Lesson 11
The Bethesda System II
Automated review
If the case is examined by an automated
device, indicate whether the scanning was
successful, the device and the manufacturers
name
Ancillary testing
Include the method (name and brief description)
used for reflex human papillomavirus (HPV) test
Results for reflex HPV test can be reported as:
A result only
As a result with a recommendation for clinical
management
As a result plus the probability of an associated
dysplasia
As a definitive interpretation that reflects both
the cytomorphology and the HPV status
Interpretation/Result
Negative for intra-epithelial lesion or
malignancy
When there is no cellular evidence of
neoplasia, state this in the General
Categorization previously mentioned and/or in
the Interpretation/Result section of the
report, indicate whether or not there are
organisms or other nonneoplastic findings
Organisms
Trichomonas vaginalis
Fungal organisms morphologically consistent
with Candida spp.
Shift in flora suggestive of bacterial vaginosis
Bacterial morphologically consistent with
Actinomyces spp.
Cellular changes consistent with herpes
simplex virus
NILM: Atrophy
Parabasal cells with occasional pyknotic
degenerated cells. Globular collections of
basophilic amorphous material (blue blobs) present
Other
Endometrial cells after age 40, particlularly
out of phase or after menopause may be
associated with benign endometrium,
humoral alterations and less commonly,
endometrial/uterine abnormalities
Clinical correlation is recommended
Endometrial Cells
Glandular cell
Atypical
Glandular cells
Endocervical cells
Endometrial cells
Atypical
Endocervical cells, favour neoplastic
Glandular cells, favour neoplastic
ASC-H
Metaplastic cells with enlarged nuclei and
nuclear contour irregularities showing
variation in size, shape and ratio of nuclear
to cytoplasmic area
LSIL
HPV nuclear and cytoplasmic changes (binucleation
and koilocytosis) are consistent with LSIL
HSIL.
Isolated abnormal cells with evenly distributed
coarse chromatin, centrally placed enlarged
nuclei, and dense / metaplastic cytoplasm
are consistent with HSIL