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Difference between revisions of "Uterine cervix"
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→Cervical intraepithelial neoplasia: re-work
m (→IHC) |
(→Cervical intraepithelial neoplasia: re-work) |
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===Microscopic=== | ===Microscopic=== | ||
Features: | ====CIN I==== | ||
* | Features - CIN I:<ref name=Ref_PBoD1075-6>{{Ref PBoD|1075-6}}</ref> | ||
*Cytoplasmic halos (koilocytic atypia). | |||
*Nuclear enlargement -- >=3:1 enlarged nucleus:normal nucleus. | |||
*CIN II = | *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> | ||
*Atypical cells usually close to basement membrane. | |||
**May be seen, focally, in the upper layers.<ref name=Ref_GP146>{{Ref GP|146}}</ref> | |||
====CIN II==== | |||
Features - CIN II:<ref name=Ref_PBoD1075-6>{{Ref PBoD|1075-6}}</ref> | |||
*Increased nuclear-cytoplasmic ratio, loss of polarity, incr. mitoses, hyperchromasia. | |||
**If there are large nuclei... you should seen 'em on low power, i.e. 25x. | **If there are large nuclei... you should seen 'em on low power, i.e. 25x. | ||
====CIN III==== | |||
Features - CIN III:<ref name=Ref_PBoD1075-6>{{Ref PBoD|1075-6}}</ref> | |||
*Same changes as in CIN II + outer third (or full thickness). | |||
Notes: | Notes: | ||
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#Some mild changes at the squamo-columnar junction are expected. | #Some mild changes at the squamo-columnar junction are expected. | ||
#Look for the location of mitoses... | #Look for the location of mitoses... | ||
#* If there is a mitosis in the inner third (of the epithelial layer) = | #* If there is a mitosis in the inner third (of the epithelial layer) = think CIN I. | ||
#* If there is a mitosis in the middle third (of the epithelial layer) = | #* If there is a mitosis in the middle third (of the epithelial layer) = think CIN II. | ||
#* If there is a mitosis in the outer third = CIN III. | #* If there is a mitosis in the outer third = think CIN III. | ||
# | #Prominent [[nucleoli]] are ''not'' present in CIN.<ref name=Ref_GP146>{{Ref GP|146}}</ref> | ||
#*Nucleoli are common in reactive changes.<ref>STC. January 2009.</ref> | #*Nucleoli are common in reactive changes.<ref>STC. January 2009.</ref> | ||
#The most probably place for CIN is the posterior cervix (6 o'clock position) - risk is marginally increased.<ref name=pmid16378031>{{Cite journal | last1 = Pretorius | first1 = RG. | last2 = Zhang | first2 = X. | last3 = Belinson | first3 = JL. | last4 = Zhang | first4 = WH. | last5 = Ren | first5 = SD. | last6 = Bao | first6 = YP. | last7 = Qiao | first7 = YL. | title = Distribution of cervical intraepithelial neoplasia 2, 3 and cancer on the uterine cervix. | journal = J Low Genit Tract Dis | volume = 10 | issue = 1 | pages = 45-50 | month = Jan | year = 2006 | doi = | PMID = 16378031 }} | #The most probably place for CIN is the posterior cervix (6 o'clock position) - risk is marginally increased.<ref name=pmid16378031>{{Cite journal | last1 = Pretorius | first1 = RG. | last2 = Zhang | first2 = X. | last3 = Belinson | first3 = JL. | last4 = Zhang | first4 = WH. | last5 = Ren | first5 = SD. | last6 = Bao | first6 = YP. | last7 = Qiao | first7 = YL. | title = Distribution of cervical intraepithelial neoplasia 2, 3 and cancer on the uterine cervix. | journal = J Low Genit Tract Dis | volume = 10 | issue = 1 | pages = 45-50 | month = Jan | year = 2006 | doi = | PMID = 16378031 }} | ||