cells represents a peptolytic process that is rarely encountered in superficial squamous cells and practically never in parabasal cells. The gynecologic specimen exhibits naked nuclei of intermediate cells, cellular debris and abundant bacilli.3 When the cytolytic process is excessive, evaluation of the sample is limited due to partially obscuring debris. Not only the recognition of endocervical cells may be a problem, but also epithelial abnormalities. This may have potential legal implications in disputed cases of sample adequacy in Pap smears. We report quality control (QC) of cervical- vaginal samples interpreted as within normal limits (WNL) with an adequacy score of satisfactory but limited by (SBLB) excessive cytolysis by prospective, random, 10% QC and high-risk (HR) QC for a six-month period in the Cytology Laboratory, Thomas Jefferson University Hospital