The Bethesda System for Reporting Cervical Cytology
Noman H. Siddiqui · Archives of Pathology & Laboratory Medicine · 2005
2nd ed, edited by Diane Solomon and Ritu Nayar, 191 pp, with illus, New York, NY, Springer-Verlag, 2004.The second edition of The Bethesda System for Reporting Cervical Cytology incorporates the 2001 revision of the Bethesda classification. The “blue book,” as it has come to be known in cytopathology circles, retains not only its blue front cover but its goals as well (ie, clarification and expansion of criteria and description of the Bethesda classification for reporting cervical cytology test results), thereby facilitating its uniform application. A Web-based atlas of images that serves as a companion to this book is also available at www.cytopathology.org/ NIH.Although the first edition was more in the form of an atlas, the current edition can probably be best described as an atlas with text. This edition is more than double in volume, with 191 pages, including 186 illustrations, compared with 81 pages with 61 illustrations in its predecessor. This increase is due to incorporation of more information in every chapter and the addition of several new chapters. New chapters discuss ancillary testing, anal cytology, computer-assisted interpretation of cervical cytology reports, educational notes, and suggestions appended to cytology reports.The layout of the book is logical. It starts with an outline of the major 2001 Bethesda system interpretive categories. This outline is followed by chapters on each of these categories. Each chapter starts with a background discussion followed by a description of cytologic criteria and explanatory notes. Cytomorphologic criteria are described for conventional and liquid-based preparations. Complementary illustrations depict the discussed features very well. Here again, the illustrations of both conventional and liquid-based preparations are included. Some of the images in the book were originally part of the Bethesda interobserver reproducibility project and were posted on the Web.Although all chapters are expanded, considerable attention is paid to the chapter on specimen adequacy. Not only criteria but also useful information regarding practical application of these criteria is given. Liquid-based preparations and some of the differences between the 2 currently available systems are also mentioned. Several images are included as part of a reference image system in assessing specimen cellularity, which is practical. Chapters on criteria for reporting the presence of endometrial cells, glandular lesions, and a new category of atypical squamous cells highlight some of the changes in the current Bethesda guidelines.Overall, this book provides a wealth of information on cervical smears. This book is likely to help anybody who wishes to interpret cervical cytology, including pathologists, cytotechnologists, and pathology residents. The user is likely to find this book practical and informative.