Bethesda 2001

Author: Andreia Carreira, Carla Lopes. See authors page.
Last edited: Pathologika, October 30, 2019.
Cite this page: Carreira, A. & Lopes, C., Bethesda 2001 – Pathologika. Available at: https://pathologika.com/en/cytology/cervical-cytology/bethesda-system/bethesda-2001/ [Accessed: date].

Bethesda 2001 reporting

The Bethesda System for reporting cervico-vaginal cytology reports dates back to December 1988.

Following the first introduction of terminology in 1988, revisions have already taken place in 1991, 2001 and recently in 2014.

For the diagnosis to be made according to the Bethesda 2001 System nomenclature, the interpretative cytology report must comply with certain parameters described below.

Specimen Type

  • conventional smear (Pap smear)
  • vs. liquid-based preparation
  • 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
  • Other: See Interpretation/result (e.g., endometrial cells in a woman >= 40 years of age)
  • Epithelial Cell Abnormality: See Interpretation/result (specify ‘squamous’ or ‘glandular’ as appropriate)

Interpretation / Results

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 spp
   * Shift in flora suggestive of bacterial vaginosis
   * Bacteria morphologically consistent with Actinomyces spp.
   * 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
      – of undetermined significance (ASC-US)
      – cannot exclude HSIL (ASC-H)
   * Low grade squamous intraepithelial lesion (LSIL)
   (encompassing: HPV/mild dysplasia/CIN 1)
   * High grade squamous intraepithelial lesion (HSIL)
   (encompassing: moderate and severe dysplasia, CIS, CIN 2
   and CIN 3)
      – with features suspicious for invasion (if invasion
        is suspected)
   * Squamous cell carcinoma

GLANDULAR CELL
   * Atypical
      – endocervical cells (not otherwise specified (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
   * Adenocarcinoma:
      – endocervical
      – endometrial
      – extrauterine
      – not otherwise specified (NOS)

OTHER MALIGNANT NEOPLASMS: (specify)


References

Solomon D, Davey D, Kurman R, et al: The Bethesda System 2001: terminology for reporting the results of cervical cytology. JAMA 2002;287:2114-2119.

Citopatologia do colo uterino – atlas digital https://screening.iarc.fr/atlasclassifbethesda.php?lang=4 (accessed October 30, 2019)