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Cite this page: Bethesda System 2001 for Cervicovaginal Cytology reporting. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/cervixcytologybethesda.html. Accessed August 20th, 2017.
Definition / general
- Based on workshop held in April / May 2001 at National Cancer Institute (JAMA 2002;287:2114)
- By 2003, was implemented by 85% of labs participating in College of American Pathologists’ Interlaboratory Comparison Program in Cervicovaginal Cytology (Arch Pathol Lab Med 2004;128:1224)
- Changes from Bethesda 1991
- Specimen type:
Indicate conventional smear (Pap smear), liquid based preparation or other preparation (describe)
- Specimen adequacy:
Satisfactory for evaluation (describe presence or absence of endocervical / transformation zone component and all other quality indicators, such as partially obscuring blood, inflammation, etc.)
- Assessment of specimen adequacy (satisfactory and unsatisfactory):
- Adequate number of squamous cells (conventional smear should have 8,000 - 12,000 cells, liquid based preparation should have 5,000 cells)
- The presence or absence of endocervical cells should be reported; an adequate number of endocervical cells (at least 10 well preserved endocervical or metaplastic cells, singly or in clusters) confirms sampling of transition zone
- Specimen with more than 75% of cells obscured by inflammation and bacteria is unsatisfactory (assuming that no abnormal cells are present)
- Assessment of specimen adequacy (satisfactory and unsatisfactory):
- Unsatisfactory for evaluation (indicate reason)
- Specimen rejected / not processed (indicate reason)
- Specimen processed and examined but unsatisfactory for evaluation of epithelial abnormality (indicate reason)
- Interpretation/result
- Negative for Intraepithelial Lesion or Malignancy (NILM)
- 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 associated with Herpes simplex virus
- Other nonneoplastic findings (optional to report, list is not inclusive)
- Reactive cellular changes associated with:
- Inflammation (includes typical repair)
- Radiation
- Intrauterine contraceptive device (IUD)
- Glandular cells status post hysterectomy
- Atrophy
- Reactive cellular changes associated with:
- Other
- Endometrial cells (in a woman older than or equal to 40 years of age; specify if "negative for squamous intraepithelial lesion")
- Organisms
- 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 I
- High grade squamous intraepithelial lesion (HSIL)
- Encompassing: moderate and severe dysplasia / CIN2 / CIN3 / CIS
- With features suspicious for invasion (if invasion suspected)
- Squamous cell carcinoma
- Atypical squamous cells
- Glandular cell
- Atypical
- Endocervical cells (NOS or specify in comment)
- Endometrial cells (NOS or specify in comment)
- Glandular cells (NOS or specify in comment)
- Atypical
- Endocervical cells, favor neoplastic
- Glandular cells, favor neoplastic
- Endocervical Adenocarcinoma in situ
- Adenocarcinoma
- Endocervical
- Endometrial
- Extrauterine
- Not otherwise specified (NOS)
- Atypical
- Other malignant neoplasms (Specify)
- Ancillary testing: Describe briefly the test method(s) and report the result so that it is easily understood by the clinician
- Automated review: If case is examined by automated device, specify the device and result
- Educational notes / suggestions: If provided, should be concise and consistent with clinical guidelines published by professional organizations
- Squamous cell
- Negative for Intraepithelial Lesion or Malignancy (NILM)
Additional references
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