One Procedure-One Reporting System: Rationale for Standardization in Small Biopsy Reporting Based on Cytology Systems

Minimally invasive diagnostic procedures increasingly yield multiple concurrent specimens, including fine-needle aspiration (FNA) and core needle biopsy (CNB), often obtained during the same clinical encounter. While cytopathology has successfully implemented standardized, risk-stratified reporting systems across multiple organ systems, the reporting of small biopsies remains largely descriptive and non-uniform. This discrepancy creates a critical gap in diagnostic communication, with potential implications for clinical decision-making and patient outcomes.

This review synthesizes current evidence and conceptual frameworks addressing the role of standardized reporting in pathology, drawing on the established success of cytology systems. It examines the historical evolution of cytopathology standardization, the diagnostic and communicative limitations of non-standardized small biopsy reporting and the emerging need for integrated reporting models.

Particular emphasis is placed on the concept of 'one procedure-one reporting system', which proposes a unified diagnostic report incorporating all specimens obtained during a single procedure. The review further explores the challenges associated with translating cytology-based frameworks to histologic specimens, including differences in tissue architecture, risk of malignancy calibration and workflow integration. Despite these challenges, growing evidence supports the feasibility and clinical value of structured, integrated reporting approaches.

Standardization in pathology reporting is not merely a technical refinement but a fundamental requirement for effective communication in modern medicine. The integration of cytology-derived structured systems into small biopsy reporting represents a critical step towards improving diagnostic clarity, enhancing interdisciplinary communication and ultimately optimizing patient care.