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Spirabrush Cervical Specimens

In 2002 the FDA approved a novel device for obtaining cervical samples that are diagnostically equivalent to those obtained via punch biopsy of the cervix.[132] The device is worthy of mention because it poses some challenges in terms of the accurate diagnosis of cervical cancer precursors. Unlike a punch biopsy, which provides a fragment of cervix containing surface epithelium and attached underlying stroma, the Spirabrush device samples only the epithelial surface. As such, the samples lack the orientation and epithelial polarity provided by attached stroma. This lack of orientation did not preclude the accurate diagnosis of cervical samples in clinical trials, but it challenges the diagnostic pathologist to redefine the way cervical samples are evaluated.

Spirabrush samples are prepared as cell blocks. The pathologist receives slides in which numerous strips of squamous and glandular epithelium are arranged at random. Sample adequacy relies on the …