TABLE 241-3. BETHESDA CLASSIFICATION OF CERVICAL CYTOLOGY

TABLE 241-3. BETHESDA CLASSIFICATION OF CERVICAL CYTOLOGY
Category	Specifics
Adequacy of the specimen	Satisfactory for evaluation Satisfactory for evaluation but limited by ...(specify reason) Unsatisfactory for evaluation ...(specify reason)
General categorization (optional)	Within normal limits Benign cellular changes: See descriptive diagnosis Epithelial cell abnormalities: See descriptive diagnosis
Descriptive diagnosis
Benign cellular changes
Infection	Trichomonas vaginalis Fungal organisms morphologically consistent with Candida sp Predominance of coccobacilli consistent with shift in vaginal flora Bacteria morphologically consistent with Actinomyces sp Cellular changes associated with herpes simplex virus Other^a
Reactive cellular changes	Inflammation (includes typical repair) Atrophy with inflammation (atrophic vaginitis) Radiation Intrauterine contraceptive device Other
Epithelial cell abnormalities
Squamous cell	Atypical squamous cells of undetermined significance: qualify^b Low-grade squamous intraepithelial lesion (LSIL) encopassing HPV^a infection and mild dysplasia/CIN I High-grade squamous intraepithelial lesion encompassing moderate and severe dysplasia (CIN II and CIN III/ CIS) Squamous cell carcinoma
Glandular cell	Endometrial cells, cytologically benign in postmenopausal woman Atypical glandular cells of undetermined significance: qualify^b Endocervical adenocarcinoma Endometrial adenocarcinoma Extrauterine adenocarcinoma Adenocarcinoma, NOS
Other malignant neoplasms	Specify
Hormonal evaluation (applies only to vaginal smears)	Hormonal pattern compatible with age and history Hormonal pattern incompatible with age and history: (specify) Hormonal evaluation not possible due to ...(specify)
^aCellular changes of HPV—previously termed koilocytosis, koilocytotic atypia, and condylomatous atypia—are included in the category of LSIL.
^bAtypical squamous or glandular cells of undetermined significance should be further qualified, if possible, as to whether a reactive or premalignant/malignant process is likely.
HPV = human papillomavirus; CIN = cervical intraepithelial neoplasia; CIS = carcinoma in situ; NOS = not otherwise specified.
The Bethesda system for reporting cervical/vaginal cytologic diagnoses—Report of the 1991 Bethesda Workshop, National Institutes of Health.