C1 (Inadecuada)

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La designación de un aspirado como “inadecuado” es a veces subjetiva. La experiencia de quien toma la muestra y/o de quien la interpreta juegan un rol definitivo. La determinación de un material como adecuado se basa en la presencia de un número suficiente de células epiteliales para dar un diagnostico confiable.

Una rata de C1 ideal debe ser menor del 25%

En caso de que el laboratorio tenga cifras mayores del 20%. La técnica de BACAF debe ser revisada.

Diferentes causas pueden determinar que un extendido sea inadecuado:

Error en la toma de la muestra
Mala técnica al extender el material
Mala fijación (fijadores vencidos, una fijación no inmediata)
Inadecuado secado de la muestra
Mala coloración (Sub/super coloreadas)
Pobre celularidad

Errors in sampling: Sometimes diagnostic information may be present in the sample and may be included in the report. For example adipose tissue fragments could be consistent with a clinical diagnosis of lipoma. Aspirates from some lesions, (cysts, abscesses, fat necrosis and nipple discharge specimens) might not contain epithelial cells but should not be classified as inadequate.

Bad spreading: Crush artefact, when too much pressure is used during smearing or when smears are too thick when not enough pressure is applied.

Poor fixation: (expired fixatives, fixation not immediate).

Inadequate drying: when the material for air-drying dries too slowly or when the wet fixed, dries out before fixation.

Bad staining (under/over).

Poor cellularity: Remember that smears from some malignant lesions may contain only few atypical elements because of the desmoplastic reaction such as that found in some lobular carcinomas. It is always important to keep in mind that any case with few atypical elements should not be considered as inadequate.