Cytologie du col utérin selon le système Bethesda 2001
Auteur : Dr Aly Abbara
Mise à jour : 11 Mai, 2023

 

 
BETHESDA SYSTEM 2001
En anglais


  • SPECIMEN TYPE :
    • Indicate conventional smear (Pap smear) vs. liquid-based 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
    • Epithelial Cell Abnormality: See Interpretation/Result (specify "squamous" or "glandular" as
      appropriate)
    • Other : See Interpretation/Result (e.g. endometrial cells in a woman > 40 years of age)

  • AUTOMATED REVIEW
    • If case examined by automated device, specify device and result.

  • ANCILLARY TESTING
    • Provide a brief description of the test methods and report the result so that it is easily understood by the clinician.

  • INTERPRETATION/RESULT
    • 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 (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)

    • EDUCATIONAL NOTES AND SUGGESTIONS (optional)
      • Suggestions should be concise and consistent with clinical follow-up guidelines published by professional organizations (references to relevant publications may be included).


    • Défintion des abréviations et correspondance en français :
      • UNSAT :
         Insatisfaisant pour évaluation.

      • NILM :
         No evodence of Epithelial lesion or Malignancy
        Absence de lésion malpighienne intra-épithéliale ou signe de malignité.

      • ASCUS :
        Atypical Squamous Cells of Undetermined Significance.
        Cellules dans lesquelles les modifications sont plus importantes que dans les processus réactionnels bénins, mais ne répondant pas au diagnostic formel de lésion squameuse intra-épithéliale.

      • AGCUS :
        Atypical galndular cells undetermined significance
      • LSIL :
         Low Grade Saquamous intraepithelial Lesion.
        Lésion de grande, Modifications précoces de la taille et de la forme des cellules à la surface du col.

      • HSIL :
         High Grade Squamous intraepithelial Lesion.
        Lésion de haut grade. Cellules pré-cancéreuses très différentes des cellules normales.

      • SCC :
         Squamous Cell Carcinoma.
        Cancer débutant dans les cellules non glandulaires - squameuses. Les cellules squameuses sont fines et plates et tapissant la surface du col.

      • CIN :
        Cervical intraepithelial neoplasia

      • NOS : not otherwise specified

Les différentes classifications des lésions épidermoïdes du col utérin
et les correspondances
Dysplasie légère
Condylome
CIN I avec Koïlocytose
Lésion épidermoïde intra-épithéliale de bas grade (LSIL)
Dysplasie moyenne
CIN II avec ou sans Koïlocytose
Lésion épidermoïde intra-épithéliale de haut grade (HSIL)
Dysplasie sévère
CIN III avec ou sans Koïlocytose
Carcinome in situ (CIS)
Carcinome épidermoïde invasif
Carcinome épidermoïde invasif
Carcinome épidermoïde invasif


 
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