Difference between revisions of "Squamous dysplasia of the head and neck"

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*High-grade SIL.
*High-grade SIL.
*Carcinoma in situ.
*Carcinoma in situ.
Low-grade squamous intraepithelial lesion:<ref name=pmid24689850/>
*Increased prickle cell layer.
*+/-Thickening of basal and/or parabasal cell layers.
*No significant [[nuclear atypia]].
*Rare mitotic figures.
*Dyskeratotic cells - rare.
*Must show maturation to surface.
High-grade squamous intraepithelial lesion:<ref name=pmid24689850/>
*Long axis perpendicular to basement membrane.
*Lower half or more abnormal.
*[[Nuclear pleomorphism]] present.
**Irregular nuclear contours.
**Hyperchromasia.
**Nucleoli increased in size and number.
*Increased [[NC ratio]].
*Mitotic activity in predominantly in the lower 2/3 of the epithelium.
*Dyskeratotic cell common.
Carcinoma in situ:<ref name=pmid24689850/>
*"Full thickness" loss of stratification.
**May have thin layer of compressed-appearing cells (3-5 cells thick) with their long axes parallel to the basement membrane.
*[[Nuclear pleomorphism]] present.
**Irregular nuclear contours.
**Hyperchromasia.
**Nucleoli increased in size and number.
*Increase mitotic activity.
**Atypical mitoses common.
*Dyskeratotic/apoptotic cells typically very common.
Negatives:
*Basement membrane intact.
**Smooth contour between epithelial layer and underlying stroma.
*No [[stromal desmoplastic response]].
Subtypes:
*Basal cell type.
**Non-eosinophilic cytoplasm.
**No apparent intercellular bridges (prickles).
**Long axis of cells perpendicular to the basement membrane.
**Typically non-keratinizing.
*Spinous cell type.
**Intercellular bridges (prickles) present.
**Eosinophilic cytoplasm.
**Typically keratinizing.


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