Difference between revisions of "Anal intraepithelial lesions"
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Revision as of 14:20, 6 May 2016
Anal intraepithelial neoplasia, abbreviated AIN, the precursor of anal squamous cell carcinoma.
General
- Precursor lesion of anal squamous cell carcinoma.
- Usually HPV associated.
- May be prevented by HPV vaccine.
Microscopic
DDx:
Grading
AIN is graded much like cervical intraepithelial neoplasia:[1]
- High-grade anal intraepithelial neoplasia (HGAIN).
- Low-grade anal intraepithelial neoplasia (LGAIN).
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ANAL CANAL, RIGHT UPPER QUADRANT, BIOPSY: - LOW-GRADE SQUAMOUS INTRAEPITHELIAL LESION (CONDYLOMA ACUMINATUM-LIKE).
ANAL CANAL, LEFT UPPER QUADRANT, BIOPSY: - LOW-GRADE SQUAMOUS INTRAEPITHELIAL LESION. - RECTAL MUCOSA WITHIN NORMAL LIMITS.
SKIN LESION, PERIANAL, BIOPSY: - ANAL INTRAEPITHELIAL NEOPLASIA 3 (SEVERE DYSPLASIA), WARTY-TYPE. - MARGIN POSITIVE FOR ANAL INTRAEPITHELIAL NEOPLASIA 3.
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
References
- ↑ Roberts, JM.; Jin, F.; Thurloe, JK.; Biro, C.; Poynten, IM.; Tabrizi, SN.; Fairley, CK.; Templeton, DJ. et al. (Jun 2015). "High reproducibility of histological diagnosis of human papillomavirus-related intraepithelial lesions of the anal canal.". Pathology 47 (4): 308-13. doi:10.1097/PAT.0000000000000246. PMID 25938361.
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