Difference between revisions of "Low-grade squamous intraepithelial lesion"

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#redirect [[Gynecologic cytopathology#Low-grade squamous intraepithelial lesion]]
'''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]]

Revision as of 19:47, 30 January 2014

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

SIL is divided into grades:

  • Low-grade.
  • High-grade.

The new and old terminology

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:[1]

  • "Koilocytic atypia":[2]
    • 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).[3]

Note:

  • Atypical cells usually close to basement membrane.
    • May be seen, focally, in the upper layers.[2]

DDx:

See also

References

  1. ↑ Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. (2005). Robbins and Cotran pathologic basis of disease (7th ed.). St. Louis, Mo: Elsevier Saunders. pp. 1075-6. ISBN 0-7216-0187-1.
  2. ↑ 2.0 2.1 Nucci, Marisa R.; Oliva, Esther (2009). Gynecologic Pathology: A Volume in Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 146. ISBN 978-0443069208.
  3. ↑ Roteli-Martins CM, Derchain SF, Martinez EZ, Siqueira SA, Alves VA, Syrjänen KJ (2001). "Morphological diagnosis of HPV lesions and cervical intraepithelial neoplasia (CIN) is highly reproducible". Clin Exp Obstet Gynecol 28 (2): 78–80. PMID 11491378.
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