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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