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Gynecologic Pathology and Cytopathology

• Editor's Note
• List of Articles

List of Articles

• The Bethesda System - An Overview
  By the 1980s, DNA determination by flow cytometry and cell image analysis began to enhance the diagnostic accuracy of cytopathology. The first Bethesda Conference met on December 12-13, 1988 in Maryland (USA) at the National Institutes of Health (NIH) to consider methods of reporting gynecologic cytology in meaningful diagnostic terminology. Between 1988 and 1991, The Bethesda System (TBS) nomenclature materialized on cytology reports in the United State, Europe, Asia and Latin America. Today both exfoliative and aspiration biopsy cytology have gained widespread acceptance. The TBS format and their appropriate usage are the main focus of this document. Specimen adequacy and the terminology and its clarification are discussed in detail.
  
  
• Human Papillomavirus (HPV) And Testing
  The early successes in cervical cancer screening were based on the development of morphologic criteria for recognizing cells shed from cervical cancer and its precursors. However, our ability to manage cervical diseases more effectively has been limited by an incomplete understanding of the pathogenesis and biology of cervical neoplasia. Recognition that human papillomavirus (HPV) causes most cervical neoplasia suggests that improved screening and management strategies that reflect the biology and behavior of HPV infections may be possible. The purpose of this document is to review the structure and biology of HPVs and summarize the clinical applications of HPV testing and areas of ongoing research will be discussed.
  
  
• Pathology Of Breast Cancer
  Understanding the histopathologic features of breast cancer has been recognized as a necessary element for appropriate management of breast carcinoma. There have been two general approaches to prognostication via histopathologic analysis. The first categorizes carcinomas based on specific features, recognizing the so-called special-type carcinomas. The second approach evaluates individual characteristics of the carcinoma, such as nuclear pleomorphism or gland formation (grading). The purpose of this document is to review the histopathology of invasive breast carcinoma, emphasizing the proven and potential settings in which it provides prognostic information. In-situ carcinomas of the breast were first recognized in the early 20th century and were identified morphologically as cells cytologically similar to those of invasive carcinomas but confined to duct structures. Short- and long-term risks associated with specific histologic variants or types of in-situ carcinomas are also discussed in this chapter.
  
  
• Pathologic Features of Uterine Cancer
  The purpose of this document is to enhance the understanding of endometrial hyperplasia and endometrial neoplasia (cancer). Most commonly, the prolonged unremitting estrogen stimulation results in endometrial hyperplasia. All gradations of this phenomenon occur, ranging from one distinguished only with difficulty from a normal exuberant proliferative endometrium (so-called disordered proliferative endometrium) to an atypical one that approaches the appearance of adenocarcinoma.
  
  

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