Difference between revisions of "Anal intraepithelial lesions"

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The article deals with '''anal intraepithelial lesions''', abbreviated '''AILs'''. They are now classified as either low grade or high grade, as in the uterine cervix.
#redirect [[Anal intraepithelial neoplasia]]
 
'''Anal intraepithelial neoplasia''', abbreviated '''AIN''', is an older term that is still used.<ref name=pmid26274593>{{Cite journal  | last1 = Dietrich | first1 = A. | last2 = Hermans | first2 = C. | last3 = Heppt | first3 = MV. | last4 = Ruzicka | first4 = T. | last5 = Schauber | first5 = J. | last6 = Reinholz | first6 = M. | title = Human papillomavirus status, anal cytology and histopathological outcome in HIV-positive patients. | journal = J Eur Acad Dermatol Venereol | volume = 29 | issue = 10 | pages = 2011-8 | month = Oct | year = 2015 | doi = 10.1111/jdv.13205 | PMID = 26274593 }}</ref>
 
Regardless of the name, they are considered to be the precursor of [[anal squamous cell carcinoma]].
 
==General==
*Precursor lesion of [[anal squamous cell carcinoma]].
*Usually [[HPV]] associated.
**May be prevented by HPV vaccine.
**Strong association with [[HIV]] infection.<ref name=pmid26274593/>
 
==Microscopic==
DDx:
*[[Anal squamous cell carcinoma]].
 
===Grading===
AIN is graded much like [[cervix|cervical intraepithelial neoplasia]]:<ref name=pmid25938361>{{Cite journal  | last1 = Roberts | first1 = JM. | last2 = Jin | first2 = F. | last3 = Thurloe | first3 = JK. | last4 = Biro | first4 = C. | last5 = Poynten | first5 = IM. | last6 = Tabrizi | first6 = SN. | last7 = Fairley | first7 = CK. | last8 = Templeton | first8 = DJ. | last9 = Carr | first9 = AD. | title = High reproducibility of histological diagnosis of human papillomavirus-related intraepithelial lesions of the anal canal. | journal = Pathology | volume = 47 | issue = 4 | pages = 308-13 | month = Jun | year = 2015 | doi = 10.1097/PAT.0000000000000246 | PMID = 25938361 }}</ref>
*High-grade anal intraepithelial neoplasia (HGAIN).
*Low-grade anal intraepithelial neoplasia (LGAIN).
 
==Sign out==
<pre>
Anus (Submitted as "Anal Intraepithelial Neoplasia"), Biopsy:
- HIGH GRADE SQUAMOUS INTRAEPITHIAL LESION (HSIL) of the anus.
- Benign colorectal type mucosa.
 
Comment:
The HSIL is in keeping with AIN 3.
</pre>
 
===Block letters===
<pre>
ANAL CANAL, RIGHT UPPER QUADRANT, BIOPSY:
- LOW-GRADE SQUAMOUS INTRAEPITHELIAL LESION (CONDYLOMA ACUMINATUM-LIKE).
</pre>
 
<pre>
ANAL CANAL, LEFT UPPER QUADRANT, BIOPSY:
- LOW-GRADE SQUAMOUS INTRAEPITHELIAL LESION.
- RECTAL MUCOSA WITHIN NORMAL LIMITS.
</pre>
 
<pre>
SKIN LESION, PERIANAL, BIOPSY:
- ANAL INTRAEPITHELIAL NEOPLASIA 3 (SEVERE DYSPLASIA), WARTY-TYPE.
- MARGIN POSITIVE FOR ANAL INTRAEPITHELIAL NEOPLASIA 3.
</pre>
 
===Micro===
There is dysplastic squamous epithelium with coarse chromatin, nuclear hyperchromasia,
nuclear enlargement, irregular nuclear membranes, and an increase nuclear-to-cytoplasmic
ratio.  Mitotic activity is abundant. Several atypical mitoses are identified.
 
The dysplastic squamous epithelium shows minimal maturation toward the surface (AIN 3). A
sizable portion of the lesion show some maturation to the surface (AIN 2).
 
Inflammation at the dermal-epidermal interface is minimal and the dermal-epidermal
interface is well-demarcated.  Focal ulceration is present.
 
The margin of the biopsy has severely dysplastic epithelium (AIN 3).
 
==See also==
*[[Anus]].
*[[LSIL]].
*[[HSIL]].
 
==References==
{{Reflist|1}}
 
[[Category:Diagnosis]]
[[Category:Anus]].

Latest revision as of 14:49, 6 May 2016

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