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

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Squamous dysplasia of the head and neck (view source)

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*[[Benign leukoplakia]].
*[[Benign leukoplakia]].
*[[Head and neck squamous cell carcinoma]].
*[[Head and neck squamous cell carcinoma]].
===Grading===
*Numerous grading systems exist.<ref name=pmid24595419>{{Cite journal  | last1 = Gale | first1 = N. | last2 = Zidar | first2 = N. | last3 = Poljak | first3 = M. | last4 = Cardesa | first4 = A. | title = Current views and perspectives on classification of squamous intraepithelial lesions of the head and neck. | journal = Head Neck Pathol | volume = 8 | issue = 1 | pages = 16-23 | month = Mar | year = 2014 | doi = 10.1007/s12105-014-0530-z | PMID = 24595419 }}</ref>
====WHO system====
The 2005 "blue book" system - as summarized by Gale ''et al.'':<ref name=pmid24595419/>
*Mild dysplasia.
*Moderate dysplasia.
*Severe dysplasia.
*Carcinoma in situ.
====Ljubljana system====
As per ''Gale et al.'':<ref name=pmid24689850>{{Cite journal  | last1 = Gale | first1 = N. | last2 = Blagus | first2 = R. | last3 = El-Mofty | first3 = SK. | last4 = Helliwell | first4 = T. | last5 = Prasad | first5 = ML. | last6 = Sandison | first6 = A. | last7 = Volavšek | first7 = M. | last8 = Wenig | first8 = BM. | last9 = Zidar | first9 = N. | title = Evaluation of a new grading system for laryngeal squamous intraepithelial lesions-a proposed unified classification. | journal = Histopathology | volume = 65 | issue = 4 | pages = 456-64 | month = Oct | year = 2014 | doi = 10.1111/his.12427 | PMID = 24689850 }}</ref>
*Low-grade SIL.
*High-grade SIL.
*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.


===Images===
===Images===
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[[Category:Diagnosis]]
[[Category:Diagnosis]]
[[Category:Head and neck pathology]]
[[Category:Head and neck pathology]]
==External links==
*[https://wiki.uiowa.edu/display/protocols/Moderate+squamous+dysplasia+causing+laryngeal+leukoplakia Squamous dysplasia (wiki.uiowa.edu)].
Michael
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