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Difference between revisions of "Anal intraepithelial neoplasia"
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Anal intraepithelial neoplasia (view source)
Revision as of 02:24, 16 June 2016
, 02:24, 16 June 2016→Microscopic
(Michael moved page Anal intraepithelial neoplasia to Anal intraepithelial lesions: going to LSIL/HSIL terminology) |
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The article deals with '''anal intraepithelial neoplasia''', abbreviated '''AIN'''. | |||
AIN is now usually classified as either low grade or high grade, as in the uterine cervix.<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> AIN is considered to be the precursor of [[anal squamous cell carcinoma]]. | |||
''Anal intraepithelial lesions'' and ''anal intraepithelial lesion'' redirect here. | |||
==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: | |||
*[[Immature squamous metaplasia of the rectum]]. | |||
*[[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><ref name=pmid26688291>{{Cite journal | last1 = Burgos | first1 = J. | last2 = Curran | first2 = A. | last3 = Landolfi | first3 = S. | last4 = Navarro | first4 = J. | last5 = Tallada | first5 = N. | last6 = Guelar | first6 = A. | last7 = Crespo | first7 = M. | last8 = Ocaña | first8 = I. | last9 = Ribera | first9 = E. | title = The effectiveness of electrocautery ablation for the treatment of high-grade anal intraepithelial neoplasia in HIV-infected men who have sex with men. | journal = HIV Med | volume = | issue = | pages = | month = Dec | year = 2015 | doi = 10.1111/hiv.12352 | PMID = 26688291 }}</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]]. | |||