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Doody's Review ServiceReviewer: Ken C. Spengel, D.O.(University of Kansas Medical Center)
Description: This second edition reflects the 2001 Bethesda terminology for reporting cervical cytology. The material is presented in chapters named according to the Bethesda interpretative categories. This edition replaces the 1991 edition.
Purpose: The purpose is to establish criteria in cervical cytology which incorporates changes in the field of cervical carcinogenesis, new approaches in patient management, and new technology. It also reflects changes in criteria for diagnosing some entities such as atypical squamous cells of undetermined significance (ASCUS). It was determined that ASCUS reporting has exceeded the minimum target reporting frequency of 5 percent, prompting the new category of "Atypical squamous cells" (ASC) with a narrower definition and a simple dichotomous system of qualifiers. It also includes information on the utilization of molecular testing for human papillomavirus (HPV). The book succeeds in incorporating the changing ideas of cervical carcinogenesis and new technology into easily applicable criteria.
Audience: The book is written for cytopathologists, cytotechnologists, residents, and clinicians. All these groups would benefit from owning a copy. Dr. Solomon and Dr. Nayar are both authorities on the subject, having been appointed joint chairs of an American Society of Cytology-National Cancer Institute (ASC-NCI) task force responsible for publishing the Bethesda System 2001 Workshop conference proceedings.
Features: The new edition includes criteria for reporting cervical and endometrial cytology including non-neoplastic, infectious, and neoplastic changes. New features include chapters on anal/rectal cytology, ancillary testing, computer assisted interpretation, and individual chapter sections on liquid-based preparations (with images). The strengths of this edition are the additions and the more than 185 full color images. Each chapter also has a helpful section on reporting results with sample reports.
Assessment: This is a wonderful second edition and a must have for all cytopathologists, cytotechnologists, and pathology residents. The chapters on ancillary testing, computer-assisted interpretation, and anal/rectal cytology alone justify replacing the previous edition, not to mention twice the number of color images compared to the first edition. This second edition confirms that The Bethesda System (TBS) will continue to be the leading system for reporting cervical pathology findings.