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장기별 진료/판독 지침
The 2014 Bethesda system for reporting cervical cytology
https://bethesda.soc.wisc.edu
SPECIMEN TYPE:
conventional smear vs. Liquid based preparation
SPECIMEN ADEQUACY
Satisfactory for evaluation
Unsatisfactory
  Specimen rejected
  Specimen processed & examined, but unsatisfactory
INTERPRETATION/RESULT
NEGATIVE FOR INTRAEPITHELIAL LESION OR MALIGNANCY
NON-NEOPLASTIC FINDINGS
  Non-neoplastic cellular variations
Squamous metaplasia
Keratosis changes
Tubal metaplasia
Atrophy
Pregnancty-associated changes
Reactive celluar changes asoociated with
Inflammation
Radiation
Intrauterine contraceptive device (IUD)
Glandular cells status post hystrectomy
ORGANISMS
Trichomonas vaginalis
Fungal organisms morphologiclaly consistent with Candida spp.
Shift in flora suggestive of bacterial vaginosis
Bacteria morphologiclaly consistent with Actinomyces spp.
Cellular changes consistent with herpes simplex virus
cellular changes consistent with cytomegalovirus
OTHERS
Endometrial cells (in a women≥45 years of age)
(specify if "negative for squamous intraepitheluial lesion")
EPITHELIAL CELL ABNORMALITIES
SQUAMOUS CELL
Atypical squmous cells
of undetermined significance (ASC-US)
cannot exclude HSIL (ASC-H)
Low-grade squamous intraepithelial lesion (LSIL)
High-grade squmous intraepithelial leison (HSIL)
Squamous cell carcinoma
GLANDULAR CELL
Atypical
endocervical cells
endometrial cells
glandular cells
Atypical
endoverical cells, favor neoplastic
glandular cell, favor neoplastic
Endocervical adenocarcinoma in situ
Adenocarcinoma
endocervical 
endometrial
extrauterine
not otherwise specimen (NOS)
OTHER MALIGNANT NEOPLASMS
ADJUNCTIVE TESTING

 

 

Thyroid
The Bethesda System foir Reporting Thyroid Cytopathology
http://www.papsociety.org/atlas.html
I.  Nondiagnostic or Unsatisfactory
Cyst fluid only
Virtually acellular specimen
Other (obscuring blood, clotting artifact, dryimng artifact, etc)
II. Benign
Consistent with a benign follicular nodule (includes adenomatoid nodule, colloid nodule, etc)
Consistent with chronic lymphocytic (Hashimoto's) thyroiditis in the proper clinical context
Consistent with granulomatous (subacute) thyroiditis
Other
III.  Atypia of undetermined Signofocance or Fillicular lesion of Undetermined significance
IV. Follicular Neoplasm or Suspicious for a Follicular Neoplasm
Specify of oncocytic (Hürthle cell) Neoplasm
V.  Suspicious for Malignancy
Suspicious for papillary thyroid carcinoma
Suspicious for medullary thyroid carcinoma
Suspicious for metastatic malignancy
Suspicious for lymphoma
Other
VI. Malignant
Papillary thyroid carcinoma
Poorly differentiated carcinoma
Medullary thyroid carcinoma
  Undifferentiated (analplastic) carcinoma
Squamous cell carcinoma
Carcinoma with mixed featrues (specify)
Metastatic malignancy
Non-Hodgkin lymphoma
Other
Urine
The Paris System for Reporting Urinary Cytology
https://paris.soc.wisc.edu
* Adequacy
1. Non-diagnostic/unsatisfactory
2. Negative for high-grade urothelial carcinoma (NHGUC)
3. Atypical urothelial cells (AUC)
4. Suspicious for high-grade urothelial carcinoma (SHGUC)
5. High grade urothelial carcinoma (HGUC)
6. Low-grade urothelial neoplasm (LGUN)
7. Other; primary and secondary malignancies and miscellaneous lesions
Salivary
The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC)
Diagnostic Categories Risk of Management (ROM)  Management
Non-Diagnostic ~25% Clinical/radiologic correlation, repeat FNA
Non-Neoplastic ~10% Clinical follow-up, radiologic correlation
Atypia of Undetermined significance (AUS) ~20% Repeat FNA or surgery
Neoplasm Benign < 5% Follow or correlative surgery
  Salivary gland Neoplasm of uncertain malignant potential (SUMP) ~35% Correlative surgery
  Suspicious for malignancy ~65% Surgery, decide if low or High grade and manage accordingly
  Malignant (low vs. high grade) ~85-90% Same as above
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