Anal intraepithelial neoplasia

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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.[1] AIN is considered to be the precursor of anal squamous cell carcinoma.

Anal intraepithelial lesions and anal intraepithelial lesion redirect here.

General

Microscopic

DDx:

Grading

AIN is graded much like cervical intraepithelial neoplasia:[2][3]

  • High-grade anal intraepithelial neoplasia (HGAIN).
  • Low-grade anal intraepithelial neoplasia (LGAIN).

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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.

Block letters

ANAL CANAL, RIGHT UPPER QUADRANT, BIOPSY:
- LOW-GRADE SQUAMOUS INTRAEPITHELIAL LESION (CONDYLOMA ACUMINATUM-LIKE).
ANAL CANAL, LEFT UPPER QUADRANT, BIOPSY:
- LOW-GRADE SQUAMOUS INTRAEPITHELIAL LESION.
- RECTAL MUCOSA WITHIN NORMAL LIMITS.
SKIN LESION, PERIANAL, BIOPSY: 
- ANAL INTRAEPITHELIAL NEOPLASIA 3 (SEVERE DYSPLASIA), WARTY-TYPE.
- MARGIN POSITIVE FOR ANAL INTRAEPITHELIAL NEOPLASIA 3.

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

References

  1. 1.0 1.1 Dietrich, A.; Hermans, C.; Heppt, MV.; Ruzicka, T.; Schauber, J.; Reinholz, M. (Oct 2015). "Human papillomavirus status, anal cytology and histopathological outcome in HIV-positive patients.". J Eur Acad Dermatol Venereol 29 (10): 2011-8. doi:10.1111/jdv.13205. PMID 26274593.
  2. Roberts, JM.; Jin, F.; Thurloe, JK.; Biro, C.; Poynten, IM.; Tabrizi, SN.; Fairley, CK.; Templeton, DJ. et al. (Jun 2015). "High reproducibility of histological diagnosis of human papillomavirus-related intraepithelial lesions of the anal canal.". Pathology 47 (4): 308-13. doi:10.1097/PAT.0000000000000246. PMID 25938361.
  3. Burgos, J.; Curran, A.; Landolfi, S.; Navarro, J.; Tallada, N.; Guelar, A.; Crespo, M.; Ocaña, I. et al. (Dec 2015). "The effectiveness of electrocautery ablation for the treatment of high-grade anal intraepithelial neoplasia in HIV-infected men who have sex with men.". HIV Med. doi:10.1111/hiv.12352. PMID 26688291.
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