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Difference between revisions of "Low-grade squamous intraepithelial lesion"
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Low-grade squamous intraepithelial lesion (view source)
Revision as of 19:53, 30 January 2014
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*Both p16 and Ki-67 are usually negative in CIN I -- 75% of cases.<ref name=pmid22104735>{{Cite journal | last1 = Jackson | first1 = JA. | last2 = Kapur | first2 = U. | last3 = Erşahin | first3 = Ç. | title = Utility of p16, Ki-67, and HPV test in diagnosis of cervical intraepithelial neoplasia and atrophy in women older than 50 years with 3- to 7-year follow-up. | journal = Int J Surg Pathol | volume = 20 | issue = 2 | pages = 146-53 | month = Apr | year = 2012 | doi = 10.1177/1066896911427703 | PMID = 22104735 }}</ref> | *Both p16 and Ki-67 are usually negative in CIN I -- 75% of cases.<ref name=pmid22104735>{{Cite journal | last1 = Jackson | first1 = JA. | last2 = Kapur | first2 = U. | last3 = Erşahin | first3 = Ç. | title = Utility of p16, Ki-67, and HPV test in diagnosis of cervical intraepithelial neoplasia and atrophy in women older than 50 years with 3- to 7-year follow-up. | journal = Int J Surg Pathol | volume = 20 | issue = 2 | pages = 146-53 | month = Apr | year = 2012 | doi = 10.1177/1066896911427703 | PMID = 22104735 }}</ref> | ||
**CIN I with p16 staining appears to have a higher risk of progression the p16 negative CIN I.<ref name=pmid19683687>{{Cite journal | last1 = del Pino | first1 = M. | last2 = Garcia | first2 = S. | last3 = Fusté | first3 = V. | last4 = Alonso | first4 = I. | last5 = Fusté | first5 = P. | last6 = Torné | first6 = A. | last7 = Ordi | first7 = J. | title = Value of p16(INK4a) as a marker of progression/regression in cervical intraepithelial neoplasia grade 1. | journal = Am J Obstet Gynecol | volume = 201 | issue = 5 | pages = 488.e1-7 | month = Nov | year = 2009 | doi = 10.1016/j.ajog.2009.05.046 | PMID = 19683687 }}</ref> | **CIN I with p16 staining appears to have a higher risk of progression the p16 negative CIN I.<ref name=pmid19683687>{{Cite journal | last1 = del Pino | first1 = M. | last2 = Garcia | first2 = S. | last3 = Fusté | first3 = V. | last4 = Alonso | first4 = I. | last5 = Fusté | first5 = P. | last6 = Torné | first6 = A. | last7 = Ordi | first7 = J. | title = Value of p16(INK4a) as a marker of progression/regression in cervical intraepithelial neoplasia grade 1. | journal = Am J Obstet Gynecol | volume = 201 | issue = 5 | pages = 488.e1-7 | month = Nov | year = 2009 | doi = 10.1016/j.ajog.2009.05.046 | PMID = 19683687 }}</ref> | ||
==Sign-out== | |||
===ECC - cannot grade=== | |||
<pre> | |||
UTERINE CERVIX, BIOPSY: | |||
- FRAGEMENTS OF SQUAMOUS EPITHELIUM SHOWING DYSPLASIA, SEE COMMENT. | |||
COMMENT: | |||
The fragments of squamous epithelium do not show full epithelial | |||
thickness. Thus, while dysplasia is apparent, it is not possible | |||
to distinguish low-grade from high-grade in this specimen. That said, | |||
there is at least low grade-dysplasia. Follow-up is recommended with | |||
re-biopsy if clinically indicated. | |||
</pre> | |||
===Cervical biopsy=== | |||
<pre> | |||
UTERINE CERVIX, BIOPSY: | |||
- LOW-GRADE SQUAMOUS INTRAEPITHELIAL LESION (LSIL). | |||
- NO ENDOCERVICAL EPITHELIUM IDENTIFIED. | |||
</pre> | |||
<pre> | |||
UTERINE CERVIX, BIOPSY: | |||
- LOW-GRADE SQUAMOUS INTRAEPITHELIAL LESION (LSIL). | |||
- TRANSFORMATION ZONE PRESENT. | |||
</pre> | |||
<pre> | |||
UTERINE CERVIX, BIOPSY: | |||
- LOW-GRADE SQUAMOUS INTRAEPITHELIAL LESION (LSIL). | |||
- CERVICITIS, CHRONIC. | |||
- NO ENDOCERVICAL EPITHELIUM IDENTIFIED. | |||
</pre> | |||
<pre> | |||
UTERINE CERVIX, BIOPSY: | |||
- LOW-GRADE SQUAMOUS INTRAEPITHELIAL LESION (LSIL). | |||
- TRANSFORMATION ZONE PRESENT. | |||
COMMENT: | |||
A p16 stain is patchy and confined mostly to the lower aspect of the squamous epithelium. | |||
</pre> | |||
====CIN 1==== | |||
<pre> | |||
UTERINE CERVIX, BIOPSY: | |||
- CERVICAL INTRAEPITHELIAL NEOPLASIA 1 (MILD DYSPLASIA). | |||
- TRANSFORMATION ZONE PRESENT. | |||
</pre> | |||
<pre> | |||
COMMENT: | |||
The Ki-67 positive cells are confined to the lower aspect of the squamous epithelium. | |||
A p16 stain is negative. | |||
</pre> | |||
===Micro=== | |||
The sections show the transformation zone. The squamous epithelium has cells with an increased nuclear size, nuclear hyperchromasia, perinuclear clearing and irregularities in the nuclear membrane. The nucleus-to-cytoplasm ratio is mildly increased. Occasional binucleation is identified. Mitoses are seen in the low third of the epithelium. Nucleoli are not apparent. No columnar dysplasia is identified. | |||
==See also== | ==See also== | ||