Terminology for vulvar cytology based on the Bethesda System

To present a new terminology for vulvar cytology based on the Bethesda System.

Material for cytologic diagnosis was collected by scraping vulvar lesions with a scalpel blade.

This terminology was presented for the first time at an International Academy of Cytology conference in Kamuela, Hawaii, in 1997. It is based on the Bethesda System (1994) and WHO system. We recommend the following elements for a vulvar cytologic report: adequacy of specimen, general categorization and descriptive diagnosis. The terminology of vulvar lesions includes benign cellular changes (vulvitis and reactive changes) and epithelial cell abnormalities. If epithelial cell abmormalities are found, the following diagnoses are made: atypical squamous cells of undetermined significance, LSIL, HSIL and vulvar tumors. The most common epithelial tumors are papillary hydradenoma, squamous cell carcinoma and Paget's disease. Five hundred and sixty-three patients with vulvar cytology were examined in our department over 11 years, including 132 with normal vulvas, 220 with vulvitis, 145 with VSIL and 56 with squamous cell carcinoma. Histologic examination of 147 patients (26.11%) showed a sensitivity of 97.70% for benignity and 98.21% for malignancy and 98.87% and 94.82% for specificity, respectively.

Vulvar cytodiagnosis with the new terminology allows both reporting on the type of vulvar lesions and cancer detection.