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Revision as of 14:25, 6 May 2016

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→‎Anal intraepithelial neoplasia
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==Anal intraepithelial neoplasia==
==Anal intraepithelial neoplasia==
*Abbreviated ''AIN''.
*Abbreviated ''AIN''.
===General===
{{Main|Anal intraepithelial lesions}}
*Precursor lesion of anal [[squamous cell carcinoma]].
*Usually [[HPV]] associated.
**May be prevented by HPV vaccine.


===Microscopic===
Note:
DDx:
*The terminology changing to match the one now widely used for the [[uterine cervix]].
*[[Anal squamous cell carcinoma]].
 
====Grading====
AIN is graded much like [[cervix|cervical intraepithelial neoplasia]]:
*High-grade anal intraepithelial neoplasia (HGAIN).
*Low-grade anal intraepithelial neoplasia (LGAIN).
 
===Sign out===
<pre>
ANAL CANAL, RIGHT UPPER QUADRANT, BIOPSY:
- LOW-GRADE SQUAMOUS INTRAEPITHELIAL LESION (CONDYLOMA ACUMINATUM-LIKE).
</pre>
 
<pre>
ANAL CANAL, LEFT UPPER QUADRANT, BIOPSY:
- LOW-GRADE SQUAMOUS INTRAEPITHELIAL LESION.
- RECTAL MUCOSA WITHIN NORMAL LIMITS.
</pre>
 
<pre>
SKIN LESION, PERIANAL, BIOPSY:
- ANAL INTRAEPITHELIAL NEOPLASIA 3 (SEVERE DYSPLASIA), WARTY-TYPE.
- MARGIN POSITIVE FOR ANAL INTRAEPITHELIAL NEOPLASIA 3.
</pre>
 
====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).


=Anal cancer=
=Anal cancer=
Michael
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