A brief review of the WHO reporting system for lung cytopathology

Sule Canberk, Andrew Field, Lukas Bubendorf, Ashish Chandra, Ian A. Cree, Marianne Engels, Kenzo Hiroshima, Deepali Jain, Ivana Kholová, Lester Layfield, Ravi Mehrotra, Claire Michael, Robert Osamura, Martha B. Pitman, Sinchita Roy-Chowdhuri, Yukitoshi Satoh, Paul VanderLaan, Maureen Zakowski, Fernando C. Schmitt

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The International Academy of Cytology has joined with the International Agency for Research on Cancer to bring together a group of experts in lung cytopathology to develop a WHO Reporting System for Lung Cytopathology (WHO System). This System aims to improve and standardize the reporting of cytopathology, facilitate communication between cytopathologists and clinicians, and improve patient care. The WHO System describes 5 categories for reporting lung cytopathology: ‘Insufficient/Inadequate/Nondiagnostic’, ‘Benign’, ‘Atypical’, ‘Suspicious for malignancy’, and ‘Malignant’, each one with a clear descriptive term, a definition, a risk of malignancy, and a suggested management algorithm. The key diagnostic cytopathologic features of each of the lesions within each category have been established by consensus through an Expert Editorial Board, who are also the authors of this review and selected for each reporting system and chosen based on their expertise in the field and/or diversity of geographical representation. Many other co-authors from around the world also contributed. The assignment of writing and editing responsibilities used the same model as that used for the WHO Classification of Tumours (https://whobluebooks.iarc.fr/about/faq/). The WHO System provides the best practice application of ancillary testing, including immunocytochemistry and molecular pathology, and guides in sampling and processing techniques to optimize the handling and preparation of specimens. The WHO System was created by the authors to be applicable globally and is based on cytomorphology with possibilities for additional diagnostic management of the patient. The authors are aware that local medical and pathology resources would differ, especially in low- and middle-income countries. The WHO Tumour Classification for Thoracic Tumors, Fifth Edition, is directly accessible through the online WHO System.

Original languageEnglish
Pages (from-to)251-257
Number of pages7
JournalJournal of the American Society of Cytopathology
Issue number4
Publication statusPublished - Jul 2023
Publication typeA2 Review article in a scientific journal


  • IAC
  • IARC
  • Lung cytology
  • lung FNAB
  • Nomenclature
  • WHO reporting systems for cytopathology

Publication forum classification

  • Publication forum level 1

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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