A cytological analysis test method for determining specimen adequacy in an optical tomography system from 3D cell reconstructions, the method comprising: isolating and preserving a plurality of cells from a sputum specimen; enriching the plurality of cells to produce a plurality of enriched cells; embedding the plurality of enriched cells into an optical medium; injecting the plurality of embedded enriched cells into a capillary tube; applying pressure to the plurality of embedded enriched cells until at least one embedded cell appears in a field of view of a pseudo-projection viewing subsystem (90, 92, 94, 102, 104, 106); acquiring at least one pseudo-projection image of the at least embedded cell that is in the field of view using the pseudo-projection viewing subsystem; rotating the capillary tube about a tube axis to generate additional pseudo-projection images at different views using the pseudo-projection viewing subsystem to provide a set of pseudo-projection images for each imaged embedded cell; reconstructing each imaged embedded cell using data from the set of pseudo-projection images to produce a set of 3D cell reconstructions; operating a first cell classifier (32, 34, 38, 40) to detect reference cells from the set of 3D cell reconstructions, wherein the reference cells are normal bronchial epithelial cells; enumerating the detected reference cells in the sputum specimen; operating a second cell classifier with a predetermined single cell sensitivity value and predetermined single cell specificity value as characterized by a receiver operating curve to detect target cells from the set of 3D cell reconstructions comprising abnormal lung cells; and operating an adequacy classifier to compare the number of reference cells against a threshold value of enumerated reference cells so as to determine specimen adequacy. isolating and preserving a plurality of cells from a sputum specimen; enriching the plurality of cells to produce a plurality of enriched cells; embedding the plurality of enriched cells into an optical medium; injecting the plurality of embedded enriched cells into a capillary tube; applying pressure to the plurality of embedded enriched cells until at least one embedded cell appears in a field of view of a pseudo-projection viewing subsystem (90, 92, 94, 102, 104, 106); acquiring at least one pseudo-projection image of the at least embedded cell that is in the field of view using the pseudo-projection viewing subsystem; rotating the capillary tube about a tube axis to generate additional pseudo-projection images at different views using the pseudo-projection viewing subsystem to provide a set of pseudo-projection images for each imaged embedded cell; reconstructing each imaged embedded cell using data from the set of pseudo-projection images to produce a set of 3D cell reconstructions; operating a first cell classifier (32, 34, 38, 40) to detect reference cells from the set of 3D cell reconstructions, wherein the reference cells are normal bronchial epithelial cells; enumerating the detected reference cells in the sputum specimen; operating a second cell classifier with a predetermined single cell sensitivity value and predetermined single cell specificity value as characterized by a receiver operating curve to detect target cells from the set of 3D cell reconstructions comprising abnormal lung cells; and operating an adequacy classifier to compare the number of reference cells against a threshold value of enumerated reference cells so as to determine specimen adequacy.