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Low-grade squamous intraepithelial lesion (view source)
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'''Low-grade squamous intraepithelial lesion''', abbreviated '''LSIL''', is a pre-cancerous lesions of the [[uterine cervix]]. | |||
Increasingly, the term is being applied to other anatomical sites, e.g. [[vagina]]. | |||
It is in the larger category of '''[[squamous intraepithelial lesion]]''', abbreviated '''SIL'''. | |||
==General== | |||
*Precursor lesion of [[cervical squamous cell carcinoma]]. | |||
*Usually associated with [[human papilloma virus]]. | |||
SIL is divided into grades: | |||
*Low-grade. | |||
*High-grade. | |||
===The new and old terminology=== | |||
{| class="wikitable sortable" | |||
! SIL (current terminology) | |||
! LSIL | |||
! HSIL | |||
|- | |||
| Recent terminology | |||
| CIN I | |||
| CIN II, CIN III | |||
|- | |||
| Very old terminology | |||
| mild dysplasia | |||
| moderate dysplasia, severe dysplasia | |||
|- | |||
|} | |||
===Treatment=== | |||
Overview: | |||
*[[LSIL]]: follow-up unless persistent. It usually regresses on its own. | |||
==Microscopic== | |||
Features:<ref name=Ref_PBoD1075-6>{{Ref PBoD|1075-6}}</ref> | |||
*"Koilocytic atypia":<ref name=Ref_GP146>{{Ref GP|146}}</ref> | |||
**Cytoplasmic halos. | |||
**Nuclear enlargement >=3:1 enlarged nucleus:normal nucleus. | |||
**Nuclear membrane irregularities. | |||
**Nuclear hyperchromasia. | |||
**Coarse chromatin. | |||
**Binucleation may be seen (cytopathic effect of [[HPV]]).<ref name=pmid11491378>{{cite journal |author=Roteli-Martins CM, Derchain SF, Martinez EZ, Siqueira SA, Alves VA, Syrjänen KJ |title=Morphological diagnosis of HPV lesions and cervical intraepithelial neoplasia (CIN) is highly reproducible |journal=Clin Exp Obstet Gynecol |volume=28 |issue=2 |pages=78–80 |year=2001 |pmid=11491378 |doi= |url=}}</ref> | |||
Note: | |||
*Atypical cells usually close to basement membrane. | |||
**May be seen, focally, in the upper layers.<ref name=Ref_GP146>{{Ref GP|146}}</ref> | |||
DDx: | |||
*[[High-grade squamous intraepithelial lesion]]. | |||
*[[Uterine cervix with reactive changes]]. | |||
==See also== | |||
*[[Squamous intraepithelial lesion of the uterine cervix]]. | |||
*[[Uterine cervix]] | |||
*[[Gynecologic cytopathology]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Uterine cervix]] | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||