Standardized categorical reporting of cytopathology results: the strengths and weaknesses of a constantly evolving and expanding system.

Since the success of the Bethesda nomenclature system in standardizing Pap smear results, there has been growing interest in adopting Bethesda-like standardized categorical formats in areas of nongynecologic cytopathology. Standardized categorical reporting may have several advantages over descriptive reporting, in enhancing cytopathologist-clinician communication and inter-institutional exchange of information, providing better guidance for treatment planning, and facilitating statistical analysis for research purposes or quality control studies. On the other hand, descriptive reporting may be more effective as a tool of communication between cytopathologists, may better express the uncertainty of the observer in diagnostically difficult and equivocal cases and may better serve the purposes of training and continuing education of cytopathologists. Future studies on the pros and cons of the different reporting systems used in cytopathology may provide further insight on these issues. The most problematic areas need to be identified and optimal solutions decided. Despite the ongoing debate on the optimal reporting format in cytopathology, there is general agreement on the need for high quality cytology reports (whether descriptive or standardized) in terms of their diagnostic accuracy, clarity and clinical value.