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THE CLASSIFICATION OF CYTOLOGIC FINDINGS OF CERVIX UTERI »ZAGREB 2002« The Modification of the »Zagreb 1990« and »NCI Bethesda System 2001« Classifications

Croatian Society of Gynaecology and Obstetrics, and Croatian Society of Perinatal Medicine of Croatian Medical Association
Publication Date
  • Citologija
  • Klasifikacija Citoloških Nalaza
  • Cytology
  • Modification Of Classification
  • Cervix Uteri
  • Medicine


»Zagreb 2002«, a new unique classification of cytologic findings of the cervix uteri in Croatia presents the modification of the »Zagreb 1990« and »NCI Bethesda system 2001« classifications. There are two categories, that are »adequate« and »inadequate«, applied for the assessment of specimen adequacy. The category of inadequate also includes specimen that have not been analysed as well as the ones that have been analysed but the abnormality assessment cannot be given for whatever the reason is, accompanied by the additional explanation. According to the general division, the findings are classified as »negative for intraepithelial or invasive lesion« (no irregularities, changes with reactive and reparative reactions, results indicating certain risk) and »abnormal cells« (cellular changes which morphologically are in compliance with intraepithelial or invasive malignant lesions). Descriptive diagnosis contains the following sections: »micro-organisms«, »other non-neoplastic findings« and »abnormal cells« (squamous, glandular, non-defined and other malignant lesions). Reactive cellular changes, reparative epithelium, reserve cells, parakeratosis, dyskeratosis, hyperkeratosis, glandular cells status post hysterectomy, endometrial cells finding out of the cycle or during the postmenopause, as well as the definition that cytohormonal status is not adequate to the age and/or anamnesis all pertain to the category of »other non-neoplastic findings«, that can be found with or without abnormal cells. Squamous lesions are divided into the three groups: »atypical squamous cells« (ASC), »squamous intraepithelial lesion« (SIL) and »carcinoma planocellulare«. The news is there are the three subgroups, those are »non defined« (ASC-US), »HSIL cannot be excluded« (ASC-H) and »invasion cannot be excluded« within the category of »atypical squamous cells«. There are still three current names applied for the category of squamous intraepithelial lesion (SIL). The only change concerns the supplement »initial invasion cannot be excluded« which refers to typical cytologic pictures of carcinoma in situ with several changes on cells and the base that indicate the possibility of the early stroma invasion. Glandular lesions are also divided into the three groups: »atypical glandular cells« (three subgroups: »favor reactive, favor intraepithelial and favor invasive), »adenocarcinoma in situ« (AIS) and »adenocarcinoma«, accompanied by the suggestion of origin. The »abnormal non-defined cells« group and »other malignant neoplasms« group refer to abnormalities where it is not/is possible to set a differential cytologic diagnosis.

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