Terminology in cervical cytology

This article provides an illustrated personal view of the British Society for Clinical Cytology's (BSCC) proposal to modify their terminology for reporting cervical cytology. The BSCC did not propose any major changes but moved closer to the two-tier Bethesda system for reporting pre-cancerous changes as high-grade and low-grade. Certain principles of reporting cytology that were intended in the original BSCC terminology are reinforced and difficult areas of borderline nuclear change are clarified. Revisiting the old terminology has drawn attention to errors and omissions in existing descriptions of dyskaryosis; this term is still used although its definition has been refined. This article will describe and illustrate different manifestations of dyskaryosis, with emphasis on its recognition as such, and its distinction from a wide variety of reactive changes. The illustrations draw widely on one of the author's (LT's) extensive experience with both types of liquid-based cytology preparations, which will now be the predominant methods of cell preparation in the UK.