[The Papanicolaou classification in the Bethesda system (National Cancer Institute, Bethesda, Maryland)].

In December of 1988, the National Cancer Institute in Bethesda, Maryland (USA), held a workshop that produced published guidelines for reporting the results of cervical and vaginal cytology. A second workshop was held in April 1991 to discuss the initial proposal and suggest modifications. The final recommendations are the following: the Papanicolaou classification for reporting consultation is not acceptable in the modern practice of diagnostic cytopathology (because it does not reflect current understanding of cervical/vaginal neoplasia--has no equivalent in diagnostic histopathologic terminology--does not provide diagnoses for non-cancerous entities and, as a result of numerous modifications, the specific Papanicolaou classes no longer reflect diagnostic interpretations uniformly). The cytologic report is a medical consultation in the same manner as is the histomorphologic report. Clinical information is absolutely essential for making the diagnosis. (A cytopathologic diagnosis should be an interpretation of morphologic findings, but this interpretation is best made in the context of the patient's clinical situation). The cytopathologist should determine whether the specimen is adequate for diagnostic evaluation. If unsatisfactory or satisfactory for evaluation but limited by ..., this should be noted in the report. The use of precise diagnostic terms to facilitate unambiguous communication between cytopathologist and clinician. The terminology for squamous epithelial lesions includes: 1) Atypical squamous cells of undetermined significance. 2) Squamous intraepithelial lesion (SIL), which encompass the spectrum of squamous cell carcinoma precursors, divided into low-grade SL (HPV-associated cellular changes, mild dysplasia and CIN1) and high-grade SIL (moderate dysplasia, severe dysplasia and carcinoma in situ and CIN2 and CIN3).(ABSTRACT TRUNCATED AT 250 WORDS)