10. Bethesda System 2001 One example of a significant change in this version of The Bethesda System is the incorporation of the new technology called "liquid-based" collection. Instead of taking a conventional smear that spreads the cell specimen across a glass slide, liquid-based collection involves rinsing or dropping the collection instrument in a vial of liquid fixative. Previous versions of Bethesda required an evaluation of whether the specimen was considered adequate, but criteria were based on the conventional smear and did not address the new technologies. The 2001 Bethesda System incorporates new criteria for evaluating liquid-based specimens.
11.
12.
13.
14.
15.
16.
17. Comparison of the Categories Specimen Adequacy and Diagnosis in Bethesda 1991 and 2001 Benign endometrial cells over age 40 years - Other - AGC, AEC AGC-favor neoplastic,AEC-favor neoplastic AMC Adenocarcinoma in situ AGUS–favor reactive, AEC–favor reactive AGUS, NOS, AGUS-EC NOS AGUS-favor neoplastic, AGUS-EC-favor neoplastic AGUS-EM (AMC) - Glandular cells - ASC-US ASC, cannot exclude HSIL (ASC-H) LSIL HSIL ASCUS – favor reactive ASCUS – not otherwise specified (NOS) ASCUS – favor SIL Atyical metaplastic cells 6 LSIL HSIL Epithelial cell abnormalities Squamous cells Negative for intraepithelial lesion or malignancy (NIL) Negative for intraepithelial lesions or malignancy with reactive / reparative cellular changes Within normal limits (WNL) Reactive/reparative cellular changes (R/R) No epithelial cell abnormality Satisfactory Satisfactory with quality indicator Unsatisfactory Satisfactory Satisfactory but limited by… (SBLB) Unsatisfactory Specimen adequacy Bethesda 2001 Modified a Bethesda 1991 Category
18.
19.
20. FOR LABORATORY USE ONLY MICROSCOPIN FINDINGS Satisfactory for interpretation Satisfactory but limited Unsatisfactory Within normal limits Benign Cellular changes Epithelial cell abnormality Benign Cellular changes Epithelial cell abnormality Infection Squamous cells TV Candida ASCUS LSIL (mild dysplacia, CIN-I; HPV associated changes Coccobacilli Actino HSIL HSV Other Moderate dysplasia (CIN Grade-II) Severe displasia/CA-in-situ(CIN GradeIII) Reactive changes associated with: Inflamm Repair Squamouc cell CA Invasive Atrophic Radiation Glandular cells Endometrial cells, cytologically benign in a post menopausal IUCD effect Other A typical glandular cells of undetermined significance (AGUS) Adenocarcinoma probable site of origin Endocervical Endometrial Extra Uterine Not otherwise specified Compatible with age and History Other malignant neoplasm Incompatible with age and History Cytodiagnosis _________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________ Recommendation ______________________________________________________________________________________________________ Date __________________________ Cytoscreener ______________________ Cytopathologist ____________________
![Papanicolaou’s Classification ,[object Object],[object Object],[object Object],[object Object],[object Object]](data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7)