The Bethesda System

Question 1

What is one of the most important recommendations of the Bethesda system in regards to how a Pap report begins?

Answer 1

• That each report begins with a statement of adequacy of the specimen

Question 2

In 2001 the Bethesda system went from a 3 category to 2 category reporting system for adequacy, what are the 2 categories?

Answer 2

• satisfactory

- unsatisfactory

Question 3

What other reporting elements are allowed/ permitted by the 2001 Bethesda system?

Answer 3

• Mentioning the presence or absence of a transformation zone component
• Allows for comments regarding obscuring elements

Question 4

What are the adequacy requirements for liquid based cytology ?

Answer 4

• 5000 squamous cells

Question 5

What are the adequacy requirements for conventional cytology preparations?

Answer 5

• 8000 to 12,000 squamous cells

Question 6

What report components must be present in a specimen that is adequate for evaluation?

Answer 6

• A satisfactory squamous cell component must be present
• Note the presence or absence of the endocervical / transformation zone
• Obscuring elements may be mentioned if 50% to 75% of epithelial cells are obscured
• Note: obscuring elements include inflammation, blood, drying artifact, and other (sperm)

Question 7

What report components must be present in a specimen that is unsatisfactory for evaluation and not processed/rejected?

Answer 7

• Specify the reason the specimen is not evaluated/rejected

- Reasons may include: lack of patient identification or unacceptable specimen (slide broken beyond repair)