• Title/Summary/Keyword: Bethesda System

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The Bethesda System (TBS) - A New Reporting System of Cervicovaginal Smear - (The Bethesda System (TBS) - 자궁경부 세포진 검사의 새로운 보고양식 -)

  • Kim, Hy-Sook
    • The Korean Journal of Cytopathology
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    • v.6 no.2
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    • pp.85-98
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    • 1995
  • In 1989, the Bethesda System (TBS) was introduced as an attempt to standardize cervical/vaginal reporting systems. TBS nomenclature was created for reporting cytologic diagnoses to replace the currently used Cervical Intraepithelial Neoplasia (CIN) and Papanicolaou Class System, which are deemed less reproducible. The name for preinvasive squamous lesions was changed to squamous intraepithelial lesion(SIL), subdivided into low-grade and high-grade types. TBS recommends a specific format for cytologic report, starling with explicit statement on the adequacy of the specimen, followed by general categorization and descriptive diagnosis. Pathologic and epidemiologic studios performed over last 10 years have provided evidence that human papillomavirus (HPV) plays a significant role in the development of cervical neoplasia, TBS corresponds not only to currently held views of the behavior of preinvasive lesions and their HPV distribution, but also to the current guidelines for clinical management.

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The Bethedsa System 2001 Workshop Report (The Bethesda System 2001의 최신지견)

  • Hong, Eun-Kyung;Nam, Jong-Hee;Park, Moon-Hyang
    • The Korean Journal of Cytopathology
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    • v.12 no.1
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    • pp.1-15
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    • 2001
  • The Bethesda System (TBS) was first developed in 1988 for the need to enhance the communication of the cytopathologic findings to the referring physician in unambiguous diagnostic terms. The terminology used in this reporting system should reflect current understanding of the pathogenesis of cervical/vaginal disease so the framework of the reporting system should be flexible enough to accommodate advances in medicine including virology, molecular biology, and pathology. Three years after the Introduction of TBS, the second Bethesda workshop was held to set or amend diagnostic criteria for each categories of TBS. TBS 1991 is now widely used. The third Bethesda workshop, The Bethesda System 2001 Workshop, was held in National Cancer institute Bethesda, Maryland from April 30 to May 2, 2001. Again, the goals of this workshop were to promote effective communication and to clarify in reporting cervical cytopathology results to clinicians and to provide with the information to make appropriate decisions about diagnosis and treatment. Nine forum groups were made and there were Web-based bulletin board discussions between October, 2000 and the first week of April, 2001. On the basis of bulletin board comments and discussions, the forum moderators recommended revised terminologies in the Workshop. Hot discussions were followed after the presentation by forum moderators during the workshop. Terminologies confusing clinicians and providing no additional informations regarding patient management were deleted in the workshop to clarify the cervicovaginal cytology results. Any informations related to the patient management were encouraged to add. So 'Satisfactory for evaluation but limited by...' of 'Specimen Adequacy' catergory was deleted. Terminology of 'Unsatisfactory' was further specified as 'Specimen rejected' and 'Specimen processed and examined, but unsatisfactory'. Terminologies of 'Benign Cellular Change' and 'Within Normal Limits' were combined and terminology was changed to 'Negative for intraepithelial lesion or malignancy'. In General categorization, category 'Other' was newly inserted and the presence of 'Endometrial cells' in women over 40 years old can be checked. Although the category 'Benign Cellular Change' was deleted, the organisms or reactive changes of this category can be listed in the descriptive diagnoses. Terminologies of ASCUS and AGUS were changed to atypical squamous cell and atypical glandular cell, respectively. Diagnostic term of 'Adenocarcinoma in situ', which is highly reproducible with reliable diagnostic criteria, was newly Inserted. The category of hormonal evaluation was deleted. Criteria for liquid-based specimen were discussed. Reporting by computer-assisted cytology was discussed and terminology for automated review was newly inserted. This is not the final edition of Bethesda 2001. The final document can be prepared before the ASCCP meeting in which Consensus Guidelines for the Management on Cytology Abnormalities and Cervical Precursors will develop in September 2001.

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Evaluation of "Atypical Squamous Cells of Undetermined Significance" by the Bethesda System (Bethesda system에 의한 "atypical squamous cells of undertermined significance"의 평가)

  • Kim, Yee-Jeong;Hong, Sung-Ran;Kim, Hy-Sook;Park, Jong-Sook;Kim, Kye-Hyun;Lim, Kyung-Ho;Shim, Jae-Uk;Park, Chong-Taik;Chun, Chong-Soo
    • The Korean Journal of Cytopathology
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    • v.4 no.2
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    • pp.81-86
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    • 1993
  • The recently proposed Bethesda system for cervical/vaginal cytology has made a standardization related to "atypia". In cellular changes due to inflammation or repair, the word "benign cellular change" has been suggested as a substitute for atypia. Terminology related to atypical cells may become standardized, but the cytologic criteria has not been well defined yet. We evaluated 160 cases of atypical squamous cells of undetermined significance(ASCUS) by the Bethesda Sys4em(TBS). Among 30,428 cases screened, a cytologic diagnosis of ASCUS was made in 498 cases(1.6%) and 160 cases were histologically verified ASCUS was diagnosed based on nuclear enlargement and nonclassical signs of condyloma. The results are as follows: One hundred and twenty three cases(76.9%) revealed chronic cervicitis. Thirty seven cases(23.1%) demonstrated squamous intraepithelial lesion. Among intraepithelial lesions, condyloma and mild dysplasia were 28 cases(75.7%). Moderate and severe dysplasia were 5 cases(13.5%) and 4 cases(10.8%), respectively. it is concluded that patients with ASCUS should be colposcopically examined.

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Histologic and Cytologic Follow-up in Atypical Squamous Cells of Undetermined Significance(ASCUS) on Cervical Smears (자궁경부도말에서 Atypical Squamous Cells of Undetermined Significance(ASCUS)의 조직학적 및 세포학적인 추적 관찰)

  • Shin, Mi-Kyung
    • The Korean Journal of Cytopathology
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    • v.9 no.1
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    • pp.29-35
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    • 1998
  • In 1988, The Bethesda System for reporting cervical and vaginal cytologic diagnoses was introduced and this was revised in 1991. The new diagnostic category "atypical squamous cells of undetermined significance(ASCUS)" introduced by The Bethesda System is an area of controversy about the diagnostic category, clinical significance and appropriate treatment. A retrospective 2 years and 9 months study(April, 1994-December, 1996) was performed to evaluate the significance of reporting ASCUS on cervical smears. Sixtyseven(1.17%) of 5,730 smears were diagnosed as ASCUS and 21 cases were followed by cervical biopsies and/or endocervical curettages in 4 cases(19%), and repeat cervical smears in 17 cases(81%). Tissue diagnoses were benign in 2 cases and squamous cell carcinoma in situ in 2 cases. Cytologic diagnosis of follow up smear were negative in 14 cases(82.4%) and persistent ASCUS in 3 cases(17.6%).

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Nucleus Segmentation and Recognition of Uterine Cervical Pap-Smears using Enhanced Fuzzy ART Algorithm (개선된 퍼지 ART 알고리즘을 이용한 자궁 경부 세포진 핵 분할 및 인식)

  • Kim, Kwang-Baek
    • Journal of the Korean Institute of Intelligent Systems
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    • v.16 no.5
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    • pp.519-524
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    • 2006
  • Segmentation for the region of nucleus in the image of uterine cervical cytodiagnosis is known as the most difficult and important part in the automatic cervical cancer recognition system. In this paper, the region of nucleus is extracted from an image of uterine cervical cytodiagnosis using the fuzzy grey morphology operation. The characteristics of the nucleus are extracted from the analysis of morphemetric features, densitometric features, colormetric features, and textural features based on the detected region of nucleus area. The classification criterion of a nucleus is defined according to the standard categories of the Bethesda system. The enhanced fuzzy ART algorithm is used to the extracted nucleus and the results show that the proposed method is efficient in nucleus recognition and uterine cervical Pap-Smears extraction.

Highlights of the 2023 Bethesda System for Reporting Thyroid Cytopathology, 3rd Edition (갑상선 세침흡인세포검사 2023년 베데스다 시스템, 3판의 하이라이트)

  • Dong Eun Song
    • Korean Journal of Head & Neck Oncology
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    • v.40 no.1
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    • pp.1-5
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    • 2024
  • The Bethesda System for Reporting Thyroid Cytopathology (TBSRCT) is crucial for cytopathologists to use a standardized, category-based reporting system for thyroid fine needle aspirations and is effective for clear communication with the referring physicians. The new Bethesda System for Reporting Thyroid Cytopathology, the third edition in 2023, provides several key updates. The most important update is the assignment of only single name for each of the six diagnostic categories: (I) nondiagnostic; (II) benign; (III) atypia of undetermined significance; (IV) follicular neoplasm; (V) suspicious for malignancy; and (VI) malignant. An implied risk of malignancy (ROM) for each of six categories has been updated based on extensively published data since the second edition of TBSRTC in 2017 and offers both an average ROM for each category and the expected range of cancer risk. Estimated final ROM after excluding "Noninvasive Follicular Thyroid Neoplasm with Papillary Like Nuclear Features (NIFTP)" for each of six categories has been updated based on the reported mean decreases in the ROM if excluding NIFTP. For atypia of undetermined significance (AUS) category, the subcategorization is simplified and more formalized into 2 subgroups, AUS-nuclear atypia or AUS-other, based on the implied ROM and molecular profiling. For the pediatric thyroid disease, pediatric ROMs and management algorithms are newly added for the same six reporting categories for this age group. New or revised disease nomenclatures including high-grade follicular-derived carcinoma has been updated according to the recently published 2022 World Health Organization Classification of Thyroid Neoplasms. Brand new two chapters are added including clinical perspectives and imaging studies (Chap. 13) and the use of molecular and other ancillary tests (Chap. 14). The atlas is updated with new images to illustrate more effectively for new disease entity and diagnostic criteria.

Evaluation of "Atypical Squamous Cells of Undetermined Significance(ASCUS)" on Uterine Cervical Cancer

  • Ahn, Seung-ju;Kim, Sun-Jin;Shon, Jae-Jeong;Lee, Jeong-min;Yoon, Si-Rak
    • Biomedical Science Letters
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    • v.7 no.3
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    • pp.133-138
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    • 2001
  • The recently proposed Bethesda system for cervical/vaginal cytology has made a standardization related to "atypia". In cellular change due to inflammation or repair, the word "benign cellular change" has been suggested as a substitute for atypia. Terminology related to atypia cells may become standardized, but the cytologic criteria has not been well defined yet Among 8113 cases screened, we evaluated 182 cases as atypia squamous cells undetermined significance (ASCUS) by the Bethesda system (TBS): 52 cases of ASCUS were cytologically diagnosed and 33 cases were histologically verified. ASCUS was diagnosed based on nuclear enlargement and nonclassical signs of condyloma. The results are as follows; Six cases (16.6%) turned out to have benign cellular change. Twenty five cases (69.1%) demonstrated squamous intraepthelial lesion, condyloma was 2 cases (6.0%) and mild dysplasia was not revealed. Moderate and severe dysplasia were 1 case (3.0%) and 16 cases (48.4%), squamous cell carcinoma and adenocarcinoma were 4 (12.1%) and 1 cases (3.0%), respectively. Our data suggested that patients with ASCUS are highly recommended to be examined colposcopic biosy to cornfim.

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Nucleus Recognition of Uterine Cervical Pap-Smears using FCM Clustering Algorithm

  • Kim, Kwang-Baek
    • Journal of information and communication convergence engineering
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    • v.6 no.1
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    • pp.94-99
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    • 2008
  • Segmentation for the region of nucleus in the image of uterine cervical cytodiagnosis is known as the most difficult and important part in the automatic cervical cancer recognition system. In this paper, the region of nucleus is extracted from an image of uterine cervical cytodiagnosis using the HSI model. The characteristics of the nucleus are extracted from the analysis of morphemetric features, densitometric features, colormetric features, and textural features based on the detected region of nucleus area. The classification criterion of a nucleus is defined according to the standard categories of the Bethesda system. The fuzzy C-means clustering algorithm is employed to the extracted nucleus and the results show that the proposed method is efficient in nucleus recognition and uterine cervical Pap-Smears extraction.