25/10/2025
🔬MESSAGE FROM THE PATHOLOGY DESK📢
Here’s a quick look at the nuts and bolts of cytology reporting — what those terms really mean in your patient’s report.
From Bethesda to Paris!
Dear Colleagues (in every scope of Clinical practice), Cytopathology reporting has been standardized globally to make communication between clinicians and pathologists crystal clear 🧠💬.
Here’s a quick overview of the official reporting systems we use — so our reports speak a universal language:
Here’s a quick refresher on the official reporting systems across organs 👇
🔬 Organ – Reporting System – Year
1️⃣ Cervix: The Bethesda System for Reporting Cervical cytology (TBS, 2015)
➡️ Categories like ASC-US, LSIL, HSIL guide HPV related management and follow-up.
2️⃣ Thyroid: The Bethesda System for Thyroid Cytopathology, Second edition (TBSRTC, 2023)
➡️ 6-tiered categories with defined ROM (Risk of Malignancy) & Management — from “Nondiagnostic” to “Malignant”.
➡️ Each category carries a defined risk of malignancy (ROM) → assists in deciding surgery vs. observation.
3️⃣ Salivary Gland: The Milan System (2018)
➡️ Brings clarity to categories like SUMP (salivary gland of unknown malignantl potential) And AUS (Atypia of Undetermined significance)
➡️ Stratifies neoplasms and indeterminate cases → helps plan excision or further testing.
4️⃣ Breast: The Yokohama System (2020)
➡️5-tiered categories linking cytology to clinical management.
5️⃣ Respiratory Tract: The International System for Lung Cytopathology (ISL, 2020)
➡️Applies to sputum, BAL, and FNAC specimens → supports multidisciplinary diagnosis.
6️⃣ Serous Effusions: The International System for Serous fluid cytopathology (TIS, 2020)
➡️ Standardizes reporting of pleural/peritoneal/pericardial fluids bringing global uniformity to effusion cytology.
7️⃣ Pancreaticobiliary: The Papanicolaou Society System (2015)
➡️ Helps correlate cytology with imaging/endoscopy for cystic & solid lesions.
8️⃣ Lymph Node: The Sydney System (2020)
➡️ Improves consistency in FNAC reports for suspected lymphoma or metastasis.
9️⃣ (And in the practice of Clinical Pathology) Urinary Tract: The Paris System (2022)
➡️ Which is mainly focused on detecting High-Grade Urothelial Carcinoma (HGUC) & reduces over-calling.
💡Why it matters:
These systems ensure that when you read “AUS,” “SUSPICIOUS,” or “MALIGNANT,” you can interpret it consistently, regardless of who signed out the case.
🧠 Keep this list handy for clinical discussions, CME sessions, or teaching rounds!
📩 For any pathology-related queries or if you’d like access to reference books or resources, feel free to email me. (theddo04@gmail.com)
Dr Tewodros Wubshet Desta, Assistant professor
Dire Dawa University, Department of Pathology
Dire Dawa
Telegram: t.me/HakimEthio
