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Adekvátnost vzorku

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Vzorek m?že být nedostate?ný v d?sledku nadbytku krve, silné vrstvy nát?ru, vyschnutí alkoholem fixovaných nát?r? nebo nedostate?ného po?tu folikulárních bun?k. Nutné minimum je definováno jako šest skupin po deseti folikulárních bu?kách (Bethesda 2010).

U zkušených nep?evyšuje procento nedostate?ných vzork? 5-10%.  Bylo by chybou považovat  nedostate?né nebo nediagnostické vzorky za negativní. Nejnižší podíl nedostate?ných vzork? je výsledkem spolupráce klnika a patologa a okamžitého vyhodnocení výt?žnosti odb?ru.

A follicle lined by bland thyrocytes. At least 5 such groups should be identified. In additon a macrophage with a typically vacuolated cytoplasm and a background of fluid colloid (bluish) can be seen.
A group comprising 3-4 normal follicles. The nuclei are round and the chromatin fine; cytoplasm is abundant, pale and indistinct. A peripheral “flare” is seen on the cell membrane, suggesting hyperfunctionality.
The result of an FNA with a 25G needleon a benign thyroid nodule. Note the very small central haemorrhage. There appears to be a correlation between entity of changes and size of needle, if prominent these changes may hamper histological correlation.
Inadequate smear (blood). A clearly inadequate smear at low power, showing blood only. Even if occasional thyroid cells may be present their identification is greatly hampered by excessive blood. Feed back between the sample taker and the cytologist are essential in order to decrease the number of such cases. The thyroid being a very vascular organ however, even in optimal circumstances a small proportion of cases will be inadequate.