2001 Bethesda System Terminology

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Specimen Type: Indicate conventional smear (Pap smear) vs. liquid based vs. other

Specimen Adequacy

  • Satisfactory for evaluation (describe presence or absence of endocervical/transformation zone component and any other quality indicators, e.g., partially obscuring blood, inflammation, etc.)
  • Unsatisfactory for evaluation … (specify reason)
    • Specimen rejected/not processed (specify reason)
    • Specimen processed and examined, but unsatisfactory for evaluation of epithelial abnormality because of (specify reason)

General Categorization (optional)

  • Negative for intraepithelial lesion or malignancy
  • Epithelial cell abnormality: See interpretation/result (specify ‘squamous’ or ‘glandular’ as appropriate)
  • Other: See interpretation/result (e.g. endometrial cells in a woman > 40 years of age)

Automated Review

  • If case examined by automated device, specify device and result.

Ancillary Testing

  • Provide a brief description of the test methods and report the result so that it is easily understood by the clinician.

Interpretation/Result

  • Negative for Intraepithelial Lesion or Malignancy (when there is no cellular evidence of neoplasia, state this in the General Categorization above and/or in the Interpretation/Result section of the report, whether or not there are organisms or other non-neoplastic findings)

Organisms:

  • Trichomonas vaginalis
  • Fungal organisms morphologically consistent with Candida species
  • Shift in flora suggestive of bacterial vaginosis
  • Bacteria morphologically consistent with Actinomyces species.
  • Cellular changes consistent with Herpes simplex virus
  • Other non neoplastic findings (Optional to report; list not inclusive):
  • Reactive cellular changes associated with
  • inflammation (includes typical repair)
  • radiation
  • intrauterine contraceptive device (IUD)
  • Glandular cells status post hysterectomy
  • Atrophy

Other

  • Endometrial cells (in a woman > 40 years of age)
  • (Specify if ‘negative for squamous intraepithelial lesion’)

Epithelial Cell Abnormalities

SQUAMOUS CELL

  • Atypical squamous cells (ASC)
  • of undetermined significance (ASC-US)
  • cannot exclude HSIL (ASC-H)
  • Low grade squamous intraepithelial lesion (LSIL)
  • encompassing: HPV/mild dysplasia/cervical intraepithelial neoplasia (CIN) 1
  • High grade squamous intraepithelial lesion (HSIL)
  • encompassing: moderate and severe dysplasia, carcinoma in situ (CIS)/CIN 2 and CIN 3
  • with features suspicious for invasion (if invasion is suspected)
  • Squamous cell carcinoma

GLANDULAR CELL

  • Atypical
  • endocervical cells (NOS or specify in comments)
  • endometrial cells (NOS or specify in comments)
  • glandular cells (NOS or specify in comments)
  • Atypical
  • endocervical cells, favor neoplastic
  • glandular cells, favor neoplastic
  • Endocervical adenocarcinoma in situ (AIS)
  • Adenocarcinoma
  • endocervical
  • endometrial
  • extrauterine
  • not otherwise specified (NOS)

Other Malignant Neoplasms: (specify)

Educational Notes and Suggestions (optional)
Suggestions should be concise and consistent with clinical follow-up guidelines published by professional organizations (references to relevant publications may be included).

 


References:

  1. Solomon D, Davey D, Kurman R, Moriarty A, O’Connor D, Prey M, Raab S, Sherman M, Wilbur D, Wright T Jr, Young N; Forum Group Members; Bethesda 2001 Workshop. The 2001 Bethesda System: terminology for reporting results of cervical cytology. JAMA. 2002 Apr 24;287(16):2114-9. [Medline]

Created: May 20, 2007