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By Robert J. Kurman, Diane Solomon

THE BETHESDA method FOR REPORTING CERVICAL/VAGINAL CYTOLOGIC DIAGNOSES was once built at a countrywide melanoma Institute subsidized workshop in December 1988 to supply uniform diagnostic terminology that may facilitate verbal exchange among the laboratory and the clinician. The structure of The Bethesda method file features a descriptive prognosis and an review of specimen adequacy. The Bethesda procedure we designed to be versatile so that it might probably evolve in keeping with altering wishes in cervical melanoma screening in addition to to advances within the box of cervical pathology. therefore, a moment workshop was once held in April 1991 to judge the influence of The Bethesda process in real perform and to amend and alter it the place wanted. one of many significant strategies of this moment assembly used to be that specific standards might be formulated for either the diagnositic phrases and for the descriptors of specimen adequacy. that's the meant objective of this document.

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Additional resources for The Bethesda System for Reporting Cervical/Vaginal Cytologic Diagnoses: Definitions, Criteria, and Explanatory Notes for Terminology and Specimen Adequacy

Example text

Squamous cell carcinoma-keratinizing . 61 62 The Bethesda System Glandular Cell Endometrial Cells, Cytologically Benign, in a Postmenopausal Woman Benign Endometrial Epithelial Cells (Fig. 46): Criteria Cells occur in small clusters and less commonly as single cells A sheet-like pattern is seen when endometrial cells are obtained directly from the lower uterine segment or endometrial cavity Small, round nuclei approximate the size of normal intermediate squamous cell nuclei Small or inconspicuous nucleoli are typical Cell borders are ill-defined and cytoplasm is scant, basophilic, and sometimes vacuolated.

Atypical EndocelVical Cells, Favor Reactive (Fig. 49): Criteria Cells occur in sheets and strips with minor degrees of nuclear overlap Nuclear enlargement, up to three to five times the area of normal endocervical nuclei, may be seen Mild variation in nuclear size and shape occurs Slight hyperchromasia frequently is evident Nucleoli often are present Abundant cytoplasm and distinct cell borders often are discernible.

FIGURE 22. ASCUS: Atypical squamous celis, possibly LSIL. FIGURE 23. ASCUS: Atypical squamous celis, possibly LSIL. 35 36 The Bethesda System Changes diagnostic of HPV cytopathic effects-well-defmed, optically clear, perinuclear cavity associated with a peripheral rim of thickened cytoplasm as well as nuclear alterations-are classified as LSIL. Cells with some but not all of these features, which are suggestive of HPV cytopathic effects, are included in the ASCUS category (see Figs. 21-24). Note that cytoplasmic vacuolization alone, without any nuclear atypia, is considered a benign cellular change and should not be classified as LSIL or ASCUS (Fig.

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