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Epithelial Cell Abnormalities: Squamous

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The Bethesda System for Reporting Cervical Cytology

Abstract

Our understanding of preinvasive HPV-associated squamous lesions supports only two conceptual divisions: HPV infection and true precancer. Transient infections generally regress over the course of 1–2 years, and lesions with HPV persistence are associated with an increased risk of developing a cancer precursor (precancer) or invasive cancer. This concept led to the introduction of the two-tiered nomenclature of low-grade squamous intraepithelial lesion (LSIL) and high-grade squamous intraepithelial lesion (HSIL), by the Bethesda System (TBS) in 1988. The 2014 Bethesda update maintains this dichotomous reporting terminology for the squamous intraepithelial lesions. Since the focus of cervical cancer screening is primarily the detection of HSIL, this chapter has been substantially expanded to include problematic patterns and mimics that may lead to locator and/or interpretation errors of non-neoplastic changes as HSIL/ASC-H or vice versa.

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Author information

Authors and Affiliations

  1. Department of Laboratory Medicine, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA

    Michael R. Henry MD

  2. Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, 601 Elmwood Avenue, 626, Rochester, NY, 14642, USA

    Donna K. Russell CT(ASCP)HT, MEd

  3. Anatomic Pathology Division for Clinical Trials, Quest Diagnostics, Teterboro, NJ, 07608, USA

    Ronald D. Luff MD, MPH

  4. 8829 Ladue Road, Ladue, Missouri, 63124, USA

    Marianne U. Prey MD

  5. Department of Pathology and Cell Biology, Columbia University, 631 W 168th St, New York, NY, 10032, USA

    Thomas C. Wright Jr MD

  6. Department of Pathology, Feinberg School of Medicine, Northwestern University, Northwestern Memorial Hospital, 251 East Huron Street, Galter Pavilion, 7-132B, Chicago, IL, 60611, USA

    Ritu Nayar MD

Authors
  1. Michael R. Henry MD
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  2. Donna K. Russell CT(ASCP)HT, MEd
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  3. Ronald D. Luff MD, MPH
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  4. Marianne U. Prey MD
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  5. Thomas C. Wright Jr MD
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  6. Ritu Nayar MD
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Corresponding author

Correspondence to Michael R. Henry MD .

Editor information

Editors and Affiliations

  1. Department of Pathology, Northwestern Memorial Hospital, Chicago, Illinois, USA

    Ritu Nayar

  2. Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA

    David C. Wilbur

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Henry, M.R., Russell, D.K., Luff, R.D., Prey, M.U., Wright, T.C., Nayar, R. (2015). Epithelial Cell Abnormalities: Squamous. In: Nayar, R., Wilbur, D. (eds) The Bethesda System for Reporting Cervical Cytology. Springer, Cham. https://doi.org/10.1007/978-3-319-11074-5_5

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  • DOI: https://doi.org/10.1007/978-3-319-11074-5_5

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-11073-8

  • Online ISBN: 978-3-319-11074-5

  • eBook Packages: MedicineMedicine (R0)

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